Hamovitch PI
Summer 2014
A research publication of the Hamovitch Center for Science in the Human Services at the USC School of Social Work
A new partnership emerges
Social work and engineering researchers join forces By Charli Engelhorn
A mutually beneficial relationship between the disciplines of social work and engineering is not necessarily an obvious combination. Researchers to explore possible unintended consequences of housing the homeless
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However, leaders from the USC School of Social Work and USC Viterbi School of Engineering believe collaboration between the two fields is a completely appropriate development. “There is an organic relationship between social work and several other disciplines in a historical holistic perspective,” said Haluk Soydan, associate dean
Study finds teens who identify as sexual minorities face a higher risk of binge drinking
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of research at the USC School of Social Work and director of the school’s Hamovitch Center for Science in the Human Services. “Engineering is about technical solutions and social work is about social solutions. When you come down to it, there are questions and areas of interest that make them close to each other.” PARTNERS | continued on page 10
Clinical professor interviews people older than 100 to discover the secrets of longevity
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Vol. 4, Issue 2 Summer 2014 From the Director
It cannot be emphasized enough how richly the current issue of Hamovitch PI reflects the multidimensional nature of the USC School of Social Work’s research enterprise. The school made history recently by hiring an engineer to join the ranks of its social work faculty. The marriage between social work and engineering is strategically designed to propel the pursuit of better and more efficient solutions to human and societal problems. We also report on some of our empirical studies on critical issues in social work, including the effect of housing on HIV risk among individuals experiencing homelessness and patterns of heavy drinking among gay and lesbian teens under stress. Big data, or large amounts of information characterized by many variables ranging from genetic to behavioral to social characteristics of very large populations, is one of the most exciting developments of modern research and holds the promise of improving lives and societies. California Gov. Jerry Brown honored one of our researchers for extraordinary efforts and contributions in this emerging field with the Commissioner’s Award from the Administration on Children, Youth and Families. Finally, we delve into the innovative research of a clinical professor at the USC School of Social Work who is seeking the secrets of long life in cultures around the world. Enjoy this summer issue of Hamovitch PI!
Haluk Soydan, PhD Director of the Hamovitch Center
Dean Marilyn Flynn Editor Eric Lindberg Staff Writer Charli Engelhorn
Hamovitch PI is a research newsletter published quarterly by the Hamovitch Center for Science in the Human Services at the USC School of Social Work. Send questions, comments, and reprint requests to elindber@usc.edu
Front page: Industrial engineer Shinyi Wu (second from right) discusses a project with executive director William Vega (right) and other researchers and staff members from the USC Roybal Institute on Aging. Photo/Eric Lindberg
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Newest faculty member brings fresh perspective to social work professionals, said William Vega, provost professor with the USC School of Social Work and executive director of the USC Roybal Institute on Aging. He said Wu and her engineering colleagues take a unique approach that differs from traditional public health and social work models. “They start with a conclusion and work backwards, thinking through the chain of steps that have to be taken in order to Despite being drawn to the social sci- arrive at that conclusion,” he said. “We ences and efforts to improve societal well- don’t think that kind of way. We’re kind of being, she possessed a strong desire to deterministic and start at the other end.” pursue a career in the natural sciences and Wu began developing that engineering engineering. At that time, those interests perspective during her childhood in a rural led down separate and mutually exclusive region of Taiwan. paths in academia. “I grew up in a very natural environment, Wu eventually settled on industrial engi- so we built a lot of things for our own fun,” neering, but she never lost her passion for she said. “I was trained to be very hands-on.” devising ways to improve the health and She also cared for her grandparents as they well-being of vulnerable individuals from a aged, giving her insight into the social sciwider perspective. ences realm in addition to problems in the “All along, I kept an eye toward social health care system. Wu saw opportunities sciences and how my to improve the efficiency engineering methodology of care while reducing could be applied to solve “All along, I kept an eye costs and improving social problems,” she said. patient satisfaction. toward social sciences Wu now has an oppor- and how my engineering As a doctoral stutunity to meld her two dent at the University methodology could be interests as the newest of Wisconsin–Madison, applied to solve social member of the USC which offered the only School of Social Work problems. Social work industrial engineering faculty. The associate program with a focus on is the engineering professor, who transiequivalent of the social health systems at that tioned from her previous time, Wu explored issues sciences. I think we can of chronic illness, aging, post at the USC Viterbi use many of the things School of Engineering and the rapid expansion earlier this year, said she we learn in engineering of aging populations. She is excited to tackle issues to address social issues.” later took a position at facing the U.S. health care RAND Corporation as system such as chronic Shinyi Wu the nonprofit institution’s illness, population aging, first engineer focused and the rising cost of care. solely on health. “Social work is the engineering equivalent In an effort to determine how emerging of the social sciences,” Wu said. “I think technology could facilitate better health, we can use many of the things we learn in Wu evaluated a model for providing care engineering to address social issues.” to individuals with chronic illnesses and Bringing a fresh perspective to developed a tool kit to help health care prothe social work profession is critical fessionals use best practices to addressing large-scale problems in chronic care. such as challenges facing health care Intrigued by the interplay
As a young scholar in Taiwan, Shinyi Wu felt like she was being pulled in opposite directions.
