Biography of Primary Presenter

Marvin So, MPH, CHES, is a program evaluation and health education specialist. Currently a Post-Graduate Fellow at the Emory School of Medicine and an Evaluation Fellow at the CDC, he works to advance science dedicated to preventing mental, behavioral, and developmental disorders in childhood. A former caseworker trained in the Parents as Teachers home visiting model, he is committed to strengthening the systems of care that cultivate optimal health, stable relationships, and nurturing development for vulnerable and special needs children, youth, and their families. He received his BA in Community Health and Human Development from UC Berkeley, where he served as the Founding Director of the UC Berkeley Mental Health Coalition. He received his MPH in Social and Behavioral Sciences from Harvard University, where he was a U.S. Maternal-Child Bureau Title V Scholar and Fellow of the Harvard Women and Public Policy Program.

Highest Degree of Primary Presenter

Master's Degree

Presentation Abstract

Among other challenges, homeless children often struggle with internalizing and externalizing behavior problems that impair functioning and well-being (Bassuk, et al., 1997). Given the instability of service continuity often present in the lives of homeless families and their children, it is strikingly common for child mental and behavioral disorders to be caught at a later developmental stage among this group compared to both housed and other low-income peers (Grant, et al., 2007). Emergency shelters represent an untapped setting in which to deploy universal, evidence-based screeners for problem behaviors among this population. We implemented universal screening interventions across three shelters serving families in Georgia using Plan-Do-Study-Act (PDSA) cycles, a common tool in quality improvement practice. We present our process evaluation of the program to-date, using a multi-method qualitative approach involving structured participant observation, focus group discussions, and semi-structured interviews to identify barriers and facilitators to universal screening implementation at each stage of the PDSA cycle. We conducted cross-case analysis (Khan & VanWynsberghe, 2008) in partnership with shelter staff and residents to elicit themes with dependability and credibility. Common barriers included lack of staff awareness of empirically-supported screening instruments, mixed support from shelter leadership, and leakage across the care continuum once children are referred outside of the shelter system (particularly in rural areas). Key facilitators included on-site mental health providers, the presence of child care provider trainings on common signs for behavior problems, and partnerships with academic institutions. These findings point to practical actions that can be undertaken to implement viable screening programs for vulnerable children, and is particularly salient given that many characteristics common to homelessness are also associated with child psychopathology (Bitsko, et al., 2016). We contextualize this study in relation to evidence on implementing Positive Behavioral Interventions and Supports in low-resource settings (e.g., Atkins, et al., 2003).

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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Improving screening for problem behaviors among homeless children in Georgia

Among other challenges, homeless children often struggle with internalizing and externalizing behavior problems that impair functioning and well-being (Bassuk, et al., 1997). Given the instability of service continuity often present in the lives of homeless families and their children, it is strikingly common for child mental and behavioral disorders to be caught at a later developmental stage among this group compared to both housed and other low-income peers (Grant, et al., 2007). Emergency shelters represent an untapped setting in which to deploy universal, evidence-based screeners for problem behaviors among this population. We implemented universal screening interventions across three shelters serving families in Georgia using Plan-Do-Study-Act (PDSA) cycles, a common tool in quality improvement practice. We present our process evaluation of the program to-date, using a multi-method qualitative approach involving structured participant observation, focus group discussions, and semi-structured interviews to identify barriers and facilitators to universal screening implementation at each stage of the PDSA cycle. We conducted cross-case analysis (Khan & VanWynsberghe, 2008) in partnership with shelter staff and residents to elicit themes with dependability and credibility. Common barriers included lack of staff awareness of empirically-supported screening instruments, mixed support from shelter leadership, and leakage across the care continuum once children are referred outside of the shelter system (particularly in rural areas). Key facilitators included on-site mental health providers, the presence of child care provider trainings on common signs for behavior problems, and partnerships with academic institutions. These findings point to practical actions that can be undertaken to implement viable screening programs for vulnerable children, and is particularly salient given that many characteristics common to homelessness are also associated with child psychopathology (Bitsko, et al., 2016). We contextualize this study in relation to evidence on implementing Positive Behavioral Interventions and Supports in low-resource settings (e.g., Atkins, et al., 2003).