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Barber P.,The Urban Institute
Voluntas | Year: 2012

A major shift in the climate for the solicitation of charitable donations in the United States occurred in the second half of the twentieth century. Starting with legislation passed by the Legislatures of New York and Massachusetts in 1954 and eventually including 40 largely similar laws in force today, state governments grew to playing a predominant part in the regulation of appeals for public support for charitable activities. State regulators, voluntary oversight and advocacy groups, accounting standards-setting bodies, and the data-collection activities of the Internal Revenue Service all influenced the development of the body of regulations which now shape the process of seeking support for nonprofits' work. This article summarizes the effect of earlier innovations in the field of fundraising and then examines the interplay of public and private actors in the course of the creation of the present regulatory climate. © 2011 International Society for Third-Sector Research and The John's Hopkins University.

Freedman V.A.,University of Michigan | Spillman B.C.,The Urban Institute
The journals of gerontology. Series B, Psychological sciences and social sciences | Year: 2014

OBJECTIVES: Older adults with care needs live in a variety of settings-from traditional community housing to nursing homes. This analysis provides new estimates of the size and characteristics of the older population across settings and examines unmet needs for assistance.METHOD: Data are from the 2011 National Health and Aging Trends Study (N = 8,077). Multinomial logistic regressions focus on people in settings other than nursing homes who are at risk for unmet needs, defined as receiving help or having difficulty with household, self-care, or mobility activities (N = 4,023).RESULTS: Of 38.1 million Medicare beneficiaries ages 65 and older, 5.5 million (15%) live in settings other than traditional housing: 2.5 million in retirement or senior housing communities, nearly 1 million in independent- and 1 million in assisted-living settings, and 1.1 million in nursing homes. The prevalence of assistance is higher and physical and cognitive capacity lower in each successive setting. Unmet needs are common in traditional community housing (31%), but most prevalent in retirement or senior housing (37%) and assisted living settings (42%). After controlling for differences in resident characteristics across settings, those in retirement or senior housing communities have a higher likelihood of unmet needs than those in traditional community housing, while those in independent or assisted living settings have a lower relative likelihood.DISCUSSION: Substantial numbers of older adults, many with care needs, live in a continuum of settings other than traditional community housing. Unmet needs are prevalent among older adults with limitations across all settings and warrant further investigation and monitoring. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Jones R.M.,Virginia Commonwealth University | Devers K.J.,The Urban Institute | Kuzel A.J.,Virginia Commonwealth University | Woolf S.H.,Virginia Commonwealth University
American Journal of Preventive Medicine | Year: 2010

Background: Barriers experienced by patients influence the uptake of colorectal cancer (CRC) screening. Prior research has quantified how often patients encounter these challenges but has generally not revealed their complex perspective and experience with barriers. Purpose: This mixed-methods study was conducted to understand current perspectives on CRC screening. Methods: A two-part, mixed-methods study was conducted of primary care patients recruited from Virginia Ambulatory Care Outcomes Research Network practices. First, in June-July 2005 a survey was mailed to 660 patients aged 50-75 years posing an open-ended question about "the most important barrier" to CRC screening. Second, beginning in October 2005, seven gender- and largely race-specific focus groups involving 40 patients aged 45-75 years were conducted. Beginning in October 2005, survey verbatim responses were coded and quantitatively analyzed and focus group transcripts were qualitatively analyzed. Results: Responses to the open-ended survey question, answered by 74% of respondents, identified fear and the bowel preparation as the most important barriers to screening. Only 1.6% of responses cited the absence of physician advice. Focus group participants cited similar issues and other previously reported barriers, but their remarks exposed the intricacies of complex barriers, such as fear, lack of information, time, the role of physicians, and access to care. Participants also cited barriers that have little documentation in the literature, such as low self-worth, "para-sexual" sensitivities, fatalism, negative past experiences with testing, and skepticism about the financial motivation behind screening recommendations. Conclusions: Mixed-methods analysis helps to disaggregate the complex nuances that influence patient behavior. In the present study, patients explained the web of influences on knowledge, motivation, and ability to undergo CRC screening, which clinicians and policymakers should consider in designing interventions to increase the level of screening. © 2010 American Journal of Preventive Medicine.

de Briggs X.S.,Office of Management and Budget | Comey J.,The Urban Institute | Weismann G.,100 Cambridge Street
Housing Policy Debate | Year: 2010

Improving locational outcomes emerged as a major policy hope for the nation's largest low-income housing program over the past two decades, but a host of supply and demand-side barriers confront rental voucher users, leading to heated debate over the importance of choice versus constraint. In this context, we examine the Moving to Opportunity experiment's first decade, using a mixedmethod approach. MTO families faced major barriers in tightening markets, yet diverse housing trajectories emerged, reflecting variation in: (a) willingness to trade location - in particular, safety and avoidance of "ghetto" behavior - to get larger, better housing units after initial relocation; (b) the distribution of neighborhood types in different metro areas; and (c) circumstances that produced many involuntary moves. Access to social networks or services "left behind" in poorer neighborhoods seldom drove moving decisions. Numerous moves were brokered by rental agents who provided shortcuts to willing landlords but thereby steered participants to particular neighborhoods. © 2010 Virginia Polytechnic Institute and State University.

Popkin S.J.,The Urban Institute
Housing Policy Debate | Year: 2010

The Chicago Housing Authority is midway through its ambitious Plan for Transformation. This paper presents new evidence about how residents have fared since the transformation began. Questions remain about where they are living, the circumstances of their new housing, and how relocation has affected their overall well-being. This paper presents new evidence on resident outcomes from the HOPE VI Panel Study, a national study that includes Chicago. The findings show that those residents who received vouchers are living in better housing in dramatically safer neighborhoods; many report improved mental health; and their children are having fewer behavior problems. But there are also very real reasons for concern. Voucher holders are experiencing economic hardship that may place them at risk for housing instability and the most troubled families are at risk for being left behind in traditional public housing, little better off than they were when the Plan began. © 2010 Virginia Polytechnic Institute and State University.

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