abstract: '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. (C) 2012 Elsevier Ltd. All

  rights reserved.'
affiliation: 'Kneipp, SM (Corresponding Author), Univ N Carolina, Sch Nursing, Chapel
  Hill, NC 27599 USA.

  Kneipp, Shawn M., Univ N Carolina, Sch Nursing, Chapel Hill, NC 27599 USA.

  Kairalla, John A., Univ Florida, Coll Med, Gainesville, FL 32611 USA.

  Kairalla, John A., Univ Florida, Coll Publ Hlth \& Hlth Profess, Gainesville, FL
  32611 USA.

  Sheely, Amanda L., Univ N Carolina, Sch Social Work, Chapel Hill, NC USA.'
author: Kneipp, Shawn M. and Kairalla, John A. and Sheely, Amanda L.
author-email: skneipp@unc.edu
author_list:
- family: Kneipp
  given: Shawn M.
- family: Kairalla
  given: John A.
- family: Sheely
  given: Amanda L.
da: '2023-09-28'
doi: 10.1016/j.socscimed.2012.08.011
eissn: 1873-5347
files: []
issn: 0277-9536
journal: SOCIAL SCIENCE \& MEDICINE
keywords: 'Health disparities; Welfare policy; Temporary Assistance for Needy

  Families (TANF); Women''s health; Public health nursing; Economic

  recession; USA'
keywords-plus: TEMPORARY ASSISTANCE; NEEDY FAMILIES; LIFE
language: English
month: MAR
number-of-cited-references: '57'
orcid-numbers: 'Sheely, Amanda/0000-0002-1733-6059

  Kneipp, Shawn/0000-0002-8907-0587'
pages: 130-140
papis_id: 9e95f88b0169c45738fe843b938c20a9
ref: Kneipp2013randomizedcontrolled
researcherid-numbers: 'Sheely, Amanda/C-3921-2017

  '
times-cited: '14'
title: 'A randomized controlled trial to improve health among women receiving welfare
  in the US: The relationship between employment outcomes and the economic recession'
type: Article
unique-id: WOS:000209447300016
usage-count-last-180-days: '0'
usage-count-since-2013: '8'
volume: '80'
web-of-science-categories: 'Public, Environmental \& Occupational Health; Social Sciences,

  Biomedical'
year: '2013'