CBPR to Reduce Women's Health Disparities thru TANF

自1996年以来，美国福利制度的重大变化导致 对贫困家庭的临时援助(TANF，或‘福利’)援助主要是贫困的少数族裔 通过“从福利到工作”或福利过渡计划，将她们转移到低薪工作岗位 (WTP)。研究证明，30%的人在退出后一年内因困难而重新进入该计划 保持就业，以及推动重新进入的一个因素是慢性健康的极高流行率。 此组中的条件。我们的数据和其他人的数据表明，目前解决健康问题的方法 WTP中的妇女问题严重不足，既不会降低健康水平 也不能提高他们实现自给自足目标的能力。改善妇女健康的研究 尽管有明确而令人信服的证据表明他们的健康率较高，但接受TANF的人并不存在 比一般人口中的妇女和其他低收入妇女都存在更多问题，而且这一点很少 在WTP中进行，以满足他们的健康需求。因此，这项研究对于改善这一群体的健康是必要的；它 也是胡言乱语，因为干预是基于WTP参与者本身的需求和偏好。 这项研究的具体目的是： 1.重新设计当前的WTP临床健康筛查工具，使其具有文化相关性、敏感性和 可用于测试以福利参与者为中心的健康计划(WPCHP)的有效性 参与式研究方法。 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 治疗慢性健康疾病，b)增加必要的知识和技能，以驾驭 医疗补助制度，c)随着时间的推移改善功能和健康状况，d)增加就业时间 使用参与性研究方法在有慢性健康状况的WTP中登记的妇女。

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.