This study explored social workers perceptions of disproportionality of African American children in the child welfare system, with a particular focus how they felt child welfare agencies, and organization address the specific needs of African American children and families. Along with the types of services social workers felt could be implemented in order to address the concerns amongst African American families. Major findings in the research under represent the perspective of the social workers who work closely with these children and their families. The overall research method that was utilized in this study was qualitative by design. The data collection consisted of 11 face to face interviews with different types of social workers with current and past experiences working with African American children and families, in the child welfare agency. This research called for opinions, experience and personal beliefs from social workers. The survey consist of 13 open/close ended question and demographical questions that were personally asked to each social worker on a one on one bases. The results of this study identified African American children entering and staying in the system at longer rates, poverty, lack of resources in the community, distrust in the government and cultural competency as major contributing factors to disproportionality in the child welfare system. This study displayed a need for social workers to take on more of a strength based approach and remembering to model the NASW code of ethics when working with African American families. Recommendations for future studies include but are not limited to: exploring options to have preventative services for African American families to be offered in their homes or alternatives to easy accessible services and to explore different strategies, tool and techniques in efforts to increase the relationships between the African American families and the social workers.

This project examined the extent to which Nova Scotian adolescents’ counselling needs are being met with respect to physical, sexual, substance use, and psychosocial health by their family physicians. This was accomplished by assessing how well Nova Scotian physicians provide preventative advice consistent with the Guidelines for Adolescent Preventative Services (GAPS). Analyses were performed using pooled data from surveys carried out in 2003 and 2006. Descriptive analyses, Poisson and logistic regression were used to examine associations of sociodemographic characteristics, need, and the presence of school based health centres (SBHCs) with the provision of advice. Advice was not well provided and appeared to be need-driven. Females were significantly more likely to be provided advice and respondent access to a SBHC increased the likelihood of advice being provided. These results have implications for policy and practice, specifically, ways to refine preventative healthcare services for the province’s adolescents to ensure optimal care.

Delivery of primary care preventative services can be significantly increased utilizing Six Sigma methods. Missed preventative service opportunities were compared in the study clinic with the community clinic in the same practice. The study clinic had 100% preventative services, compared with only 16.3% in the community clinic. Preventative services can be enhanced to Six Sigma quality when the nurse executive and medical staff agree on a single standard of nursing care executed via standing orders.