CBPR to Reduce Women's Health Disparities thru TANF

描述（由申请人提供）：自1996年以来，美国福利制度的重大变化导致贫困家庭临时援助（TANF，或“福利”）援助大幅减少，主要是贫困，少数民族妇女通过“福利到工作”或福利过渡计划（WTP）将其转移到低工资工作。研究表明，30%的人由于难以维持就业而在退出后一年内重新加入该计划，而推动“重新加入”的一个因素1是这一群体中慢性健康状况的极高患病率。我们的数据和其他人的数据表明，目前解决WTP妇女健康问题的方法远远不够，既不能减少健康差距，也不能提高她们实现自给自足目标的能力。尽管有明确和令人信服的证据表明，接受TANF的妇女的健康问题发生率高于一般人口和其他低收入妇女，但缺乏改善TANF妇女健康的研究，而且WTP在满足其健康需求方面做得很少。因此，这项研究是必要的，以改善这一群体的健康，它也是hovel，在干预的基础上的需要和偏好的支付意愿参与者自己。 本研究的具体目的是：1.重新设计目前的支付意愿临床健康筛查工具，使其具有文化相关性、敏感性和可接受性，以便使用参与性研究方法来测试以福利受益者为中心的健康计划（WPCHP）的有效性。 2.为了测试WPCHP在以下方面的功效：a）提高自愿筛查，识别， 慢性健康状况的治疗，B）增加必要的知识和技能，以浏览医疗补助制度，c）改善功能和健康状况随着时间的推移，和d）增加就业时间的妇女登记在WTP与慢性健康状况使用参与性研究方法。

DESCRIPTION (provided by applicant): Major changes to the U.S. welfare system since 1996 have resulted in significant reductions in Temporary Assistance to Needy Families (TANF, or 'welfare') assistance to predominantly poor, minority women by moving them into low-wage jobs through 'welfare-to-work', or welfare transition programs (WTPs). Studies have documented that 30% re-enter the program within one year of exit due to difficulty maintaining employment, and one factor driving 're-entry1 is the extremely high prevalence of chronic health conditions in this group. Our data, and data from others, suggests current approaches for addressing health problems among women in WTPs are woefully inadequate, and will result in neither reducing health disparities nor improve their ability to meet self-sufficiency goals. Studies to improve the health of women receiving TANF are absent, despite clear and compelling evidence they suffer from higher rates of health problems than women in both the general population and other low-income women, and that little is being done in WTPs to meet their health needs. Thus, this study is necessary to improve the health of this group; it is also hovel, in that the intervention is based on the needs and preferences of WTP participants themselves. The specific aims of this research are: 1. To redesign the current WTP clinical health screening tool so that it is culturally relevant, sensitive, and acceptable for use in testing the efficacy of a Welfare Participant-Centered Health Program (WPCHP) using a participatory research methodology. 2. To test the efficacy of a WPCHP in: a) increasing rates of voluntary screening, identification, and treatment for chronic health conditions, b) increasing the knowledge and skills necessary to navigate the Medicaid system, c) improving functional and health status over time, and d) increasing employment duration among women enrolled in WTPs with chronic health conditions using a participatory research methodology.