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Background: This study aimed to determine whether subjective dimensions of recovery such as empowerment are associated with self-report of more objective indicators such as level of participation in the community and income from employment. A secondary aim was to investigate the extent to which diagnosis or other consumer characteristics mediated any relationship between these variables. Methods: The Community Integration Measure, the Empowerment Scale, the Recovery Assessment Scale, and the Camberwell Assessment of Needs Short Appraisal Schedule were administered to a convenience sample of 161 consumers with severe mental illness. Results: The majority of participants had a primary diagnosis of schizophreniform, anxiety/depression or bipolar affective disorder. The Empowerment Scale was quite strongly correlated with the Recovery Assessment Scale and the Community Integration Measure. Participants with a diagnosis of bipolar affective disorder had signifi cantly higher recovery and empowerment scores than participants with schizophrenia or depression. Both empowerment and recovery scores were significantly higher for people engaged in paid employment than for those receiving social security benefits. Conclusions: The measurement of subjective dimensions of recovery such as empowerment has validity in evaluation of global recovery for people with severe mental illness. A diagnosis of bipolar disorder is associated with higher scores on subjective and objective indicators of recovery.

ABSTRACTThis paper describes the implementation of a specific, community‐based, multi‐family group (MFG) intervention strategy (Families and Schools Together [FAST] babies) aimed at improving the outcomes for infants of teenage mothers in 11 Canadian communities. The aims of this social work group intervention were (1) to engage the teenage mothers into a socially inclusive experience that might challenge the social disapproval they often experience, (2) to enhance the mother–infant bond, while increasing feelings of parental efficacy, and (3) to enhance the social context of the teenage mother by reducing stress, social isolation and intergenerational family conflict. Groups were co‐led by teams of service users (a young mother, a grandmother of the baby of a teenage mother and a father of the baby of a teenage mother) collaborating with multi‐agency professionals (health visitors and social workers). Teams that reflected the ethnic diversity of the participating family members were trained to facilitate eight weekly group meetings. They showed respect for the young women's 'voice', and supported her 'choice' to prioritize motherhood as her defining identity. The meetings comprised a range of activities, including crafts and singing, discussion of 'conflict scenarios' in cross‐familial, cross‐generational groups, infant massage delivered to babies by the young mothers, grandmother support groups, and a shared community meal. Where necessary, teams made referrals for specialist help. One hundred twenty‐eight young mothers came once to 17 groups, and 90% graduated having attended a minimum of six sessions. Evaluation data from mothers and grandmothers showed positive change when comparing pre and post, based on standardized questionnaires. One‐tailed, pairedt‐tests showed statistically significant increases in parental self‐efficacy for the teenage mothers, improved parent–child bonds, reductions in stress and family conflict, and increases in social support. Given that rates of teenage pregnancy in the UK are among the highest in Europe, this paper concludes with a discussion of the feasibility and possible merits of introducing FAST babies to England.

OBJECTIVES: To examine barriers and facilitators to sustaining a sexual health continuous quality improvement (CQI) programme in clinics serving remote Aboriginal communities in Australia. DESIGN: Qualitative study. SETTING: Primary health care services serving remote Aboriginal communities in the Northern Territory, Australia. PARTICIPANTS: Seven of the 11 regional sexual health coordinators responsible for supporting the Northern Territory Government Remote Sexual Health Program. METHODS: Semi-structured in-depth interviews conducted in person or by telephone; data were analysed using an inductive and deductive thematic approach. RESULTS: Despite uniform availability of CQI tools and activities, sexual health CQI implementation varied across the Northern Territory. Participant narratives identified five factors enhancing the uptake and sustainability of sexual health CQI. At clinic level, these included adaptation of existing CQI tools for use in specific clinic contexts and risk environments (eg, a syphilis outbreak), local ownership of CQI processes and management support for CQI. At a regional level, factors included the positive framing of CQI as a tool to identify and act on areas for improvement, and regional facilitation of clinic level CQI activities. Three barriers were identified, including the significant workload associated with acute and chronic care in Aboriginal primary care services, high staff turnover and lack of Aboriginal staff. Considerations affecting the future sustainability of sexual health CQI included the need to reduce the burden on clinics from multiple CQI programmes, the contribution of regional sexual health coordinators and support structures, and access to and use of high-quality information systems. CONCLUSIONS: This study contributes to the growing evidence on how CQI approaches may improve sexual health in remote Australian Aboriginal communities. Enhancing sustainability of sexual health CQI in this context will require ongoing regional facilitation, efforts to build local ...

Objectives To examine barriers and facilitators to sustaining a sexual health continuous quality improvement (CQI) programme in clinics serving remote Aboriginal communities in Australia. Design Qualitative study. Setting Primary health care services serving remote Aboriginal communities in the Northern Territory, Australia. Participants Seven of the 11 regional sexual health coordinators responsible for supporting the Northern Territory Government Remote Sexual Health Program. Methods Semi-structured in-depth interviews conducted in person or by telephone; data were analysed using an inductive and deductive thematic approach. Results Despite uniform availability of CQI tools and activities, sexual health CQI implementation varied across the Northern Territory. Participant narratives identified five factors enhancing the uptake and sustainability of sexual health CQI. At clinic level, these included adaptation of existing CQI tools for use in specific clinic contexts and risk environments (eg, a syphilis outbreak), local ownership of CQI processes and management support for CQI. At a regional level, factors included the positive framing of CQI as a tool to identify and act on areas for improvement, and regional facilitation of clinic level CQI activities. Three barriers were identified, including the significant workload associated with acute and chronic care in Aboriginal primary care services, high staff turnover and lack of Aboriginal staff. Considerations affecting the future sustainability of sexual health CQI included the need to reduce the burden on clinics from multiple CQI programmes, the contribution of regional sexual health coordinators and support structures, and access to and use of high-quality information systems. Conclusions This study contributes to the growing evidence on how CQI approaches may improve sexual health in remote Australian Aboriginal communities. Enhancing sustainability of sexual health CQI in this context will require ongoing regional facilitation, efforts to build local ...