B R DeForge

University of Maryland, Baltimore, Baltimore, MD, United States

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Publications (51)174.44 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Social capital has been extensively discussed in the literature as building blocks that individuals and communities utilize to leverage system resources. Similarly, some families also create capital, which can enable members of the family, such as children, to successfully negotiate the outside world. Families in poverty confront serious challenges in developing positive family capital, because of lack of resources. For those families that are successful in developing positive family capital, family capital can help to create positive outcomes for family interactions. Thus, family capital can provide information about opportunities, exert influence on agents who make decisions involving the actor, provide social credentials that indicate a connection to a social network, and reinforce the actor's identity and recognition, which maintains access and entitlement to these social resources.
    Journal of Family Social Work 01/2011; 14(1):68-85.
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    ABSTRACT: This study explored the relationship between personal resources and previous adverse life events such as homelessness and depression. Participants were recruited from two church sponsored multisite social service centers in Anne Arundel County, Maryland. The interview included demographics and several standardized scales to assess history of homelessness, medical history, personal resources, and depressive symptoms. A hierarchical multiple regression analysis revealed that participants with higher levels of depressive symptoms were older, had a history of homelessness, had more health problems, had a history of mental illness, and had lower self-esteem, mastery, and mattering. A subanalysis indicated that individuals who had experienced homelessness at or before age 21 had higher levels of depressive symptoms than those who were first homeless as an adult. Previous history of homelessness, especially before age 21, and lack of personal resources may place individuals at risk for psychological distress, including higher levels of depressive symptoms.
    Journal of Loss and Trauma 01/2008; 13:222-242. · 1.03 Impact Factor
  • John R. Belcher PhD, MDiv, LCSW-C, Bruce R. Deforge PhD
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    ABSTRACT: Many faith-based organizations (FBO) provide services to poor people. A major challenge for these organizations is to determine who is eligible to receive services. Thus, these organizations seek to make sure that that the poor are “truly worthy” and do not take advantage of a particular charity. The purpose of the study is to determine the kinds of barriers to service delivery that confront volunteers as they provide services to the poor. Volunteers possess the motivation to assist; however, many volunteers are given limited training, which may only include a basic understanding of the resources available at the center. We used a combination of qualitative methodologies to observe two FBOs in Anne Arundel County, Maryland. We observed and interviewed a total of 24 volunteers; 12 from each site, over a 3-month period. The two sites were similar in that they were faith-based and relied on volunteers. One site was located in a middle to lower economic area and the other site was located in a more affluent area of the county. Support provided included donations of food and financial assistance for eviction, utilities, and other emergencies. From this qualitative analysis, four working hypotheses emerged: (1) Volunteers expressed a sense of frustration over the limited resources and the increasing number of people in need; (2) Many volunteers expressed frustration that increasing burdens limited their ability to utilize the centers as a place to obtain friendship and social networks; (3) Volunteers expressed concerns and praise for the leadership at the two sites, and (4) Volunteers commented on how their faith influenced their decision to volunteer. The authors explore methods to address these challenges so clients in need can be better served.
    Journal of Religion & Spirituality in Social Work 01/2007; 26(4):1-19.
  • Young-Ju Kim, Nilda Peragallo, Bruce DeForge
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    ABSTRACT: Little is known about predictors of participation and attrition in HIV prevention programs for socially deprived Latino women. The purpose of this study was to examine factors that predict program participation and attrition among Latino women in a community-based, culturally specific HIV risk reduction intervention. This was a cross-sectional comparison of baseline data drawn from a randomized HIV risk reduction trial. Information was drawn from study subjects residing in a predominately Latino low-income community in Chicago. Among 404 study subjects in the intervention group, 214 of Latino women who had attended at least 5 of 6 intervention sessions were considered participants. One hundred and twelve women who never attended and 29 of women who attended fewer than 3 sessions were considered dropouts. The baseline data of program participants were compared to those of dropouts. The influence of the following factors on program participation was examined: sociodemographic characteristics, self-esteem, HIV knowledge, intimate partner violence, depression, and communication with partner. Logistic regression analysis showed that Mexican women were more likely to participate in the intervention program than Puerto Rican women (odds ratio (OR)=1.88, 95% confidence interval (CI)=1.64, 4.23). Other significant predictors of program participation included: being older (OR=1.08, 95% CI=1.03, 1.14), unemployed (OR=0.46, 95% CI=0.25, 0.83), having higher risk reduction behavior intentions score (OR=1.16, 95% CI=1.06, 1.26), and lower level of depressive symptoms (OR=0.97, 95% CI=0.95, 0.99). The recruitment and retention strategies should be developed by considering those important predictors of intervention participation to prevent Latino women from dropping out of the HIV prevention program.