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Photo/Vincent Lim
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Shinyi Wu, an industrial engineer by training who recently joined the USC School of Social Work as an associate professor, is interested in applying an engineering perspective to major social issues such as chronic illness and other problems in the health care system.
between depression and longterm diseases such as diabetes, Wu partnered with Kathleen Ell, the Ernest P. Larson Professor of Health, Ethnicity, and Poverty at the USC School of Social Work, who led groundbreaking studies in the 1970s that linked depression to mortality among patients with heart disease. “Her extensive experience in clinical trials and clinical expertise in depression helped me realize my dream to carry out a large trial of system redesign,” Wu said. Seeking to improve how individuals with diabetes and depression manage their illness and make decisions about their health, the researchers developed technology to orchestrate
communication between providers and patients, assess patient needs in a more userfriendly and efficient way, and help health care professionals manage their patient caseloads. “It felt like a dream come true,” Wu said of the resulting model, which relies on an automated telephone and registry system to ensure patients are receiving treatment and follow-up care when it is most needed. “I feel like now we really have systematic solutions to chronic illness care.” She said initial study results have shown that patients are willing to embrace this new technological approach, are less likely to be depressed, are more likely to have regular diabetes checkups, and are
more satisfied with the care they receive. The system is also proving to be cost effective, Wu said, equating every dollar spent on the automated system to $35 in costs had health care professionals been required to perform that work manually. “Providers have had a noticeable difference in how they use their time,” she said. Instead of trying to figure out which patients need care, she said they are spending more energy and effort actually treating patients. As Wu settles into her new position, she plans to continue pursuing ways to improve health care processes, including expanding the model she developed with Ell to other issues such as cancer and palliative care.
She is also working closely with Vega on a major initiative to improve how county and city agencies in the Los Angeles region provide health and social services. Developing models to help policy makers make critical decisions at that level is difficult, Vega said, given the dynamic and fluctuating nature of large care systems. “This is going to be something that requires big-scale thinking,” he said. “If the work doesn’t ultimately go to changing policy that improves the health of communities, it isn’t worth doing. It’s a hard perspective to hold to, but someone like an engineer who has this kind of experience is exactly the kind of refined thinking we need.” t
Photo/Eric Lindberg
Members of the Homelessness, Housing, and Social Environment research cluster at the USC School of Social Work, led by Suzanne Wenzel, will examine how the transition from chronic homelessness to housing affects sexual risk behavior (clockwise from left, Wenzel, Eric Rice, Benjamin Henwood, Harmony Rhoades, and Hailey Winetrobe).
Study explores how housing affects HIV risk to risks like HIV,” said Suzanne Wenzel, that people were having more sex and were a professor at the USC School of Social having more unprotected sex,” Rhoades Work and principal investigator of a new said. “Romantic, sexual relationships are a four-year, $2.7 million project funded by huge part of people’s lives. Even though we the National Institute on Drug Abuse. want people to use condoms and we want The funding will enable Wenzel and sev- to reduce HIV risk behavior, we also want eral colleagues, including assistant profes- people to live really wonderful, fulfilling sors Benjamin Henwood and Eric Rice lives, and having a partnership that may be and research assistant professor Harmony represented by the sexual behavior we’re Rhoades, to examine how seeing is in some ways a moving to permanent positive sign.” housing affects HIV risk “It’s very clear that Surprised to find a and prevention behaviors, dearth of research on HIV housing works to end social networks, drug use, risk and the provision of homelessness, but and mental health sympHIV prevention services there’s nothing to say toms among chronically for people in permanent it addresses everyone’s supportive housing except Researchers have found that the stability homeless individuals in of having a place to call home may enable Los Angeles. problems or that it for individuals who had individuals to seek treatment for drug use Inspired by discussions won’t create some other already been diagnosed problems, develop stronger ties to posi- with housing providers in with HIV or AIDS, the problems.” tive sources of support such as friends and downtown Los Angeles research team devised family, and receive medical care for chronic that revealed issues related Benjamin Henwood a longitudinal study to health conditions. However, the shift to to retaining people in pertrack chronically homeless housing may result in unexpected and manent supportive housing, individuals as they transiunintended changes. Wenzel and Rhoades led a recent pilot study tioned to housing. “For all of the emphasis on improving to explore changes in risk behaviors and In addition to surveying residents at key health and health behaviors, including relationships among 25 individuals in the points during the course of one year, the substance use and mental health, there months after they entered housing. researchers plan to conduct interviews and has been surprisingly little attention paid “One of the primary things we saw was HOUSING | continued on page 9
Transitioning from a life on the streets to permanent supportive housing undoubtedly has benefits for individuals experiencing chronic homelessness.
