Claudia J Coulton

Case Western Reserve University | CWRU · Jack, Joseph and Morton Mandel School of Applied Social Sciences

This study uses linked administrative records to examine the disruptive effects of eviction on adults and children in low-income households. By linking eviction filings for the City of Cleveland, Ohio, with administrative records, we depict residential mobility, homeless shelter use, and children’s school attendance for households, spanning a perio...

We study public assistance participation among homeless shelter users, characterizing the trajectories of public assistance receipt for individuals before and after they enter shelters and analyzing the influence of public assistance participation on subsequent shelter use. Our analysis identifies three distinct groups of shelter users based on per...

Final report of a study to better understand how seriously ill patients value certain common symptoms and outcomes.

Insight into the characteristics and system experiences for youth who touch both the child welfare and juvenile justice systems has increased over the last decade. These youth are typically studied as one population and referred to as “crossover youth.” While this literature contributes valuable insight into who crossover youth are, studies are vir...

The challenge of complex social issues drives the need for data systems that can connect information across multiple service delivery systems. Integrated data systems provide significant value for needs assessment, program planning, policy decision making, and collective impact evaluation across a range of social issues. This case study describes a...

Children placed in foster care are at risk for becoming involved with the juvenile justice system. This study documents the rates at which children involved with foster care enter the juvenile justice system (crossover or dually involved), and the factors associated with this risk. We utilize multiple birth cohorts and prospective, longitudinal dat...

A number of place-based policies attempt to deconcentrate poverty, yet not enough is known about how the socioeconomic mix of low-income neighborhoods evolves nor the role of residential mobility in this evolution. This study focuses on changes in low-income neighborhoods as they transpire at the micro level of housing unit turnover. Using a unique...

A growing body of research has explored the degree to which nonstandard work schedules affect workers and their families. However, relatively few studies to date have examined the relationship between parental nonstandard work schedules and adolescents’ academic achievement, and even less attention has been paid to Asian populations. This study aim...

Defining the proper geographic scale for built environment exposures continues to present challenges. In this study, size attributes and exposure calculations from two commonly used neighborhood boundaries were compared to those from neighborhoods that were self-defined by a sample of 145 urban minority adolescents living in subsidized housing esta...

Background and Purpose: There is increasing interest in understanding the youth in both the child welfare and juvenile justice systems. These “crossover” or “dually involved” youth may face greater challenges than youth in juvenile justice or child welfare alone. Yet, empirical evidence is limited. In this sense, the purpose of this study is to exp...

Investments in high-quality early care and education have been shown to reap societal benefits across the lives of the children served. A key intervention point is in the lives of 3- to 5-year olds during the period prior to entering kindergarten. Many jurisdictions have developed broad-based prekindergarten initiatives. This study reports on a pil...

Purpose: Neighborhood is a social and geographic concept that plays an increasingly important role in research and practice that address disparities in health and well-being of populations. However, most studies of neighborhoods as well as community initiatives geared toward neighborhood improvement make simplifying assumptions about boundaries, of...

Well-being can be conceptualized and measured in a number of ways and at multiple ecological and ecocultural levels. At the neighborhood or community level, indices of well-being can be constructed using administrative data such as census measures as well as by considering the views of neighborhood residents, both children and adults. In this paper...

Neighborhood is a social and geographic concept that plays an increasingly important role in research and practice that address disparities in health and well-being of populations. However, most studies of neighborhoods, as well as community initiatives geared toward neighborhood improvement, make simplifying assumptions about boundaries, often rel...

Residential mobility is a process that changes lives and neighborhoods. Efforts to build strong communities are unavoidably caught up with this dynamic but have insufficient understanding of its complexities. To shed light on the underlying forces of residential mobility, this study uses a unique panel survey from the Casey Foundations Making Conne...

Research has documented that the transition from Temporary Assistance for Needy Families (TANF) can be a critical period that results in elevated stress for families. The present study utilizes administrative data to examine the experiences of families exiting TANF and factors that influence subsequent child maltreatment, with particular focus on t...

The growing recognition that place matters has led to numerous foundation- and government-sponsored initiatives that attempt to simultaneously strengthen neighborhoods and address the needs of families that live there. Despite the centrality of the concept of neighborhood, these place-based initiatives have few tools to understand how residents ide...

