Thesis (Ph. D.)--University of Texas at Austin, 2008. / Vita. Includes bibliographical references.

Summary in English. / Bibliography: pages 122-126. / This dissertation studies the delivery of health care to street children. ft investigates the existing street children's facilities and the health system in Ang of a in order to determine an appropriate type of health facilities for the special health needs of these children. The study was based on a review of bibliographic material on street children and related subjects. The findings from this review were tested through a series of interviews with professionals working with street children in Angola and with ~treet children randomly selected from shelters and on the streets in Luanda. The questionnaires were designed for evaluation of the street children's facilities, the health system and to determine street children's preferences and attitudes towards formal institutions in a context where th'e main cause of family disintegration was war. The study concluded that street children's health needs in Angola would be better catered for through independent primary health centres provided with partial in-patient services (temporary sf eeping and eating facilities for children under medical care). These centres would serve mainly children with no access to shelters and those living in shelters without health centres. The study formulates guidelines and presents a design example of the type offacifity proposed.

The demographics and perceived needs of the Comprehensive Health Investment Project participants were studied along with the interventions provided by the CHIP staff. Demographic information and perceived needs were calculated on 397 household heads. These families were followed for a year and the interventions provided to them during that year were recorded. Intervention records were collected quarterly and analyzed for comparisons with the family profile grid.Results show a unique demographic makeup of CHIP participants. Sixty percent of household heads had one or more years of college; 66 percent were employed at the time of the study; 73 percent were receiving federal financial assistance of some kind. Health and nutrition of the family were the main concerns of the clients. Other needs included financial assistance, employment, and housing. Eleven percent of interventions provided by CHIP throughout the study year were directed towards financial assistance. Ten percent of services were employment oriented. CHIP participants were also shown to use physicians during well times - not just during emergencies. Results and conclusions are discussed in detail. / Master of Science

Thesis (M.S.)--University of Michigan, 1979.

Thesis (M.S.)--University of Michigan, 1979.

Thesis (M. Communication Pathology)--University of Pretoria, 2008. / Includes bibliographical references.

The Child and Adolescent Level of Care System/Child and Adolescent Service Intensity Instrument (CALOCUS/ CASH) is designed to help determine the intensity of services needed for a child served in a mental health system of care. The instrument contains eight dimensions that are rated following a comprehensive clinical evaluation. The dimensions are risk of harm, functionality, co-morbidity (psychiatric, substance abuse, development disability and medical), environmental stressors, environmental supports, the child's resiliency, and the child and family's willingness to engage in treatment. An algorithm connects the ratings to a level of care recommendation. The instrument specifies six levels of care defined flexibly enough to consider whatever services are available. The results of psychometric testing using raters with a broad range of clinical experience and training from four different systems of care around the country are presented. The testing demon-strates excellent reliability when rating vignettes. Using children and adolescents in live system of care clinical settings, the CALOCUS/CASH demonstrates reasonable validity when compared with the Child Global Assessment Scale, and the Child and Adolescent Functional Assessment Scale.

Extensive research suggests linkages among low income, erratic or ineffective parenting behaviors, and impaired health and development among children. Family support programs, offering a range of comprehensive services to low income families, have demonstrated positive health and life performance outcomes, both for children and parents. One such program, the Comprehensive Health Investment Project (CHIP) in Roanoke, Virginia, works to provide primary physician care to low income young children. One of CHIP's objectives is to enhance parenting skills so that parents can help maintain good health among their children. This study attempted to assess parents' beliefs about child development among a sample of CHIP parents and a sample of parents from a similar SES group (drawn from CHIP's waiting list) using a Likert-style opinionnaire. Results from both between-group tests and within-group (CHIP sample) tests indicate homogenous and favorable reported beliefs about child development. Very little association was found between demographic variables and responses. Suggestions regarding the practical use of these findings and recommendations for future research are made. / Master of Science