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Researchers find lesbian and gay teens more likely to binge drink Adolescence is an innately tumultuous period during which teenagers begin to form unique identities and transition from childhood to adulthood. That transition can be particularly difficult for young girls and boys who identify as sexual minorities—lesbian, gay, or bisexual (LGB). They may experience stressors that place them at high risk of engaging in negative behaviors such as heavy alcohol use, an issue explored in a recent study by Jeremy Goldbach, an assistant professor with the USC School of Social Work. “We wanted to understand whether stress that is unique to being gay, like having homophobic experiences such as bullying, lack of family support, internalized feelings of shame and homophobia, and a lack of peer support networks, was associated with binge drinking,” he said. Goldbach worked alongside Sheree Schrager, director of research in the Division of Hospital Medicine at Children’s Hospital Los Angeles, and Ian Holloway, a former doctoral student in social work at USC and now an assistant professor with the Department of Social Welfare at UCLA. Using data from a national survey of more than 1,200 LGB adolescents between the ages of 12 and 17, the researchers examined links among sources of stress, psychological distress, and binge drinking. Results suggest that stress factors experienced by LGB youths, including internalized homophobia and victimization, are associated with patterns of heavy drinking. Goldbach also noted their level of outness, or the extent to which their sexual orientation is known to family members, friends, coworkers, and others, also influences their alcohol use. “It appears to be a complicated set of relationships,” he said. “Youths who were out to more people reported lower rates
avoiding exposure to bullying and potentially negative aspects of socialization in the gay community, including prevalent alcohol use. Goldbach said he observed a similar dynamic at play in a study led by USC doctoral student Jeremy Gibbs that involved LBG individuals living in households characterized as religious and antigay. “In this analysis, we found that if youths leave their antigay religion, they report less internalized homophobia, which indirectly reduces their suicide risk indirectly,” he said. “However, leaving their religion was also directly associated with an increase in suicide risk.” “As you are pushing forward, you are also experiencing this undertow that is pulling you back,” Goldbach said. Exploring issues such as alcohol use among sexual minority adolescents is critical, Goldbach said, because binge drinking can be an early indicator of future problems such as addiction, depression, anxiety, suicide risk, and use of other addictive substances. A recent analysis of 18 studies showed “Youths who were out to more that sexual minority youths are between two to five times more likely to use drugs people reported lower rates of and alcohol than heterosexual teens. They internalized homophobia, which are also more likely to start drinking at a was associated with less binge younger age, engage in heavy drinking, and drinking. We assume that this make risky decisions regarding sex that can means being more comfortable lead to HIV infection or pregnancy. However, national funding to examine internally about your sexual these issues has been scarce, Goldbach orientation also allows you to said, noting that less than half a percent of come out to more people. At the all funding from the National Institutes same time, however, higher levels of Health is dedicated to research on of outness were directly related to sexual minorities. “Within that half a percent, only 18 perhigher binge drinking.” cent went to anything outside of HIV risk Jeremy Goldbach among young men,” he said. “Looking at adolescence, a critical identity formation period, is important. What happens when of internalized homophobia, which was you are 14, 15, or 16 has the potential to associated with less binge drinking. We really change your entire life trajectory.” assume that this means being more comGoldbach and his colleagues received supfortable internally about your sexual orien- port from the James H. Zumberge Research tation also allows you to come out to more and Innovation Fund at USC to pursue this people. At the same time, however, higher line of research. He plans to continue examlevels of outness were directly related to ining stress among adolescents who identify higher binge drinking.” as sexual minorities, including efforts to It may be difficult for teens to strike a develop a new measurement tool to assess balance between revealing their sexual sources of stress in domains such as family orientation and forming an identity while and school life. t Photo/Eric Lindberg
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Photo/Courtesy of Murali Nair
Murali Nair speaks with Bhagavan Kani, who is approximately 115 years old, during a field study in India as part of his research into how lifestyle affects longevity.
