A Comparative Analysis of Competency Frameworks for Youth Workers in the Out-of-School Time Field

Research suggests that the quality of out-of-school time (OST) programs is related to positive youth outcomes and skilled staff are a critical component of high quality programming. This descriptive case study of competency frameworks for youth workers in the OST field demonstrates how experts and practitioners characterize a skilled youth worker. A comparative analysis of 11 competency frameworks is conducted to identify a set of common core competencies. A set of 12 competency areas that are shared by existing frameworks used in the OST field are identified. The age of youth being served, descriptions of mastery for each competency area, an emphasis on developing mid-level managers, and incorporating research emerge as factors that should be addressed in future competency frameworks

A Review of the Global Literature on Dental Therapists

OBJECTIVE: Access to adequate oral health care is deficient in many parts of the world. Many countries are now using dental therapists to increase access, particularly for children. To inform the discussion on dental therapists in the workforce, particularly in the United States, the W.K. Kellogg Foundation funded a review of the global literature to identify as many documents as possible related to the practice of dental therapists since the establishment of the School Dental Service in New Zealand in 1921. METHODS: Consultants in each of the countries considered to have a substantive literature on dental therapists were asked to participate in the research; seventeen in total. In addition to identifying and reviewing published articles, a focus of the research was on identifying \u27gray\u27 documents. Standard databases were searched for key words associated with dental therapists. In addition, searches were conducted of the governmental and dental association websites of all countries known to have dental therapists in their oral health workforce. RESULTS: Fifty-four countries, both developing and developed, were identified where dental therapists are members of the workforce. Eleven hundred documents were identified from 26 of these countries, with over 2/3 of them cited in the published monograph. Reliable evidence from the related literature and verbal communication confirmed the utilization of dental therapists in an additional 28 countries. Thirty-three of the countries were members of the Commonwealth of Nations, suggesting a mechanism of spread from New Zealand. Variable lengths of training/education existed for dental therapists with the tradition being 2 years postsecondary. In a few countries, the training of therapists and hygienists is now being combined in a three academic year program. Historically, dental therapists have been employed by government agencies caring for children, typically in school-based programs. Initiatives in some countries allow limited care for adults by dental therapists with additional training. CONCLUSIONS: The evidence indicates that dental therapists provide effective, quality, and safe care for children in an economical manner and are generally accepted both by the public and where their use is established, by the dental profession

Plan Characteristics and SSI Enrollees' Access to and Quality of Care in Four TennCare MCOs

OBJECTIVE: To assess hypotheses about which managed care organization (MCO) characteristics affect access to care and quality of care—including access to specialists, providers' knowledge about disability, and coordination of care—for people with disabilities. DATA SOURCES/STUDY SETTING: Survey of blind/disabled Supplemental Security Income (SSI) enrollees in four MCOs serving TennCare, Tennessee's Medicaid managed care program, in Memphis, conducted from 1998 through spring 1999. STUDY DESIGN: We compared enrollee reports of access and quality across the four MCOs using regression methods, and we use case study methods to assess whether patterns both within and across MCOs are consistent with the hypotheses. DATA COLLECTION: We conducted computer-assisted telephone surveys and used regression analysis to compare access and quality controlling for enrollee characteristics. PRINCIPAL FINDINGS: Although the four MCOs' characteristics varied, access to providers, coordination of care, and access to some services were generally similar across MCOs. Enrollees in one plan, the only MCO with a larger provider network and that paid physicians on a fee-for-service basis, reported their providers were more knowledgeable, and they had more secondary preventive care visits. Differences found in access to specialists and delays in approving care appear to be unrelated to characteristics reported by the MCOs, but instead may be related to how tightly utilization is reviewed. CONCLUSIONS: Plan networks, financial incentives, utilization management methods, and state requirements are important areas for further study, and, in the meantime, ongoing monitoring of SSI enrollees in each MCO may be important for detecting problems and successes