Study Details | Pathways to Work

0197-Public Health Nursin

Study quality: High

High

Reason for the rating: This study received a high study quality rating because it is a randomized controlled trial with low attrition, suggesting the findings can be attributed to the program.

Program: Public Health Nursing

Characteristics of study participants:

Public benefits recipients

Services provided:

Case management, Physical health services

Setting: Tested in multiple settings

Methods and Standards Protocol version used for review: Version 1.0

Learn about our protocol

Study design

Design:

Randomized controlled trial

Study group formation:

Unemployed female TANF recipients between 18 and 60 years of age with at least one chronic health condition were invited to participate in the study. Pregnant women and those receiving disability income were excluded from the study. After participants had enrolled in the study, they were randomly assigned to either the Public Health Nursing group or the comparison group.

Time period of study:

Recruitment began in February 2007, and the follow-up period for all participants ended by April 2010.

Primary outcome domains examined:

Increase short-term employment

Other outcome domains examined:

None

Study funded by:

Not specified

Results

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Outcome domain	Measure	Timing	Study quality by finding	Comparison group mean	Program group mean	Impact	Units	Findings	Sample size
Increase short-term employment	Employed at any time in follow-up period	Three to nine months	High	64.40	73.40	9.00	percentage points		352

Short-term outcomes are those measured 18 months or fewer after participants are first offered services. Long-term outcomes are those measured between 18 months and 5 years after participants are first offered services. Very long-term outcomes are those measured 5 years or more after participants are first offered services.

Means are not displayed when not reported or not aligned with the impact estimates. For example, if the impact estimate is regression-adjusted but only unadjusted means are reported in the study, the unadjusted means are not displayed as they are not aligned with the adjusted impact estimate.

Impact estimates are not shown when the estimate units cannot be converted to natural units.

Findings quality key:

High
Moderate

Study quality terms?

The findings quality describe our confidence that a given study’s finding is because of the program. We do not display findings that rate low.

Findings key:

A moderate-to-large favorable finding that is unlikely to be due to chance
A moderate-to-large favorable finding that might to be due to chance
A small favorable finding that is unlikely to be due to chance
A small favorable finding that might be due to chance
A favorable finding that is unlikely to be due to chance, but we cannot determine the standardized effect size
A favorable finding that might be due to chance, but we cannot determine the standardized effect size
A moderate-to-large unfavorable finding that is unlikely to be due to chance
A moderate-to-large unfavorable finding that might to be due to chance
A small unfavorable finding that is unlikely to be due to chance
A small unfavorable finding that might be due to chance
An unfavorable finding that is unlikely to be due to chance, but we cannot determine the standardized effect size
An unfavorable finding that might be due to chance, but we cannot determine the standardized effect size
A finding that is unlikely to be due to chance, but we cannot determine the standardized effect size or direction
A finding of no effect that might be due to chance

Favorable findings are impacts in a direction that is socially desirable. Statistical significance indicates the likelihood that a study finding is due to the program, rather than due to chance. Findings are described as moderate-to-large if the program produced a sufficiently large change in the outcome. An impact receives this designation if the standardized effect size is equal to or greater than 0.25 or equal to or less than -0.25.

Sample characteristics

All clients in the study were women. The average sample member was about 30 years old and had 2 to 3 children. The vast majority of clients, 88 percent, were unmarried. More than half (56 percent) were African American, and nearly one-third (32 percent) had not earned a high school diploma or general education diploma. Only 20 percent had not held any jobs in the past year, and only 14 percent had received TANF four or more times. Most respondents had held one or two jobs (62 percent) and had received TANF once or twice.

Sex

Female

100%

Race and ethnicity

Black or African American	56%
White	39%
Hispanic or Latino of any race	5%

The race and ethnicity categories may sum to more than 100 percent if the authors reported race and ethnicity separately; in these cases, we report the category White, rather than White, not Hispanic.

Employment and public benefit status

Public benefits recipients

100%

Education

Had some postsecondary education	40%
Had a high school diploma or GED	68%
Did not have a high school diploma or GED	32%

Specific employment barriers

Had a chronic illness

100%

Program implementation

Implementing organization:

Florida state TANF

Program history:

The authors developed the program in collaboration with female WTP participants. The study was not a pilot.

Program services:

The Public Health Nursing program aimed to address the chronic health needs of TANF clients so those clients’ health concerns would not be a barrier to employment. People in the treatment group met with a Public Health Nurse for a comprehensive health assessment after entering the program. The nurse was a case manager who supported and coordinated access to care and helped clients manage and prevent diseases through primary care or referrals and health education. People in the treatment group could also attend a two-hour information session about Medicaid. People in the treatment group followed up with the nurse three, six, and nine months later to check in about their health and case management needs.

Mandatory services:

None.

Comparison services:

People in the comparison group participated in a typical Welfare Transition Program (WTP) that provided information on health agencies and resources but did not directly refer participants to services or coordinate those services.

Service receipt duration:

The typical participant received case management and health care coordination services for nine months.

Program funding:

Not known

Study publications

Kneipp, Shawn M., John A. Kairalla, and Amanda L. Sheely (2013). A randomized controlled trial to improve health among women receiving welfare in the U.S.: The relationship between employment outcomes and the economic recession, Social Science & Medicine 80: 130-140. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577993/.

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Pathways to Work refers to programs by the names used in study reports or manuscripts. Some program names may use language that is not consistent with our style guide, preferences, or the terminology we use to describe populations.

Study of Public Health Nursing

0197-Public Health Nursin

Study design

Design:

Study group formation:

Time period of study:

Primary outcome domains examined:

Other outcome domains examined:

Study funded by:

Results

Sample characteristics

Sex

Race and ethnicity

Employment and public benefit status

Education

Specific employment barriers

Program implementation

Implementing organization:

Program history:

Program services:

Mandatory services:

Comparison services:

Service receipt duration:

Program funding:

Study publications