Scholar seeks secrets of long life USC School of Social Work, is fascinated for one simple reason—the man is more than 100 years old. “People are definitely living longer,” Nair said. “I’m not saying that medical advances have nothing to do with it, but there are other reasons. There must be something He spends a few serene moments gazing beyond their genes, maybe something we at the early morning sun as it crests the can document.” horizon, sipping water infused with a local Through interviews and visits with dozens spice leaf called tulsi. Kani eats a simple of centenarians around the world, Nair is breakfast of raw vegetables and fruits. exploring lifestyle factors that may influBarefoot, he sweeps the leaves from a dirt ence health and promote longevity. He has path in his garden and climbs steep stone identified 11 attributes shared by all his steps to take a stroll through the hilly vil- study subjects, regardless of their socioecolage. Later that day, he sits outside his nomic background. Nair is hopeful that his coconut-leaf-thatched hut, recites tribal findings will bring legitimacy to practices songs, and talks to plants and animals. that are often overlooked and sometimes It’s a quiet existence that normally scorned by the health care establishment, wouldn’t garner much attention. But such as spiritual rituals, a positive outlook on Murali Nair, a clinical professor with the life, and various traditional healing practices.
In the lush, verdant hills of India, Bhagavan Kani rises from his bed.
“We can learn from them instead of judging before really understanding,” he said. “That is why my dream is to bring these traditional healers to our campus to sit down and listen to them.” Nair’s ethnic origin is Kerala, a state on the southwest coast of India known as “God’s own country.” As a child, he experienced many of the traditions and holistic health practices that are now a focus of his field studies and research. When he visits India to speak to scholars studying healing approaches such as Ayurveda and naturopathy, Nair said his descriptions of the scientific approach to health in the United States are often met with amusement. “Clinical studies are slowly starting to show that some spices like turmeric and cinnamon are good for your health,” he said.
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In recognition of her contributions to the prevention and treatment of child abuse and neglect through the use of “big data,” Emily Putnam-Hornstein has received the Commissioner’s Award from the Administration on Children, Youth and Families. The assistant professor at the USC School of Social Work has worked collaboratively with other researchers and state leaders in California to link massive sets of data on child welfare and well-being to examine issues such as maltreatment and poor academic performance. California Gov. Jerry Brown and other state leaders selected Putnam-Hornstein to receive the prestigious award, given annually to one person from each state and U.S. territory, during the National Conference on Child Abuse and Neglect. “It’s certainly very flattering to be acknowledged, and it’s even more meaningful when you know that a group of colleagues you’ve worked closely with were
the ones who nominated you,” PutnamHornstein said. She stressed the collaborative nature of the partnership between officials with the California Department of Social Services and researchers interested in child well-being, including colleagues at UC Berkeley’s California Child Welfare Indicators Project. Putnam-Hornstein completed her doctoral studies at UC Berkeley and said the experience gave her insight into the importance of cultivating positive connections and building trust. “We have the data and the technology,” she said. “It’s often relationships that prove problematic with projects like this. Being a part of that team [at UC Berkeley] is tremendously valuable.” Putnam-Hornstein is capitalizing on those relationships at the state level to lead a new project funded by First 5 LA to develop a research repository that will integrate data across state and local agencies. She is working closely with Jacquelyn McCroskey,
“They laugh. They say, we’ve known for thousands of years that this works. It’s a tradition passed along from generation to generation.” Along with several colleagues, Nair cowrote a book called Healing across Cultures and produced a minidocumentary titled Healing Visions of India. He became interested in possible connections between lifestyle and longevity when conducting field studies as a senior Fulbright scholar in Sri Lanka. Even though he had the funds to afford a nice house and a chauffeur while studying there, he asked instead to be placed with a family in a remote village. In Sri Lanka, Nair began exploring the correlations among social, cultural, spiritual, dietary, physical, and mental habits and the promotion of health and well-being among elders. “The scientific community is slow to accept these practices,” he said. “But if there is a person who lived to 100 and did not use modern medicine very often, there is value in sitting and listening to them.” Nair has traveled to Bali, Hong Kong, Macau, Peru, Hawaii, Canada, and India to seek out centenarians, and is planning a trip to Japan. He has found that many of the people he interviews share common characteristics. “They have a general air of optimism and
positivity and try to instill that attitude in others around them,” Nair said. “They engage in physical and mental activity on a daily basis, often cleaning, walking, gardening, cooking, reading, writing, and memorizing passages of poetry, stories, and life events. Learning never ends for them. They always hang around with people much younger than them. Even with a child, they find something to talk about.” Many of the centenarians he has met practice careful eating habits; most are vegetarians who consume fresh vegetables and fruits, spices, and herbs in small but regular quantities. Physical and mental activities and practices such as bathing in cold water and watching the sunrise in the early morning are common. Nair described one centenarian he met in India, a millionaire who had 35 servants but would still wake up early every morning to
Centenarians share common traits such as regular physical and mental exercise, a healthy diet, and a positive outlook on life.