    International Journal of Nursing Studies 08/2006; 43(5):527-34. · 2.25 Impact Factor
  • Bruce R. Deforge, John R. Belcher
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    ABSTRACT: A longitudinally based discharge planning and treatment model that integrates essential components of other successful approaches (PACT, PACED, and Bridge to Discharge) is described. The development of linkages between the inpatient and community mental health providers during the early stages of hospitalization could improve the continuity of care and establish an aftercare plan rooted in existing community resources. Placing the client's need first will ensure a smoother transition from the structure of the inpatient ward to the community while maintaining continuity of care and reducing potential re-admissions to the hospital. Potential barriers that may prevent the adoption and implementation of such a system are discussed. Belcher and DeForge (2005) in Part 1 provided a review of case management and discharge planning, as well as a critique of case management models. In Part 2, DeForge and Belcher (2005) present and describe the components of the longitudinally based discharge planning and treatment model (LDPTM).
    Social Work in Mental Health 07/2005; 3(4):33-61.
  • John R Belcher, Bruce R DeForge, Jayshree S Jani
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    ABSTRACT: Inner-city trauma centers often provide care for disproportionately indigent populations who are victims of violence. Many of these victims of violence often return to the trauma center with more violent injuries. Research has shown that a majority of these individuals who return to the trauma center for care are expensive to treat, are uninsured and have significant social problems. Two potential policy approaches are discussed: (1) the use of violence prevention programs to attempt to reduce violence in the immediate community and subsequently reduce the number of victims of violence who are treated in trauma centers and (2) the use of aftercare and discharge models that form an alliance between the trauma center and social service providers in the community. Nontraditional interventions will require the collaboration with hospital departments (emergency medicine, surgery, trauma, social work) and outside agencies, such as the courts and probation and parole. Case management, discharge planning, continuous care treatment teams, and violence intervention models offer positive alternatives to the current method of addressing the multiple problems of victims of violence who frequent the ED.
    Journal of Health & Social Policy 02/2005; 21(2):17-34.
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    ABSTRACT: HIV infection has increased within the Latina community more than in any other ethnic or racial group within the United States. Latinas comprise only 13% of the U.S. population, yet they account for 20% of the cumulative reported cases of AIDS. The purpose of the study was to evaluate a randomized culturally tailored intervention to prevent high-HIV-risk sexual behaviors for Latina women residing in urban areas. Mexican and Puerto Rican women (18-44 years of age; N = 657) who were sexually active during the previous 3 months were recruited and randomized into intervention and control groups. The intervention, facilitated by bilingual, bicultural, trained Latina women, consisted of culturally tailored sessions on understanding their bodies, HIV/AIDS and sexually transmitted diseases, condoms (myths and use), negotiating safer sex practices, violence prevention, and partner communication. Bivariate and multivariate analyses assessed changes from baseline. The intervention improved HIV knowledge, partner communication, risk-reduction behavioral intentions, and condom use, and decreased perceived barriers to condom use. The efficacy of a culturally-sensitive intervention to reduce HIV/AIDS-risk behaviors in Latina women was demonstrated in the current study.
    Nursing Research 01/2005; 54(2):108-18. · 1.56 Impact Factor
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    ABSTRACT: This paper explores the subject of homeless from the perspective of researchers. The authors show that the prevailing model of social science inquiry tends to overlook the broader systemic causes of homelessness. As an alternative, the authors propose the use of participatory action research. Over time, this approach should bring together victims of homelessness with researchers of homelessness and efforts to address the problem of homelessness should improve.
    Journal of Progessive Human Services. 01/2005; 16(2):5-23.
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    ABSTRACT: Inner-city trauma centers often provide care for disproportionately indigent populations who are victims of violence. Many of these victims of violence often return to the trauma center with more violent injuries. Research has shown that a majority of these individuals who return to the trauma center for care are expensive to treat, are uninsured and have significant social problems. Two potential policy approaches are discussed: (1) the use of violence prevention programs to attempt to reduce violence in the immediate community and subsequently reduce the number of victims of violence who are treated in trauma centers and (2) the use of aftercare and discharge models that form an alliance between the trauma center and social service providers in the community. Nontraditional interventions will require the collaboration with hospital departments (emergency medicine, surgery, trauma, social work) and outside agencies, such as the courts and probation and parole. Case management, discharge planning, continuous care treatment teams, and violence intervention models offer positive alternatives to the current method of addressing the multiple problems of victims of violence who frequent the ED.
