Siouxland Social Service

Utilization Study

Regan Murray, Ph.D.and

Todd Knealing, Ph.D.Briar Cliff University

Purpose of Study Primary purpose of study was to

gain a better understanding of barriers to service utilization from the perspective of the consumer

Previous research Historically, studies have examined barriers

to service utilization from the perspective of the service providers

Recent research has shifted to perspective of the consumers and comparing differences between the perception of providers and consumers (e.g., Hopkins et al., 2011; Rosenheck et al., 1998)

Differences in viewpoints

Present study Two phases to study

Focus groups

Surveys

Focus Group 1 8 participants (majority female and

Caucasian)

Meeting lasted 1.5 hours

Focus of meeting: Names of agencies 8 questions related to participants’

experience with and overall impression of agencies

Reaction to study “I’m surprised anyone wants to take the

time to ask us this stuff.”

“It feels sometimes like we’re invisible. They [agency staff] tell us that they’re here to help us but no one really ever asks us what we think of the help. I think they just tell themselves we should be grateful for any help we’re given and that’s that. It’s kind of nice to know people actually care about this.”

Focus Group 2 12 participants (all 8 from first

group)

Meeting lasted 1.5 hours

Focus of meeting: Feedback on cover letter Feedback on survey

Survey Goal of survey was to answer the

following questions: Do respondents know where to go for

services in a variety of areas (e.g., medical, legal, educational)

How satisfied are respondents with social service agencies in a variety of domains (e.g., ease of access, staff-consumer relations) Both general and site-specific questions

Survey Surveys mailed to approximately

1500 Woodbury County residents who earned less than $15,000/year

Return rate ~15% 23 surveys not included in analysis

Additional 208 surveys collected

Results: Demographics Majority of respondents were:

Female (~67%) Between the ages of 26 and 35

(~28%) and over the age of 56 (~26%)

Caucasian (74%) Single/never married (~38)

Results: Demographics Majority of respondents had children

(~29% childless) Employed (~52%) Minority of respondents who were

employed had health insurance (~31%) Majority of respondents earned

between $5,001 and $10,000 (~51%) Majority of respondents received

additional support (~52% food stamps, ~34% SS/SSD)

Results: Knowledge of Services Majority of respondents knew

where to obtain help in a variety of domains Highest knowledge areas were for

medical care, substance abuse services, mental health services, and food

Lowest knowledge areas were for emergency shelter or help with child care

Results: Knowledge of Services Knowledge of services, however,

significantly depended on both the gender and ethnicity of the respondent

Males were less likely to know where to obtain all services compared to females

African-Americans were less likely to know where to obtain services relative to other ethnicities

Results: Knowledge of Services

Results: Agency Satisfaction Majority of respondents had favorable

opinions about the delivery of agency services. Highest ratings were in the following

categories: use services again (~68%), information about my rights (~62%), and convenient location (~62%)

Lowest ratings were in the following categories: receive as much help as needed (~41%), child friendly (~43%), and seen as someone worth helping (~44%)

Results: Agency Satisfaction Agency satisfaction results varied with ethnicity

African-American respondents were less likely to be satisfied by agency service delivery compared to Caucasian respondents; this was true to a lesser extent for Hispanics

Agency satisfaction results also varied with gender Males were less likely to be satisfied by agency

service delivery

Results: Agency Satisfaction

Results: Agency Satisfaction

Respondents’ comments 38% included written comments,

mostly related to their experiences with social service agencies

Approximately 45% of the written comments included favorable remarks about the survey and/or about agencies

Favorable remarks “I have used many of the agencies on your list

and have nothing but good things to say about them. They provided not just financial help when my family needed it, but also made me feel better about myself during a really low point in my life.”

“Wish I didn’t have to use these agencies. The people that helped me out always made me feel like I could get through the bad times and that I WOULD get back on my feet. Please tell them [listed several individual agencies] thank you.”

Respondents’ comments Approximately 40% of comments

were unfavorable

These remarks generally could be broken down into two areas: Wasted time Problems with staff

Unfavorable remarks : Wasted time “I know that there is always going to be lots of

paperwork. I just wish I actually knew what all the forms were for.”

“If one agency sends me to another agency for services, why do I have to repeat pretty much the exact same paperwork at the second place? Seems like these agencies should be able to share – I’ll sign whatever I got to sign so they can do that.”

“My time is valuable too. I get that the government makes us fill out these forms but I don’t understand half the things I’m told I need to sign. The few times that I’ve asked receptionists or care workers to explain what I’m signing, I’ve been told not to worry about it. I don’t think they knew what all the forms were for.”

Unfavorable Remarks: Staff “Just because I’m poor doesn’t mean I’m

lazy or stupid. That’s how people at some of these places treat me and my friends.”

“Someone at [site name] asked me why I hadn’t found a job and then said I probably wasn’t trying hard enough. I got enough people blaming me for not working. I thought people who worked with poor people would view things a little differently. Guess I was wrong – never went back there again. I could have really used the help from them, but it wasn’t worth it.”

Respondents’ comments Remaining comments don’t fit into any

one category

“I’ve only had to use food pantries once. Fingers crossed I’ll keep my job now. Thanks for giving me a list of where I can go for help if needed later on.”

“I’m 93 and still kicking it.”

Summary In general, most respondents reported

knowing where to obtain help in a variety of domains Race and gender important factors

Most respondents appeared to be satisfied with social service agencies across all domains (e.g., access, understanding of rights and rules, staff-consumer relations) Race and gender important factors

Implications More outreach appears to be needed

with males and African Americans to ensure that they are aware of the services available in Woodbury County

Increased sensitivity to cultural and gender issues may be needed to help ensure that all consumers are being afforded the same level of care

Future directions Specific prescriptions for individual

agencies cannot be clearly made based on present data

More detailed data could be collected on specific agencies to identify relative areas of strength and weakness

Individual Agencies Agency directors may contact me

for agency-specific information Will obtain information related to

how many times your individual agency was listed and for which questions

Further analysis can be done upon request