Photo/Eric Lindberg
Gov. Brown honors researcher for big-data work
the John Milner Professor of Child Welfare at the USC School of Social Work, to develop the Children’s Data Network, which seeks to foster collaboration among researchers, policy makers, agency leaders, and community officials to improve services for children and their families. t sweep leaves, walk into the village instead of taking a car, and stick to a strict eating schedule even if his guests are late. “Some people say, oh, I’m rich, I have servants, I can sit here and watch television,” Nair said. “He still takes an axe and chops firewood, he’s out there cleaning and reading and writing.” Nair has embraced much of this lifestyle himself. He practices early morning sun gazing, yoga, and mindful meditation, and has a positive perspective on life in general. Very careful about what enters his body, Nair maintains a vegan diet, grows his own sprouts, and drinks plenty of fresh water. He shares his insights about longevity during seminars and presentations throughout the world, has produced four minidocumentaries, and is working with a physician and scientist on a manuscript about the secrets of long life focused on evidence-based traditional healing. “My end goal is that we can say, yes, there is something to our traditional values and we can translate this into evidence-based practices,” he said. “We need a dialogue with these traditional healers, to create a welcoming atmosphere to understand and learn from them.” t
Professor guides effort to improve juvenile detention For decades, young people who ran afoul of the law found themselves in dismal locked facilities, surrounded by barbed wire and chain-link fences.
Photo/Brian Goodman
Photo/Michelle Newell
These jail-like structures, featuring large dormitories and staff members who relied on a controlling and coercive model of oversight, have proven to be ineffective and harmful, leading to increased recidivism, lower academic achievement, issues Research suggests that large dormitories in juvenile detention facilities may have a negative effect on rehabilitation. of alcohol and substance abuse, and mental health problems among youths. in bond funding in 2007 to improve county In an effort to rectify these flaws, a new juvenile detention facilities, and McCroskey rehabilitative focus, coupled with newly and her fellow committee members will available state funding in California, is offer recommendations for a second round beginning to take shape. of proposals to allocate approximately $80 “Our understanding of how to best million in remaining money. deal with youths in the juvenile justice During the past two years, McCroskey system has changed a lot over the past few has advised county leaders who successfully decades,” said Jacquelyn McCroskey, the lobbied for state funding during the initial John Milner Professor of Child Welfare at round of proposals about designing probathe USC School of Social Work. tion camps that are more rehabilitative in Instead of housing dozens or even hunnature. She credited the leadership of Jerry dreds of teenagers together, leaving staff Powers, the county’s chief probation officer, members little choice but to act as security as well as Arturo Delgado, superintendent guards rather than caseworkers, McCroskey of the county’s Office of Education, for said a more promising approach is to create spearheading efforts to overhaul services smaller groups of 10 to 12 youths and offer for youths in those facilities. therapeutic treatment for mental health, “We need to send the “There has been a real effort to rebuild trauma, and substance use issues in a less one facility and to spread this set of more message that these threatening and oppressive environment. effective ideas about programming to other kids have something “We need to send the message that these facilities,” she said. to offer. Yes, they have kids have something to offer,” she said. “Yes, Los Angeles County currently boasts the committed crimes that they have committed crimes that we have largest juvenile justice system in the nation, to address, but they are still kids.” we have to address, but featuring three juvenile halls and 14 probaDue to her extensive expertise in child tion camps. On any given day, approximately they are still kids.” welfare and development, including a 2,000 youths are confined in those facilities. stint as a probation officer at Los Angeles Jacquelyn McCroskey Although the newest camp was built in County’s Central Juvenile Hall, McCroskey the early 1990s, McCroskey said many of has been selected to advise state leaders the structures date back to the 1960s and on the construction and renovation of established by the California Board of resemble penitentiaries, with juvenile justice facilities as a member of State and Community Corrections. barracks-style dormitories an executive steering committee recently State legislators approved $300 million ringed by perimeter fences
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topped with razor wire. “They have that very oldstyle, institutional look,” she said, adding, “You can certainly do this new style of programming in an old facility, but it’s so much easier if the message is that this is about rehabilitation and restorative justice, not that this is a jail.” New camps and juvenile detention facilities being built throughout the county are more reminiscent of an academic campus, with grass and trees surrounding buildings with broad windows that allow plenty of natural light. As a young probation officer and recent college graduate, McCroskey had the opportunity to see firsthand how detention facilities affected young adults. She worked closely with girls in a family treatment unit and came to realize that many were struggling with sexual abuse, trauma, and other issues that led them to engage in delinquent behavior. “Having the opportunity early on to work with those families and those girls led me to want to work on systems at the macro level,” she said. “I loved working with the kids, but I could see the whole system needed to change.” Although she eventually pursued research and advocacy initiatives focused on other areas, including early childhood education and community-based support services for young families, McCroskey said having the opportunity to return to issues surrounding juvenile justice is gratifying. “I was delighted to be recruited to do some of this work, particularly when we started seeing these changes in Los Angeles County,” she said. “There has been strong leadership and a real desire to improve things and make sure the programming is what it needs to be.” t
Photo/Brian Goodman
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“It is simply more cost-effective to provide permanent supportive housing to a homeless person than to allow him or her to languish on the streets, end up in hospital emergency departments, and cycle through other institutions. Housing is also a human right.”