    Journal of Health & Social Policy 01/2005; 21(2):17-34.
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    ABSTRACT: Homelessness is a major public health problem among persons with severe mental illness (SMI). Cost-effective programmes that address this problem are needed. To evaluate the cost-effectiveness of an assertive community treatment (ACT) programme for these persons in Baltimore, Maryland. A total of 152 homeless persons with SMI were randomly allocated to either ACT or usual services. Direct treatment costs and effectiveness, represented by days of stable housing, were assessed. Compared with usual care, ACT costs were significantly lower for mental health in-patient days and mental health emergency room care, and significantly higher for mental health out-patient visits and treatment for substance misuse. ACT patients spent 31% more days in stable housing than those receiving usual care. ACT and usual services incurred $242 and $415 respectively in direct treatment costs per day of stable housing, an efficiency ratio of 0.58 in favour of ACT. Patterns of care and costs varied according to race. ACT provides a cost-effective approach to reducing homelessness among persons with severe and persistent mental illnesses.
    The British Journal of Psychiatry 05/1999; 174:346-52. · 6.61 Impact Factor
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    ABSTRACT: African Americans have higher rates of hypertension and poorer health status than their white counterparts. This study assessed the relationship between health status, cardiovascular risk factors, and measured blood pressure. Free blood pressure screenings were performed at businesses and organizations located in west Baltimore. All individuals with cardiovascular risk factors were offered health education. Also, participants with a measured blood pressure of > or = 140/90 mm Hg were referred for free medical treatment. Participants completed a questionnaire that included demographics, cardiovascular risk factors, the Medical Outcomes Study SF 36, and two tests on cholesterol and heart disease knowledge. A total of 1389 African-American men and women were screened; 20% were found to have high normal blood pressure and 31% had stage 1 hypertension or higher. Those with hypertension reported lower physical functioning and poorer general health than those without high blood pressure. When compared with US normative data, participants reported higher levels in vitality and physical and emotional role functioning, more bodily pain, and poorer general health, but they were similar in physical functioning, social functioning, and mental health. Preliminary data suggest that hypertension does have an effect on health function.
    Journal of the National Medical Association 12/1998; 90(11):658-64. · 0.91 Impact Factor
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    ABSTRACT: This experiment evaluated the effectiveness of an innovative program of assertive community treatment (ACT) for homeless persons with severe and persistent mental illnesses. One hundred fifty-two homeless persons with severe and persistent mental illness were randomized to either the experimental ACT program or to usual community services. Baseline assessments included the Structured Clinical Interview for DSM-III-R, Quality-of-Life Interview, Colorado Symptom Index, and the Medical Outcomes Study 36-Item Short Form Health Survey. All assessments (except the Structured Clinical Interview) were repeated at the 2-, 6-, and 12-month follow-up evaluations. Subjects in the ACT program used significantly fewer psychiatric inpatient days, fewer emergency department visits, and more psychiatric outpatient visits than the comparison subjects. The ACT subjects also spent significantly more days in stable community housing, and they experienced significantly greater improvements in symptoms, life satisfaction, and perceived health status. Relative to usual community care, the ACT program for homeless persons with severe and persistent mental illness shifts the locus of care from crisis-oriented services to ongoing outpatient care and produces better housing, clinical, and life satisfaction outcomes.
    Archives of General Psychiatry 12/1997; 54(11):1038-43. · 13.77 Impact Factor
  • L.C.S.W.-C. John R. Belcher Ph.D., Bruce R. DeForge Ph.D.
    The Journal of Mental Health Administration 09/1997; 24(4).
  • B R DeForge, DAVID M. BARCLAY
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    ABSTRACT: 199 homeless men were administered the General Mattering Scale to assess their belief that they mattered to others in their community. Analysis indicated that homeless men felt that they were important to others, that others pay attention to them, that they would be missed by others if they went away, that people were interested in what they had to say, and that others depended on them. The General Mattering Scale displayed strong internal consistency (Cronbach alpha of 85).
    Psychological Reports 05/1997; 80(2):429-30. · 0.44 Impact Factor
  • J R Belcher, B R DeForge
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    ABSTRACT: This article explores the role of the state hospital in providing long-term care. It is argued that long-term care is an important part of a mental health system, specifically for people with severe mental illness. The state hospital can be made to function more efficiently and also provide needed long-term care.
