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对贫困家庭临时援助(TANF)的援助大幅减少，通过“从福利到工作”或福利过渡计划(WTP)将她们转移到低工资工作中，从而大大减少了对主要是贫穷的少数族裔妇女的援助。研究证明，30%的人在退出后一年内因难以维持就业而重新加入该计划，推动重新进入该计划的一个因素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严重不足，既不会缩小健康差距，也不会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治疗的妇女的健康问题发生率高于一般人口中的妇女和其他低收入妇女，但缺乏改善TANF妇女健康状况的研究，而且WTP几乎没有采取什么行动来满足她们的健康需求。因此，这项研究对于改善这一群体的健康是必要的；它也是一种胡言乱语，因为干预是基于WTP参与者本身的需求和偏好。 本研究的具体目的是：1.重新设计当前的WTP临床健康筛查工具，使其在文化上具有相关性、敏感性，并可用于使用参与式研究方法测试以福利参与者为中心的健康计划(WPCHP)的有效性。 2.测试WPCHP在以下方面的有效性：a)提高自愿筛查、身份识别和 这些措施包括：(A)增加对慢性疾病的治疗；b)增加驾驭医疗补助系统所需的知识和技能；c)随着时间的推移改善功能和健康状况；d)利用参与性研究方法，增加参加慢性病患者治疗计划的妇女的就业时间。

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.