HOUSING | from page 4 focus groups with housing supervisors and frontline employees to gain a better sense of how HIV and risk behaviors are addressed. “Many homeless adults are sexually active, do not have safe sex, and have multiple partners,” Wenzel said. “HIV/AIDS risk reduction, promotion of sexual health, and service access must be part of the conversation about health and should be incorporated into the package of integrated services if the evidence indicates that it is important.” Working with five of the largest providers of permanent supportive housing in Los Angeles including the downtown area known as Skid Row, which has a large population of homeless individuals, the research team will recruit approximately 400 people as they transition to housing. In addition to discussing health and sexual risk, participants will describe how they are adjusting to living alone, whether they have remained in touch with friends from the street, and whether their drug use behaviors have changed. Interviewing individuals before they enter housing is crucial, said Henwood, noting that a previous study he conducted involved interviewing people an average of 70 days after they moved into their new home. “We didn’t see a lot of change in quality of life,” he said. “It could be that a lot happens during that initial period when people first move into housing. When there’s that kind of dramatic change, you might be missing a lot.” Henwood, who specializes in qualitative and mixed-method research, will shadow approximately 30 residents of permanent supportive housing as part of the new study, following them as they go about their daily routine to add a depth of understanding about their lifestyle. “We’ll be able to see and describe and understand risk and changes in social networks,” he said. “What’s actually causing that, what are people thinking? Having that experience of going out with them and hearing what they have to say in real time does add a nice dimension.” A key aspect of the study is its reliance on
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Suzanne Wenzel social network analysis. Using an iPad application, researchers will ask participants to describe people they have had contact with during a certain time period. The application will visually map out each study participant’s social network, allowing them to answer specific questions about their friends and peers with a simple tap of their finger. Rice, who designed the app with Rhoades and project specialist Hailey Winetrobe, said initial results from the pilot study suggested that the transition from chronic homelessness to housing has a positive influence on some individuals in terms of their interpersonal relationships, but may result in negative changes for others. Citing anecdotal evidence, he said some individuals see the shift to housing as an opportunity for a fresh start, whereas others may invite friends from the streets to stay with them despite prohibitions on such behaviors. “A lot of these people have been on the streets for years and have long-term ties to other homeless people,” he said. “We’re curious to see if moving into housing is going to be disruptive to those relationships. The hope is that by moving into housing, they will be in networks with more people who are stable, fewer people who are consuming drugs, and fewer people who are engaging in risky sexual behavior.” One of the ultimate goals of the research is to inform interventions and programs that can address the lack of HIV and sexually transmitted disease prevention in permanent supportive housing. How those programs are developed or adapted from existing models will depend on study findings and the policy and service context, Wenzel said. However, because the housing model has proven to be a solid foundation for the provision of other health services, the researchers expect that introducing programs focused on HIV risk prevention and treatment should not be a problem. Although the study will examine potential negative consequences of housing, Wenzel and HIV/AIDS | continued on page 12
“I define technology as exploiting phenomena for useful purposes— exploiting meaning collaborating and leveraging technology, taking something and making something else out of it. I believe we will see a convergence with social phenomena, and disciplines like social work will borrow or implement or partner with technologies and ways of thinking that have an engineering aspect.” Yannis Yortsos suggestions to organizations working with this population, but without Tambe’s contribution, he would not have had any concrete evidence to support his assessment. The collaboration, he said, elevated his research to a new level, allowing the researchers to provide advice backed by definitive evidence about what works and what doesn’t regarding prevention interventions. “Our hope is we will have a product that has very specific guidance for HIV prevention programming around effective strategies,” said Rice. “It would be great to be able to go to an organization and say, ‘This is likely a winning strategy that should be low cost and will work in the networks of this youth population.’”
