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创伤知情的贫困家庭临时援助(TANF):一项具有两代影响的随机对照试验。

Trauma-informed Temporary Assistance for Needy Families (TANF): A Randomized Controlled Trial with a Two-Generation Impact.

作者信息

Booshehri Layla G, Dugan Jerome, Patel Falguni, Bloom Sandra, Chilton Mariana

机构信息

1College of Nursing & Health Professions, Drexel University, 1601 Cherry Street, Philadelphia, PA 19102 USA.

2Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA.

出版信息

J Child Fam Stud. 2018;27(5):1594-1604. doi: 10.1007/s10826-017-0987-y. Epub 2018 Jan 1.

Abstract

Temporary Assistance for Needy Families (TANF) has limited success in building self-sufficiency, and rarely addresses exposure to trauma as a barrier to employment. The objective of the Building Wealth and Health Network randomized controlled trial was to test effectiveness of financial empowerment combined with trauma-informed peer support against standard TANF programming. Through the method of single-blind randomization we assigned 103 caregivers of children under age six into three groups: control (standard TANF programming), partial (28-weeks financial education), and full (same as partial with simultaneous 28-weeks of trauma-informed peer support). Participants completed baseline and follow-up surveys every 3 months over 15 months. Group response rates were equivalent throughout. With mixed effects analysis we compared post-program outcomes at months 9, 12, and 15 to baseline. We modeled the impact of amount of participation in group classes on participant outcomes. Despite high exposure to trauma and adversity results demonstrate that, compared to the other groups, caregivers in the full intervention reported improved self-efficacy and depressive symptoms, and reduced economic hardship. Unlike the intervention groups, the control group reported increased developmental risk among their children. Although the control group showed higher levels of employment, the full intervention group reported greater earnings. The partial intervention group showed little to no differences compared with the control group. We conclude that financial empowerment education with trauma-informed peer support is more effective than standard TANF programming at improving behavioral health, reducing hardship, and increasing income. Policymakers may consider adapting TANF to include trauma-informed programming.

摘要

“贫困家庭临时援助”(TANF)在促进自给自足方面成效有限,而且很少将遭受创伤视为就业障碍。“建设财富与健康网络”随机对照试验的目的是检验金融赋权与创伤知情同伴支持相结合相对于标准TANF计划的有效性。通过单盲随机化方法,我们将103名六岁以下儿童的照顾者分为三组:对照组(标准TANF计划)、部分干预组(28周的金融教育)和完全干预组(与部分干预组相同,同时提供28周的创伤知情同伴支持)。参与者在15个月内每3个月完成一次基线调查和随访调查。各组的回应率始终相当。我们采用混合效应分析,将第9、12和15个月的项目后结果与基线进行比较。我们建立了小组课程参与量对参与者结果影响的模型。尽管遭受创伤和逆境的程度很高,但结果表明,与其他组相比,完全干预组的照顾者自我效能感提高,抑郁症状减轻,经济困难减少。与干预组不同,对照组报告其子女的发育风险增加。尽管对照组的就业水平较高,但完全干预组的收入更高。部分干预组与对照组相比几乎没有差异。我们得出结论,在改善行为健康、减轻困难和增加收入方面,金融赋权教育与创伤知情同伴支持比标准TANF计划更有效。政策制定者可考虑调整TANF,纳入创伤知情计划。

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