Celebrating Social Work Month this March, we put a spotlight on CISWH. Social workers play a crucial role in healthcare by bridging the gap between medical care and social services to ensure that individuals and communities receive quality, affordable, holistic care. By providing support, advocacy, and resources to patients and families facing medical challenges, social workers help others navigate the complexity of our healthcare and social services systems. They also contribute to research and policy development by working to address social determinants of health and promote health equity. It is important we, as a society, continue to recognize the vital contributions of social workers in health and the transformative impact of their work.

As we enter Social Work Month this March, we take a moment to reflect on CISWH’s commitment to social work and health over the past year. CISWH, in collaboration with dedicated professionals and leaders, has conducted transformative research and launched initiatives that will leave a lasting impact on the intersection of social work, health, and public health.

Boston Children’s Hospital

Boston University School of Social Work (BUSSW) Prof. and Research Core Director Christina Lee is leading a research project with Boston Children’s Hospital that examines the impact of social workers on health outcomes for children and families in Child Protective Services. Under her guidance, a team of BUSSW faculty analyzed data trends in the utilization of the Children’s Hospital emergency department, social work services, and referral patterns. As the project advances into the data analysis phase, findings are expected to be unveiled in late 2024.

The Collaborative Improvement and Innovation Network to Advance Care for Children with Medical Complexity (CMC CoIIN)

In 2023 CISWH concluded its work on the HRSA-funded CoIIN program for children with medical complexity. The CoIIN brought together groups of interdisciplinary teams of families, social workers, medical providers, policy makers, and payers to develop strategies to improve child quality, family well-being, and cost-effectiveness of care. The culmination of this 5-year project resulted in the publication of several papers in the journal Pediatrics, showcasing the team’s significant contributions in increasing access to care for children with medical complexities.

Supporting Replication (SURE) of Housing Interventions in the Ryan White HIV AIDS Program

In 2023 the SURE Housing Initiative was funded to implement and evaluate housing-related interventions for people with HIV who experience unstable housing. Through collaborative efforts with project partners, 10 community organizations were chosen nationwide to implement housing interventions for individuals with HIV. As the selected organizations prepared to implement the intervention, the SURE team conducted a comprehensive training on how to evaluate the multi-site project at the first all-site meeting in Washington D.C.

Visit to Kenya

In July Ellie Zambrano, CISWH executive director, BUSSW Prof. Margaret Lombe, and MSW students traveled to Kenya to collaborate with Jesuit Refugee Services (JRS), the United Nations International Children’s Emergency Fund (UNICEF), the United Nations High Commissioner for Refugees (UNHCR), the United Nations Fund for Population Activities (UNFPA), the Nymbani Children’s Home Orphans, and the Catholic University of Eastern Africa in Nairobi, Kenya on new programming. The goal of the trip was to learn more about refugee experiences in eastern Africa and the role social workers can play in improving the lives of displaced communities.

Project IMPACT
BUSSW Prof. Astraea Augsberger, along with Wendy Zeitlin from Montclair State University and Trupti Rao from the Westchester Institute of Human Development, received a National Institute of Health grant to expand the reach and funding for their successful Project IMPACT (Improving Parenting Achievements Together). This intensive parent training program, tailored for parents with intellectual disabilities in the child welfare system, demonstrated success in preserving families compared to standard services. Prof. Augsberger is now conducting learning sessions with policymakers, practitioners, and researchers to share findings and shape the next steps in research, practice and policy advocacy.

The Prevention of Violence Against Young Children in South Africa

BUSSW Profs. Margaret Lombe and Lenette Azzi-Lessing recently completed a one-year research project in which the team identified community-driven and evidence-based interventions to address violence against young children in South African communities. The team will now share their evidence globally in the hopes of mainstreaming these interventions.

Fellows Program

In 2023 CISWH established a Graduate and Doctoral Fellows Program to help prepare social work and public health leaders for influential careers in the field. CISWH fellows conduct research, create policy briefs, support strategic planning, and much more.