This paper addresses the policy recommendation that child protection efforts be reoriented to the neighborhood level. Residents of neighborhoods with varying rates of reported child maltreatment were questioned as to the roles of neighbors and/or the government in preventing child abuse and neglect. Residents in all neighborhoods were more optimist...

Purpose: The recognition that place matters has led to several generations of community initiatives that attempt to address conditions in poor neighborhoods by changing them from within. However, high levels of residential mobility are seen as a challenge for this work. While high levels of residential turnover arguably undermine social cohesivenes...

A growing literature on small-area effects has linked neighborhood conditions with indicators of child well-being. This paper addresses some of the challenges in identifying and understanding these linkages, with a focus on children’s definitions and perceptions of their neighborhood geographies. The study included 60 children aged 7 to 11 and one...

The six papers from five continents in this collection reflect growing awareness of the importance of small areas for understanding the context of child well-being. The papers point to the need for concerted efforts to capture the contexts in which children and families live and the need for innovative approaches to these issues. The papers lend th...

Participation in organized activities outside of school can prevent poor outcomes in at-risk children and youth. In low income neighborhoods, though, there may be barriers to involving children and youth in these activities. This study examined the degree to which parental community involvement and neighborhood safety and disadvantage affected part...

Objective: This study examined utilization and physical activity levels at renovated compared to unrenovated school playgrounds. Methods: Ten unrenovated and ten renovated school playgrounds (renovated at least a year prior) in Cleveland, OH were matched on school and neighborhood characteristics. Using direct observation (SOPLAY), the number of...

Indicators are measures of the condition or status of populations or institutions that can be compared over time or between places and groups. In recent years, there has been growing interest in developing indicators at the local level that can reflect on the well being of children and their families in communities. Rather than being seen as the co...

This article reviews some conceptual and methodological issues which arise in evaluating screening programs, screening protocols, lead time, sensitivity and specificity, and base rates among others. Benefits of screening need to be separated from those of early intervention. Replicable protocols are needed to strengthen studies of the benefits of p...

A perennial issue confronting administrators is the degree to which employees' behavior should be directed to assure attainment of organizational goals. This issue takes on an even more complex dimension when the organization is a professional organization. Individual professional goals can come into conflict with organizational goals. This conflic...

This article examines the effect of job access on employment outcomes for welfare recipients in Cleveland, Ohio, leaving assistance during 1998—2000. A rich longitudinal dataset is employed, combining administrative and survey data with multiple measures of access to and competition for jobs. The focus is on both a population and a range of measure...

In implementing broad community initiatives, the ability to assess the delivery of services is a distinct challenge. Yet, understanding both the magnitude and cross-usage of services by target populations is often a precursor to effective program evaluation, program improvement and additional program planning. This research examines the extent to w...

As communities across the United States work to meet the early care and education needs of young children, more research is needed to inform decision making at many levels. One key dimension of this is having clarity about the relative availability of care in light of demographic trends and geographic dispersion. The present study demonstrates a me...

This article reviews how life table analysis can improve on cross-sectional analysis of disproportionality by comparing African American and Caucasian children's risk of being investigated for child maltreatment or being placed in foster care before their 10th birthday. We then highlight the application of life table results in advocacy. Newspaper...

Adverse child outcomes tend to be concentrated in neighborhoods with constellations of adverse conditions and risk factors. This paper examines the challenges of developing meaningful and useful indicators of child well-being at the level of the neighborhood. Recent technological advances have made it more feasible for communities to develop neighb...

To review the literature on the relationships between neighborhoods and child maltreatment and identify future directions for research in this area. A search of electronic databases and a survey of experts yielded a list of 25 studies on the influence of geographically defined neighborhoods on child maltreatment. These studies were then critically...

There is a growing concern in our society about the proper application of life-sustaining medical treatments. This concern has been stimulated by both the explosion in medical technology and the increasing emphasis on patients’ rights and autonomy in clinical decisionmaking. Technological progress enables us to prolong or sustain life, even when it...

Community is widely acknowledged as a fundamental aspect of social work practice and this formulation distinguishes social work from other professions. Because of this longstanding tradition, the field needs to make a greater investment in producing scientific knowledge to enable community change and to incorporate community context into practice....

