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Randomized Controlled Trial
. 2011 Sep;101(9):1759-68.
doi: 10.2105/AJPH.2011.300210. Epub 2011 Jul 21.

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

Shawn M Kneipp  1 , John A Kairalla, Barbara J Lutz, Deidre Pereira, Allyson G Hall, Joan Flocks, Linda Beeber, Todd Schwartz
Affiliations
Randomized Controlled Trial

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

Shawn M Kneipp et al. Am J Public Health. 2011 Sep.

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.

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Figures

FIGURE 1
FIGURE 1
Depressive symptom severity (BDI-II) by group and time: women receiving Temporary Assistance for Needy Families, Florida, 2007–2009. Note. BDI = Beck Depression Inventory.
FIGURE 2
FIGURE 2
Functional status (SF-12v2) and general health (SF-12v2) by group and time: women receiving Temporary Assistance for Needy Families, Florida, 2007–2009. Note. SF-12v2 = Short Form 12 version 2.
See this image and copyright information in PMC

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