Recent Events

• 1/26/2024: Social Work Leadership in Substance Use Treatment and Social Justice Advocacy: A conversation with Dr. Nabila El-Bassel
• 9/28/2023: CISWH Faculty and Board Members Share Expertise at “Transnational Social Protection” Panel
• 10/23/2023: Shaping the Future of Social Work in Health and Public Health
• 5/2: The 2023 Hubie Jones Lecture in Urban Health with Dr. Joseph Betancourt
• 3/23/2023: BUSSW Emerging Scholars Colloquium: Social Work, Climate & Environmental Justice
• 3/2/2023: BUSSW Dean & CISWH Director Jorge Delva Joins Colleagues to Discuss Social Work’s Role in Health Equity

The population of children with medical complexity (CMC) is steadily growing, and with it comes a rising awareness of the challenges faced by their families—lack of access to needed health and social services, financial hardship as the result of high expenses, and lost income and missed opportunities for improving outcomes. To address these needs, the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) funded the Center for Innovation in Social Work and Health (CISWH) at Boston University’s School of Social Work (BUSSW) to lead the Collaborative Improvement and Innovation Network to Advance Care for Children with Medical Complexity (CMC CoIIN).

In a new seven-paper journal supplement published in Pediatrics, a group of CMC CoIIN leaders lay out lessons learned over the duration of the project (2017 – 2022), its impact, and the future of its work to improve child quality of life, family well-being and cost-effectiveness of care. The first article in the supplement gives an overview of CISWH’s CMC CoIIN project.

How a Collaborative Improvement and Innovation Network (CoIIN) Works

A CoIIN brings together groups of interdisciplinary teams of families, medical providers, policy makers, and payers to form a network aimed at identifying problems, developing and applying interventions, and evaluating the impact of said interventions using evidence-based processes. The separate teams come together regularly to share findings with one another and ensure that successes are spread throughout the network.

The CMC CoIIN had three goals for the project across ten state teams:

● Improve the quality of life for CMC
● Improve the well-being of their families
● Improve the cost-effectiveness of care of CMC

Equitable, Measurable Family Partnership and Core Values as Guiding Principles

Guided by nationally-recognized family leaders, clinical and implementation science experts, state-based teams, affiliate organizations, and individual families, the CMC CoIIN held equitable, measurable family partnership as a key principle in achieving its goals. The following are examples of strategies used to operationalize this guiding principle:

● Active family leader participation, serving on the project’s National Advisory Committee and as faculty, case presenters, moderators and learners in the COVID-19 and CMC Extension for Community Healthcare Outcomes (ECHO) medical education program.
● Training, technical assistance, and financial support for family leaders participating in the CMC CoIIN provided by the CISWH-based leadership team.
● Tools, resources, peer-mentoring support and coaching for family leaders provided by Family Voices.
● Use of the new Family Engagement in Systems Assessment Tool (FESAT) to help state teams measure levels of family engagement in systems-level work, and, based on this data, develop team-driven plans to increase it.
● A family leaders’ affinity group call every 6 weeks for shared problem-solving and peer-support.
● Required monthly reporting by state teams on family engagement activities and outcomes to the CISWH-based leadership team.

The CMC CoIIN also centered its work around three core values:

● Accountability: The CMC CoIIN leadership and state teams held themselves accountable to CMC and their families, ensuring that families were part of the process and empowered to share their perspectives.

● Transparency: The teams held honest conversations and were open to sharing both challenges and successes across teams and hierarchies. The network was committed to building a community of trust, encouraging teams to share their disappointments and challenges, in addition to identifying any “wins” as a source of valuable learning for everyone.

● Equity: In the CMC CoIIN, family leaders were treated as equals among clinicians and other team members. Family leaders themselves were required to be treated as equals with one another as well, regardless of experience, child’s age, diagnosis, or status as a paid family leader or volunteer.