The purpose of this article is to: (1) illustrate the application of life table methodology to child abuse and neglect report data and (2) demonstrate the use of indicators derived from the life tables for monitoring the risk of child maltreatment within a community. Computerized records of child maltreatment reports from a large, urban county in O...

Keynote speaker: Dr. Claudia Coulton, Ph.D., Lillian F. Harris Professor and Co-Director of the Center on Urban Poverty and Social Change, Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio - "Community in Social Work Research"

The capacity of communities to prevent violence is examined from three perspectives: youth violence, child maltreatment, and intimate partner violence. The analysis suggests that community social control and collective efficacy are significant protective factors for all three types of violence, but these need to be further distinguished for their r...

Abstract This study investigated whether employment,levels and characteristics of the jobs that women,obtain upon leaving TANF have changed over 12 quarters from Q4 1996 through Q3 1999 as welfare reform has gone into effect. The central hypothesis was that employment,levels and quality of the initial jobs obtained by welfare leavers declined over...

Profound place-based disparities in opportunity structures and social and institutional resources affect labor market success, especially for the large numbers of welfare recipients who live in urban areas. This article argues that social and economic processes within metropolitan areas sort jobs and job seekers geographically and segment their net...

A study assessed Temporary Assistance for Needy Families (TANF) implementation and effects in Cuyahoga County between 1992-2000. It used field research, surveys and interviews of current and former welfare recipients, state and county welfare and employment records, and indicators of social and economic trends. Findings indicated Cuyahoga County re...

Awareness of worsening conditions in urban areas has led to a growing interest in how neighborhood context affects children. Although the ecological perspective within child development has acknowledged the relevance of community factors, methods of measuring the neighborhood context for children have been quite limited. An approach to measuring ne...

Neighborhood influences on children and youth are the subjects of increasing numbers of studies, but there is concern that these investigations may be biased, because they typically rely on census-based units as proxies for neighborhoods. This pilot study tested several methods of defining neighborhood units based on maps drawn by residents, and co...

The purpose of this study, as part of a larger study on neighborhoods and child maltreatment, was to determine how parents residing in neighborhoods with differing profiles of risk for child maltreatment reports defined child abuse and neglect and viewed its etiology. Parents (n = 400) were systematically selected from neighborhoods (n=20) with dif...

To better understand how neighborhood and individual factors are related to child maltreatment. Using an ecological framework, a multi-level model (Hierarchical Linear Modeling) was used to analyze neighborhood structural conditions and individual risk factors for child abuse and neglect. Parents (n = 400) of children under the age of 18 were syste...

One central thesis in recent urban poverty research, that social context has further disadvantaged poor residents of central-city neighbourhoods, has not been tested empirically. This analysis examines the strength of relationships among adverse social conditions in neighbourhoods in one North American industrial city. Using exploratory and confirm...

Although it is well documented that child maltreatment exerts a deleterious impact on child adaptation, much less is known about the precise etiological pathways that eventuate in child abuse and neglect. This paper reports on a multimethod ecological study of the relationship between neighborhood structural factors and child maltreatment reports i...

This paper examines trends that have contributed to the changing awareness and understanding of poverty and community in the United States. It also describes and comments on the recent amalgam of place-based and people-based approaches known as comprehensive community initiatives (CCIs) and community building that have grown up as a result of the n...

The geographic concentration of poverty and affluence is examined for the 100 largest metropolitan areas. Concentration of poverty and affluence are uncorrelated, but metropolitan areas can be classified into five types based on six indices of concentration and affluence. The types differ significantly in their racial and ethnic segregation, the re...

Welfare time limits and stringent work requirements, components of most states' reform plans, make employment a necessity for family survival. Yet the availability of jobs has reached new lows in many low-income communities, and steady jobs with wages that can keep a family above the poverty line are dwindling. Research on welfare incentives and re...

The recent interest in community-based practice calls for intervention strategies that are based on careful planning and thorough assessment of the ecological conditions in today's urban neighborhoods. Having access to accurate and updated community data is an essential tool. This article discusses principles for the development and strategic use o...

Objectives.-To improve end-of-life decision making and reduce the frequency of a mechanically supported, painful, and prolonged process of dying. Design.-A 2-year prospective observational study (phase I) with 4301 patients followed by a 2-year controlled clinical trial (phase II) with 4804 patients and their physicians randomized by specialty grou...

