title: Public health nursing case management for women receiving temporary assistance for needy families: a randomized controlled trial using community-based participatory research.
abstract: OBJECTIVE
  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.
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, 27599, USA. skneipp@email.unc.edu
authors.forename: Shawn M
authors.initials: SM
authors.lastname: Kneipp
authors.forename: John A
authors.initials: JA
authors.lastname: Kairalla
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Lutz
authors.forename: Deidre
authors.initials: D
authors.lastname: Pereira
authors.forename: Allyson G
authors.initials: AG
authors.lastname: Hall
authors.forename: Joan
authors.initials: J
authors.lastname: Flocks
authors.forename: Linda
authors.initials: L
authors.lastname: Beeber
authors.forename: Todd
authors.initials: T
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D019090:Case Management / Q000458:organization & administration / Q000706:statistics & numerical data*; D002908:Chronic Disease / Q000628:therapy; D055812:Community-Based Participatory Research / Q000706:statistics & numerical data; D003863:Depression / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008484:Medicaid; D008605:Mental Health Services / Q000706:statistics & numerical data; D009819:Office Visits; D011203:Poverty / Q000706:statistics & numerical data*; D011632:Public Assistance / Q000706:statistics & numerical data*; D011637:Public Health Nursing / Q000706:statistics & numerical data*; D012946:Social Welfare; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology