Public health nursing case management for women receiving temporary assistance for needy families: a randomized controlled trial using community-based participatory research

Am J Public Health. 2011 Sep;101(9):1759-68. doi: 10.2105/AJPH.2011.300210. Epub 2011 Jul 21.

Abstract

Objectives: We evaluated the effectiveness of a community-based participatory research-grounded intervention among women receiving Temporary Assistance for Needy Families (TANF) with chronic health conditions in increasing (1) health care visits, (2) Medicaid knowledge and skills, and (3) health and functional status.

Methods: We used a randomized controlled trial design to assign 432 women to a public health nurse case management plus Medicaid intervention or a wait-control group. We assessed Medicaid outcomes pre- and posttraining; other outcomes were assessed at 3, 6, and 9 months.

Results: Medicaid knowledge and skills improved (P < .001 for both). Intervention group participants were more likely to have a new mental health visit (odds ratio [OR] = 1.92; P = .007), and this likelihood increased in higher-risk subgroups (OR = 2.03 and 2.83; P = .04 and .006, respectively). Depression and functional status improved in the intervention group over time (P = .016 for both). No differences were found in routine or preventive care, or general health.

Conclusions: Health outcomes among women receiving TANF can be improved with public health interventions. Additional strategies are needed to further reduce health disparities in this population.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Case Management / organization & administration
  • Case Management / statistics & numerical data*
  • Chronic Disease / therapy
  • Community-Based Participatory Research / statistics & numerical data
  • Depression / epidemiology
  • Depression / therapy
  • Female
  • Health Status
  • Humans
  • Interpersonal Relations
  • Medicaid
  • Mental Health Services / statistics & numerical data
  • Office Visits
  • Poverty / statistics & numerical data*
  • Public Assistance / statistics & numerical data*
  • Public Health Nursing / statistics & numerical data*
  • Social Welfare*
  • Socioeconomic Factors
  • United States / epidemiology