Thanks to Tambe’s computer science background, the duo will be able to use game-like modeling to assess their strategies without having to test them on people first. The next phase for Rice and Tambe will include working on a paper and grant applications during the coming year. Soydan sees the use of computational science as a source of major potential for social work, especially in terms of largescale datasets known as big data. In his new book Evidence-Based Practice in Social Work: Development of a New Professional Culture, coauthored with colleague Lawrence Palinkas, the Albert G. and Frances Lomas Feldman Professor of Social Policy and Health, big data is described as having the potential to open up new horizons in the tracking of diseases and dysfunctions in society and to improve understanding of collective behavior patterns across national and cultural borders. “Big data are contingent upon and compelled by advances in computational science,” they wrote. “Collection and use of big data is now possible and can be done at a low cost.” Although the use of big data helps enable a wider perspective of human behavior, Yortsos believes social science still does not encompass the same level of determinism as the natural sciences. This lack of determinism makes the development of solutions more complicated. “With better tools and better methods of sensing and collecting information and understanding through technology, we can find better laws than we have now,” Yortsos said. “Social work will be helpful in making these laws not empirical, but more substantive.” This substantiveness, he continued, will be developed in part by the role of digital media in understanding and explaining phenomena. “What microscopes are to the natural sciences, digital media is to the social sciences,” he said. Yortsos pointed to a potential collaborative project with Hortensia Amaro, the Dean’s Professor of Social Work and Preventive Medicine at the USC School of Social Work and associate vice provost of community research initiatives. Discussions have centered on the proximal community around USC and creative ways to transform the neighborhood. Yortsos refers to this sort of topic as a useful purpose
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for the exploitation of technology. However, before an individual can capitalize on technology to address such a purpose, there must be an understanding of certain phenomena that can be leveraged to create change. “By phenomena, I mean a law, principle, or some sort of fundamental property that change can be based on,” he said. “In engineering, we have the skills to exploit technology, but we don’t know what the useful purpose is when it comes to social work, and sometimes we don’t know what the phenomenon is, which you need to discover before you can figure out the useful purpose.” Both departments see significant potential for future collaborations and are pleased with the progress made thus far. One notable achievement has been the transition of an engineering faculty member to the School of Social Work. Associate professor Shinyi Wu (see story on page 2) now holds a joint position with both departments after making the decision to join social work due to collaboration with Kathy Ell, the Ernest P. Larson Professor of Health, Ethnicity, and Poverty. Ell and Wu worked to find ways to use technology to improve support for patients with chronic illnesses, such as diabetes, chronic obstructive pulmonary disease, and heart disease. “We saw a potential for technology to monitor and screen patients with depression and give that information to providers,” Wu said. “This is what really got me interested in public health and safety nets.” Wu said the change to social work has afforded her the opportunity to focus more on solutions that benefit communities, something that was missing from the inherent human factors involved in engineering disciplines. “The social determinants of community allow a person to be in the best supportive environment for solutions,” said Wu. “Working with Dr. Ell and [the USC Roybal Institute on Aging] allows me to bring analysis and interventions to communities to reduce the burden on the need for health care and get the appropriate help to those who need it.” Through efforts at the Roybal Institute, Wu and her colleagues are working on a wireless-based mobile health training program for older adults with disabilities. They hope technology will help these individuals, who place a large demand on service providers, to better care for themselves, not just in terms of health but also productive
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Photo/Eric Lindberg
PARTNERS | from page 1 Soydan refers to this bridge between the disciplines as “piecemeal social engineering,” a term first coined by Karl Popper to represent the methods used to find and apply solutions to social problems through the use of social technology. Yannis C. Yortsos, dean of the USC Viterbi School of Engineering, agrees with Soydan, stating that engineering’s contribution to the development of digital media has significant potential to promote the mission of social work. “I define technology as exploiting phenomena for useful purposes—exploiting meaning collaborating and leveraging technology, taking something and making something else out of it,” Yortsos said. “I believe we will see a convergence with social phenomena, and disciplines like social work will borrow or implement or partner with technologies and ways of thinking that have an engineering aspect.” The makings of this collaboration largely hail from a joint summit held last summer between the schools. The summit gave engineering faculty members the opportunity to discuss how they articulated the grand challenges of their profession and areas where crossover exists with social work. Eric Rice, an assistant professor with the USC School of Social Work, attended that meeting and discovered interesting opportunities for partnerships concerning his work with homeless youth. After Rice found he shared mutual interests with Milind Tambe, the Helen N. and Emmett H. Jones Professor in Engineering who specializes in computer sciences, the two have been working together for the last eight months on developing an HIV prevention intervention for teens and young adults experiencing homelessness. “I presented my work [at the summit] about risk behaviors for homeless youth, and Milind got excited because of my realworld information about networks,” Rice said. “He saw an opportunity to push his computational methods forward and solve real-world problems.” Rice’s mapping of social networks among young people and Tambe’s engineering perspective on strategy development came together well. The pair is now designing effective implementation strategies to see what works for the highly complicated and transient homeless youth population. The data Rice collected through his research were sufficient to generate some
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living, meaning of life, and social connections with others. Soydan said bringing Wu into the school is a pioneering first step that is important for the school’s ultimate mission: the betterment of life for individuals and communities. “Research is not one person’s business—it’s a team business, and a team is defined as a multidisciplinary group of experts,” Soydan said. “Complex problems require multifaceted and aggressive approaches, and further collaboration between our disciplines has great potential and is in line with the spirit of the university and our school.” t
Shinyi Wu (right), an industrial engineer who recently joined the USC School of Social Work, is working with William Vega, provost professor and executive director of the USC Roybal Institute on Aging, on a large-scale project to assess and improve how county and city agencies in the Los Angeles region provide health and social services.