Using census and administrative agency data for 177 urban census tracts, variation in rates of officially reported child maltreatment is found to be related to structural determinants of community social organization: economic and family resources, residential instability, household and age structure, and geographic proximity of neighborhoods to co...

Using census and administrative agency data for 177 urban census tracts, variation in rates of officially reported child maltreatment is found to be related to structural determinants of community social organization: economic and family resources, residential instability, household and age structure, and geographic proximity of neighborhoods to co...

The Alcoholism Intervention is a specific therapeutic technique used to motivate an alcoholic to enter treatment; participants confront the alcoholic with the damage the drinking has done and with the consequences that will occur if treatment is rejected. According to the conflict-theory model of decision making, an alcoholic's decision to accept t...

The main determinants of rehospitalization of elderly people were studied with a longitudinal sample of 264 persons older than 60 years at a midwestern, urban, university-affiliated hospital. Path analysis was applied to survey data collected for this study. Seventeen percent of subjects were readmitted within 30 days of discharge. Controlling for...

The validity of the Health Assessment Questionnaire (HAQ) functional ability instrument was tested in 120 women with definite systemic lupus erythematosus (SLE) from rheumatology clinics at 2 local tertiary care institutions. Reliability and validity results for this population of women (mean age: 41 years +/- 13; age at diagnosis 33 years +/- 13)...

Multiple regression is widely used for the analysis of nonexperimental data by investigators in social work and social welfare. Most published studies test additive models in which the effects of each independent variable on the dependent variable are assumed to be constant across all levels of additional independent variables. Tests are seldom mad...

A framework is presented for evaluating family centers in the context of the community environment. The family centers will be created in a variety of communities and under varying auspices. Several will be selected as prototype centers and, as such, will need more elaborate evaluation plans than the others. Prototype centers will need to evaluate...

The abstract for this document is available on CSA Illumina.To view the Abstract, click the Abstract button above the document title.

The distribution of income is flattening in the United States, and an increasing number of the population is poor, despite general economic growth and rising median income. Most of the research on the plight of urban poor people relies on decennial census data and provides little information on recent developments. Further, studies at the national...

Elderly individuals with self-reported joint symptoms representing three ethnic groups (i.e., blacks [n = 105], Hispanics [n = 100], and whites of Eastern European origin [n = 112] answered questions about their use of self-care and medical care for these symptoms. Ethnic groups differed in both self-care practices and their use of medical care for...

Elderly individuals with self-reported joint symptoms representing three ethnic groups (i.e., blacks [n = 105], Hispanics [n = 100], and whites of Eastern European origin [n = 112] answered questions about their use of self-care and medical care for these symptoms. Ethnic groups differed in both self-care practices and their use of medical care for...

Involving patients in making decisions about their medical treatment and health care is a widely accepted goal. Yet there is considerable debate about what constitutes effective involvement, how much involvement is desirable, what are the benefits of involvement and how practitioners can help patients recognize and communicate their own preferences...

Discharge planning involves making choices about the type and amount of posthospital care a patient will receive within the reality of resource constraints. Elderly patients discharged from an acute-care hospital vary in their reactions to this decision-making process and the degree to which they exert final control over the decision. Perceived lac...

The Arthritis Impact Measure Scales (AIMS) have established validity and reliability in general adult populations with medically diagnosed rheumatoid arthritis. Our analysis extends this work to a community based sample of elderly individuals with self reported joint systems in 3 ethnic groups: Hispanics (N = 100), whites of Eastern European origin...

This exploratory survey of 100 patients with rheumatoid arthritis (RA) was conducted (1) to learn about the types and frequencies of disability law-related problems encountered as a result of having RA, and (2) to assess the respective relationships between the number of disability law-related problems reported and the patients' sociodemographic an...

Aspects of post-hospital care decisions were examined for elderly patients (n = 314) being discharged. Factor analysis identified 6 dimensions of the patients' perceptions of the decision-making: certainty about outcomes, family support for decision-making, restriction of choice, feeling of being rushed, control over the choice, and hypervigilance....

This article reviews some conceptual and methodological issues which arise in evaluating screening programs, screening protocols, lead time, sensitivity and specificity, and base rates among others. Benefits of screening need to be separated from those of early intervention. Replicable protocols are needed to strengthen studies of the benefits of p...