Educational literature distributed by the Child Health Investment Partnership (CHIP) staff to CHIP parents was identified and evaluated in terms of readability level and availability of information to assist with meeting the identified needs of CHIP parents. One-hundred percent (n=137) of the educational material available to CHIP staff through their library was analyzed. Readability levels were calculated by using the SMOG Readability Formula and the FRY Graph Reading Level Index. A previous study (Brindle, 1992) was used to determine whether CHIP had adequate material to meet the educational needs of CHIP families. Forty-eight percent of CHIP parents cited health as their primary concern. Almost one-half of an educational literature stocked in CHIP's library relates to health. Thus, results indicate that CHIP has a more than adequate amount of educational literature relating to topics CHIP parents believed they needed assistance with the most. It was found, however, that other areas such as financial and job assistance were underrepresented in CHIP's library. While 36 percent and 35 percent of CHIP parents believed they needed assistance with finances and jobs, respectively, only 6 percent of CHIP's library was devoted to financial assistance and two percent was devoted to job assistance. The apparent need for assistance in these areas greatly outweighs CHIP's educational resources. Results also indicate that the average CHIP parents (one who has completed high school) has the education equivalent to or more than was required for reading the majority of CHIP's educational literature. While the mean Reading Level of educational materials was at the tenth grade level sixty percent of CHIP families surveyed had completed high school. Results and conclusions are discussed in detail. / Master of Science

This research programme endeavours to develop, implement and evaluate an effective method of offering psychosocial support to vulnerable children. Vulnerability is defined by trained community members as including children who are experiencing especially difficult lives. The forms of difficulties experienced by the children has usually been a consequence of the HIV/AIDS pandemic, extreme poverty combined with other psychosocial risk factors, child abuse (especially child sexual abuse) and violence. This community based programme incorporates four phases of intervention, only two of which were the focus of summative evaluation. However, due to the integrated nature of the programme it was necessary to implement and document the various phases of the intervention programme: (i) community selection and mobilisation; (ii) the 5-day Sensitisation Programme (SP) sensitises adult community volunteers to the psychosocial needs of vulnerable children; (iii) the 15-session Structured Group Therapy Programme (SGTP) enables children to work through past adversities and to build resilience within small groups of peers in a programme where community volunteers served as apprentice facilitators under the supervision, guidance and ethical responsibility of qualified psychologists; (iv) community based initiatives to offer on-going of PSS activities to vulnerable children in each of the partnering communities. Nine partnering communities were selected, three township, periurban and rural communities. This programme was not effective in the informal settlements as it was not possible for these communities to place children as a priority. A qualitative summative evaluation of the SP took place using post workshop evaluation questionnaires, focus group discussions conducted by an independent researcher and an audit of the community based initiatives that developed as a result of participation in the SP. The SGTP was summatively evaluated using a 4-way Factorial design with one within-subject and three between-subject conditions: to investigate the age of the subjects, the geographic regions and gender variables. The 741 children formed five experimental and control conditions to conduct various combinations of the above-mentioned phases programmes and to adequately control for the many confounding variables. Pre- and post intervention assessments were conducted by trained community research assistants. The dependent variable measures were the Culture Free Self Esteem Inventory (Battle, 1992), the Trauma Symptom Checklist for Children (Biere & Elliot, 1997), the Reynolds Depression Scale for Children (Reynolds, 1989), the Social Support Scale (Beale Spencer, Cole, Jones, and Phillips Swanson, 1997) and the Connor's Parent Questionnaire Connors, 1998). Multivariate analysis evaluated the effectiveness of the various experimental and control conditions. The results indicate that the SGTP, run in combination with the SP, is an effective intervention strategy in that it alleviates symptoms of self-reported depression and other psychosocial manifestations of distress as well as decreased the number and severity of symptoms reported by primary caregivers, and leads to increased access to perceived social support. The SP and the SGTP conducted independently of each other have limited benefits and as such can be considered to be partially effective. The children who had formed part of the non-vulnerable control group felt left out of the programme and report an increase in symptomatology and decreased access to social support. While this community-based programme can be considered to be an effective method of therapeutic intervention and of offering psychosocial support to vulnerable children, further research is needed to consider the cost-effectiveness, the sustainability and ways in which those children who do not participate can still can benefit. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2004.