    The Journal of Mental Health Administration 02/1997; 24(1):64-71.
  • A F Lehman, E Kernan, B R DeForge, L Dixon
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    ABSTRACT: This study assessed the relationship between homelessness and specific quality-of-life problems for persons with severe and persistent mental illness. The objective and subjective quality of life of 106 homeless persons with severe mental illness who lived on the streets or in shelters in Baltimore was compared with that of 146 domiciled persons with severe mental illness who lived in the community. Objective and subjective quality of life of the homeless subjects was clearly worse than that of the domiciled group in the areas of living situation, family and social relations, employment, daily activities, and legal and safety problems. Homeless subjects were also less likely to have federal disability entitlements. Poorer quality of life is associated with homelessness among persons with severe mental illness. Their quality of life may be improved by efforts to increase their access to disability entitlements and treatment services and to help them develop supportive social networks.
    Psychiatric Services 10/1995; 46(9):922-6. · 2.01 Impact Factor
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    ABSTRACT: This study examined the cholesterol knowledge of inner-city community residents, who are representative of individuals in lower socio-economic groups. "Cholesterol Pursuit," a 10-item cholesterol knowledge test distributed by the National Heart, Lung, and Blood Institute, was administered to 316 residents in eight local grocery stores. The average percentage of correct answers was 65.8%. Community residents in a large, urban city were fairly knowledgeable about blood cholesterol reduction, but there were misconceptions concerning the importance of eggs, fish oil, and olive oil, and with foods marked "no cholesterol." White community residents appeared to be slightly better informed about reducing blood cholesterol. Identification of misperceptions concerning cholesterol will guide future education programs for these specific communities.
    Journal of the National Medical Association 09/1995; 87(8):533-6. · 0.91 Impact Factor
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    ABSTRACT: The success of the Program for Assertive Community Treatment (PACT) has led to its replication with different client populations, especially those who are underserved by the traditional treatment system. This paper describes a program in Baltimore that has adapted the PACT model to serve homeless persons with severe mental illness. Although the essential ingredients and philosophy of the original model were maintained, the original team approach has been modified by the use of "miniteams." All staff share knowledge of all program clients through formal mechanisms such as daily meetings; however, each client is assigned to a miniteam composed of a clinical case manager, a psychiatrist, and a consumer advocate. Another deviation from the PACT model is that services can be time limited. The authors describe four phases of treatment and problems, including interventions characteristic of each phase.
    Psychiatric Services 08/1995; 46(7):684-8. · 2.01 Impact Factor
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    ABSTRACT: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that health professionals recognize the importance of drug-nutrient interactions and educate patients to prevent adverse effects. Drug-nutrient interactions are an important issue in medical practice, but it is not clear how or if physicians are trained in this issue. This investigation was a needs assessment that examined attitudes and knowledge about drug-nutrient interactions that was examined in a national sample of 834 family medicine residents in 56 residency programs. Most reported they had little or no formal training in drug-nutrient interactions in medical school (83%) or residency (80%). However, 79% believed it was the physician's responsibility to inform patients about drug-nutrient interactions, although many thought pharmacists (75%) and dietitians (66%) share this responsibility. Overall, residents correctly answered 61% +/- 19 of fourteen drug-nutrient interaction knowledge items. There was a slight increase in drug-nutrient knowledge as year of residency increased. Physicians' knowledge of drug-nutrient interactions may be improved by including nutrition education in the topics taught by physicians, nutritionists, and pharmacists using several educational strategies. Nutrition educators in particular can play a role in curriculum development about drug-nutrient interactions by developing, refining, and evaluating materials and educational tools. Nutrition educators need to provide this information in academic settings for the training of all health professionals as well as in patient education settings such as hospitals and public health clinics.
    Journal of the American College of Nutrition 05/1995; 14(2):137-43. · 1.74 Impact Factor
  • Schizophrenia Research 04/1995; 15(1):218-219. · 4.59 Impact Factor

Publication Stats

631 Citations
174.44 Total Impact Points

Institutions

  • 1988–2011
    • University of Maryland, Baltimore
      • • School of Social Work
      • • Department of Medicine
      Baltimore, MD, United States
  • 1997–2006
    • Loyola University Maryland
      Baltimore, Maryland, United States
  • 1992
    • Cornell University
      • Department of Nutritional Sciences
      Ithaca, NY, United States