title: Improving 24-month abstinence and employment outcomes for substance-dependent women receiving temporary assistance for needy families with intensive case management.
abstract: OBJECTIVE
  We examined abstinence rates among substance-dependent women receiving Temporary Assistance for Needy Families (TANF) in intensive case management (ICM) over 24 months and whether ICM yielded significantly better employment outcomes compared with a screen-and-refer program (i.e., usual care).
  
  
  METHODS
  Substance-dependent (n = 302) and non-substance dependent (n = 150) TANF applicants in Essex County, New Jersey, were recruited. We randomly assigned substance-dependent women to ICM or usual care. We interviewed all women at 3, 9, 15, and 24 months.
  
  
  RESULTS
  Abstinence rates were higher for the ICM group than for the usual care group through 24 months of follow-up (odds ratio [OR] = 2.11; 95% confidence interval [CI] = 1.36, 3.29). A statistically significant interaction between time and group on number of days employed indicated that the rate of improvement over time in employment was greater for the ICM group than for the usual care group (incidence rate ratio = 1.03; 95% CI = 1.02, 1.04). Additionally, there were greater odds of being employed full time for those in the ICM group (OR = 1.68; 95% CI = 1.12, 2.51).
  
  
  CONCLUSIONS
  ICM is a promising intervention for managing substance dependence among women receiving TANF and for improving employment rates among this vulnerable population.
authors.affiliation: National Center on Addiction and Substance Abuse, Columbia University, New York, NY 10017, USA. jm977@columbia.edu
authors.forename: Jon
authors.initials: J
authors.lastname: Morgenstern
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Neighbors
authors.forename: Alexis
authors.initials: A
authors.lastname: Kuerbis
authors.forename: Annette
authors.initials: A
authors.lastname: Riordan
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Blanchard
authors.forename: Katharine H
authors.initials: KH
authors.lastname: McVeigh
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Morgan
authors.forename: Barbara
authors.initials: B
authors.lastname: McCrady
mesh_terms: D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D009515:New Jersey / Q000453:epidemiology; D015397:Program Evaluation; D012946:Social Welfare; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000453:epidemiology*