What We Learned

Over five years, the CMC CoIIN made considerable progress in understanding and quantifying the challenges of families raising CMC, particularly during the COVID-19 pandemic.

While the CMC CoIIN made good progress on improving the quality of life for CMC and the well-being of their families, the network made fewer gains on improving cost effectiveness, largely because of the small number of CMC enrolled across all teams and the impacts of the pandemic—it was difficult to see meaningful change in claims and utilization data that could be directly credited to the CoIIN teams’ interventions.

As the first collaborative quality improvement network for improving the quality of life for CMC and their families, the CMC CoIIN gained valuable learnings and experience which could have implications for future improved care delivery for this growing population of children across the United States.

Learn more about topic-specific impacts of the CMC CoIIN through the January 2024 Pediatrics Supplement.

Dear BUSSW Community, 

By now you may have heard about the Supreme Court’s decision today, June 29, 2023, regarding the use of race in considering applicants’ admission to colleges and universities. This is deeply disappointing news and one that is a set back and at odds with the values and mission of BU and our School.  Please see President Brown’s letter in response to the announcement in which he affirms BU’s enduring commitment to working within the parameters of the law to continue to support and grow the diversity of our student body, and a story in BU Today that shares reaction from the BU community.

As President Brown explains, BU is reviewing the decision to better understand the implications for the University.  However, I want to unequivocally state that the SCOTUS decision in no way changes our commitment to a diverse student community.  We will redouble our efforts to grow and support racial and ethnic diversity at our School and will work closely with central administration to ensure we do so within the parameters of the law.  We will not let this decision hinder our ongoing efforts to recruit students from underrepresented communities and we will continue to support them in their journey as they apply to and attend BUSSW. 

As we have always done when evaluating student applications, we will continue to holistically consider an individual’s background and experiences and their potential for success and contribution to society – guided by our School’s vision and mission.  It is our intention to maintain those financial aid policies that open our doors to economically disadvantaged students – policies that have made our student body the most diverse in our School’s history. And finally, to the extent permitted by law, we will maintain those programs that support students from diverse backgrounds and embed them in our community.  Guided by our professional values and commitment to a more just society, the School will continue its robust program of research and scholarship to further advance social, racial, and economic justice. 

As we continue to learn more about the implications of the decision, we will keep you updated on programmatic and policy changes we may need to consider.  We are open to hearing thoughts and ideas from our community to help inform the strategies we will develop to navigate this new landscape.  We want to also ensure that everyone understands the ramifications of this decision and the parameters that we will need to work within moving forward.   

Sincerely,

Dean Jorge Delva

Art can be an impactful tool to process emotions and grief, spark capacity for empathy, and promote healing. In a new research brief, the Black Women First Initiative (BWF), a project from the Center for Innovation in Social Work & Health at BU School of Social Work (BUSSW), shares how the team utilizes art therapy and other arts-based interventions—including photography, filmmaking, and theater—to build community and reduce social isolation and stigma amongst Black women living with HIV.

“Overall, the arts settle people and bring them together. There is something in it for every human. We are all drawn to the beauty of a voice or music or a painting or a story,” say the authors. “Agencies need to look outside of the usual ways to increase engagement and introducing the arts is a great place to start.”

These approaches foster emotional connections, reduce social isolation, address stigma and provide education to the HIV community. Art can also be an avenue for people with HIV to express harm and health from traumatic experiences they encounter in health care settings. These approaches prioritize the voices of Black women with HIV, and provide more holistic forms of care.

The Black Women First Initiative, featuring a team of researchers from BUSSW including alumni Melanie Rocco (SSW’21) and Mahlet Meshesha (SSW’19) and Profs. Judith Scott and Linda Sprague Martinez, supports the design, implementation, and evaluation of evidence-informed resources for Black women with HIV, including stigma reduction, trauma-informed care, health literacy, and expanded delivery of HIV care services.

Read the full brief here.