Hamovitch Center | 1149 South Hill Street, Suite 360 | Los Angeles, CA 90015 USC School of Social Work | Montgomery Ross Fisher Building | 669 West 34th Street | Los Angeles, CA 90089 213.821.3628 | hrc@usc.edu | usc.edu/socialwork/research HIV/AIDS | from page 9 her colleagues were careful to note that they are not suggesting the permanent supportive housing approach should be abandoned. People who have lived on the street for lengthy periods of time have significantly higher rates of morbidity and mortality, Wenzel said, and a chronically homeless individual is five to nine times more likely to die compared to someone with stable housing. “It is simply more cost-effective to provide permanent supportive housing to such a person than to allow him or her to languish on the streets, end up in hospital emergency departments, and cycle through other institutions,” she said. “There can be so many other benefits as well, some that are not so easily assessed in terms of dollars and cents, like achieving a sense of safety, security, and privacy. Housing is also a human right.” Wenzel noted that positive changes in
the social networks of newly housed individuals, such as increased contact with family and friends who engage in healthy behaviors, may decrease the risk of HIV and other negative outcomes. “It’s very clear that housing works to end homelessness, but there’s nothing to say it addresses everyone’s problems or that it won’t create some other problems,” Henwood added. “It’s definitely a lifealtering, complicated move. Any time you give people more independence, there is always risk that comes along with that.” Examining that risk is clearly a priority at the federal level. The grant proposal received a perfect score, placing it in the upper echelon of submissions. Wenzel said it was particularly gratifying to receive such a positive response because obtaining funding through the National Institutes of Health has become more competitive and challenging in recent years.
Photo/Brian Goodman
Clinical associate professor Ruth White has published a new book titled Preventing Bipolar Relapse: A Lifestyle Program to Help You Maintain a Balanced Mood and Live Well. The book outlines an innovative program known as SNAP, an acronym for sleep, nutrition, activity, and people. White provides practical tips to help individuals living with bipolar disorder recognize Research!America, a nonprofit alliance of organizations that the warning signs of oncoming manic or seeks to make health-related research a greater national priority, depressive episodes and make necessary has selected Hortensia Amaro as a member of its board of direc- changes to reduce their effects. tors. As a member of the board, Amaro will be responsible for urging Congress and other national leaders to increase funding for The National Association of Social Workers, Region F, which health-related agencies such as the National Institutes of Health includes Orange, Riverside, and San Bernardino counties, has and Centers for Disease Control and Prevention. Amaro is the recognized Leslie Wind with the Distinguished Lifetime dean’s professor of social work and associate vice provost of com- Achievement Award. The organization honored Wind, a clinical munity research initiatives. associate professor and associate dean of academic programs with the USC School of Social Work, for her decades of experience Anthony Hassan, director of the Center for Innovation and as an educator, clinician, researcher, community organizer, and Research on Veterans & Military Families advocate in the field of social work. Dozens of her colleagues, stuat the USC School of Social Work, is being dents, friends and family surprised Wind with the award during honored with the 2014 Civilian Service an annual Social Work Month celebration held in Orange County. Award from the Iraq and Afghanistan Veterans of America. Hassan received Kim Finney, a clinical associate professor with the Center recognition during the 6th Annual Heroes for Innovation and Research on Veterans & Military Families, Celebration for his efforts to establish a received the Sylvia Blanton Award from the City of Carson for her specialization in military social work and efforts to improve the well-being of veterans by educating future develop community-based research initiamilitary social workers. The honor was presented during the 2014 tives focused on service members, veterans, Women Veterans Symposium sponsored by Carson’s Veterans and their family members Affairs Commission. Photo/Brian Goodman
Vern Bengtson, an adjunct professor with the USC Roybal Institute on Aging, has received the 2014 Eugene Litwak Award in Public Health from Columbia University’s School of Public Health and School of Social Work. The award is named for a longtime professor at Columbia University who developed one of the earliest graduate programs in aging. Bengtson will deliver the Eugene Litwak Lecture on issues of aging and multigenerational change.
“Hours and hours of extremely careful work and attention to detail were poured into that proposal,” she said. “It was a great reward to get a score that said the proposal has no weaknesses and stands to make a highly significant contribution.” She added that the research team benefited from a new, innovative approach at the USC School of Social Work, which has created research clusters designed to promote scholarly interaction and activity on critical topics, including the Homelessness, Housing, and Social Environment cluster. “This study may not have happened without the cluster,” she said, “It may not have happened without the formal means of bringing us together under one umbrella, without the resources from our dean, Marilyn Flynn, to support a pilot study, and without the common cause of addressing homelessness and the wellbeing of homeless people.” t