The quality of post hospital care is of growing importance as length of stay in hospitals declines and patients are discharged with greater dependency and instability in their conditions. Recovery and rehabilitation and, at times, even survival are contingent upon post hospital care being accessible and adequate. However, it is difficult to monitor...

There are few multidimensional measures of functional status in children, and none have been developed for children with juvenile arthritis (JA). This report describes an attempt to apply selected components of the Arthritis Impact Measurement Scales (AIMS), which were developed and validated for adults, to a sample of children with active JA (n =...

Patients in the most prevalent DRGs in a Medical Intensive Care Unit (MICU) were compared with their counterparts who received only routine hospital care on adjusted total hospital costs and length of stay. Costs for both groups were compared with estimated DRG payments under an all-payer system. For patients in three DRGs, measures of severity of...

Observers rated 11 aspects of the social environments of 40 community care homes. Four basic types of homes were identified through a cluster analysis of these ratings. Discriminant analysis suggested that homes in the clusters differed primarily along two dimensions: socioemotional demands and program structure. For each cluster, the main features...

"Do not resuscitate" (DNR) decisions were examined in a medical intensive care unit (MICU) of a 1,000-bed hospital. Seventy-one (14%) of 506 study patients were designated DNR; nine survived hospitalization. Severity of illness, age, and prior health were predictive of DNR orders; race and socioeconomic factors were not. The DNR patients consumed m...

With increased competition over diminishing resources in health care today, discharge planning has become a key element for hospital survival. The sudden high status now attached to this traditional social work function has caused major power struggles for control over discharge planning. Social workers have up to now succeeded in being undisputed...

Patients discharged from state psychiatric hospitals into community care homes were followed for four months. Both observers and the patients themselves rated the homes' social environments as well as the patients' needs and capabilities. Patients' functioning in the community was shown to be enhanced when there was a congruence between the patient...

Readmission to mental hospitals resulting from a lack of congruence between a patient and the environment of a community-care home is a phenomenon that does not depend primarily on patient functioning. The reactions in the environment, especially the perceptions of caretakers, are seen as crucial in decisions. Data from a survey of 58 patients (mea...

Head nurses from 78 ICUs in 37 northeast Ohio hospitals were interviewed about visiting policies. There was tremendous variation with regard to frequency and length of visits; 25% of these ICUs allowed only 2 visits/day, and 42% restricted visits to under 20 min. Most units rarely or never allowed children under 12 yr old to visit. Traditional rati...

A telephone survey of 602 randomly selected hospitals was conducted to identify existing ethics committees, i.e., those with the potential to become involved in the decision-making process in specific cases. Using the number of acute care beds as the criterion, hospitals were divided into 2 groups: (1) over 200 beds; n = 400; (2) 200 or fewer beds;...

The differences in physical and social functioning between the elderly and the general population are likely to affect the utilization of social and health services we focus on two areas: determining whether the elderly are affected by factors known to be important to service utilization among the general population; and exploring the relationship...

Current advances in discharge planning have focused on comprehensive assessment, levels of care, and reducing the length of hospital stays. However, evidence also indicates the importance of involving patients and their families in making decisions about long-term care. This article identifies nine factors related to the patients' involvement in de...

Many aspects of quality assurance programs in health care are potentially applicable in social service agencies. The author reviews some of what has been learned about quality assurance in health care, presents a comprehensive framework for quality assurance, and suggests some guidelines for the implementation of quality assurance in social service...

Post hospital care decision making is an issue for a vast number of elder persons and yet has received little attention from social work professionals. This paper reviews literature regarding attitudes of professionals, family members and patients themselves toward decision making in a hospital context. Furthermore, an exploratory study involving 4...

The efficient use of health care resources requires that patients remain in in-patient facilities only as long as is necessary. High-quality patient care requires that patients are physically, socially and psychologically prepared for leaving the hospital and that plans for their post-hospital care are adequate. The authors discuss a study of Ortho...

Social workers have always been interested in the congruence between people's needs, capacities, and aspirations and the resources, demands, and opportunities of their environments. This concept has been referred to as person-environment fit. This article describes a study that developed and tested an instrument to measure this concept within a sam...