The high prevalence of health conditions among U.S. women receiving Temporary Assistance for Needy Families (TANF, or 'welfare') impedes the ability of many in this group to move from 'welfare-to-work', and the economic recession has likely exacerbated this problem. Despite this, few interventions have been developed to improve employment outcomes by addressing the health needs of women receiving TANF, and little is known about the impact of economic downturns on the employment trajectory of this group. Using data from a recent randomized controlled trial (RCT) that tested the efficacy of a public health nursing (PHN) intervention to address the chronic health condition needs of 432 American women receiving TANF, we examine the effect of the intervention and of recession exposure on employment. We further explore whether intervention effects were modified by select sociodemographic and health characteristics. Both marginal and more robust intervention effects were noted for employment-entry outcomes (any employment, p = 0.05 and time-to-employment, p = 0.01). There were significant effects for recession exposure on employment-entry (any employment, p = 0.002 and time-to-employment, p < 0.001). Neither the intervention nor recession exposure influenced longer-term employment outcomes (employment rate or maximum continuous employment). Intervention effects were not modified by age, education, prior TANF receipt, functional status, or recession exposure, suggesting the intervention was equally effective in improving employment-entry across a fairly heterogeneous group both before and after the recession onset. These findings advance our understanding of the health and employment dynamics among this group of disadvantaged women under variable macroeconomic conditions, and have implications for guiding health and TANF-related policy.

译文

:接受贫困家庭临时援助(TANF或“福利”)的美国女性中健康状况的普遍存在阻碍了该群体中许多人从“福利到工作”的转变能力,经济衰退可能加剧了这一状况这个问题。尽管如此,很少有干预措施通过满足接受TANF的妇女的健康需求来改善就业结果,而对于经济不景气对这一群体的就业轨迹的影响知之甚少。使用来自最近的一项随机对照试验(RCT)的数据,该数据测试了公共卫生护理(PHN)干预措施的有效性,以解决432名接受TANF的美国妇女的长期健康状况需求,我们研究了干预措施和经济衰退暴露对就业。我们进一步探讨是否通过选择的社会人口统计学和健康特征来修改干预效果。录入就业成果的边际和更强有力的干预效果均得到了记录(任何就业,p = 0.05和上班时间,p = 0.01)。衰退风险对就业进入有显着影响(任何就业,p = 0.002和上班时间,p <0.001)。干预和衰退暴露都不会影响长期就业结果(就业率或最大连续就业)。干预效果不受年龄,教育程度,TANF接受者,功能状态或衰退暴露的影响没有改变,这表明在衰退开始之前和之后,该干预措施在改善相当异类人群的就业机会方面同样有效。这些发现使我们对这组处于不利的宏观经济条件下的弱势妇女群体的健康和就业动态有了更深入的了解,并且对指导健康和TANF相关政策具有重要意义。

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