Department of Health Services, School of Public Health, University of Washington, 1959 NE Pacific St, Magnuson Health Sciences Center, Room H-680, Box 357660, Seattle, WA, 98195-7660, USA.
Department of Health Services, School of Public Health, University of Washington, 1959 NE Pacific St, Magnuson Health Sciences Center, Room H-680, Box 357660, Seattle, WA, 98195-7660, USA.
Soc Sci Med. 2020 Aug;258:113136. doi: 10.1016/j.socscimed.2020.113136. Epub 2020 Jun 14.
Integrating trauma-informed peer support curriculum into the Temporary Assistance for Needy Families (TANF) program can help address caregiver trauma symptoms (e.g., depression, low self-efficacy, economic hardship) caused by exposures to violence and adversity that negatively impact one's ability to maintain employment and improve earnings; yet, it is unclear if trauma-informed peer support interventions designed for TANF impact co-occurring disorders, such as depression and substance use, that inhibit resiliency in the labor market.
The aim of this study is to examine whether integrating trauma-informed peer support curriculum into the TANF program is associated with reductions in co-occurring depression and substance use, and improvements in self-efficacy and economic security.
From October 2015 to May 2018, 369 caregivers were enrolled in the 16-week Building Wealth and Health Network Phase II single-group cohort study. Participants responded to questions regarding their socio-demographic characteristics, mental health, economic security, and use of drugs and alcohol at baseline and four three-month follow-up surveys. Associations between the trauma-informed peer support curriculum and health outcomes were assessed using maximum likelihood estimation.
Using class attendance records, participants were separated into a low-exposure group (<four classes; n = 156) and a high-exposure group (≥four classes; n = 213). Maximum likelihood analysis revealed that the high-exposure group reported a lower Center for Epidemiologic Studies Depression Scale (CES-D) score (-1.245; p = 0.027) and lower economic Hardship Index score (-0.499; p < 0.001) than the low-exposure group. The analysis also revealed that for the high-exposure group, attending an additional class was associated with declines in CES-D score (-1.024; p = 0.016) and 12-point Alcohol Use Disorders Identification Test score (-0.557; p = 0.012).
These findings suggest that trauma-informed peer support programming improves economic security and self-efficacy and reduces the co-occurrence of depressive symptoms and alcohol use.
将创伤知情同伴支持课程纳入临时援助家庭计划（TANF）可以帮助解决因接触暴力和逆境而导致的照顾者创伤症状（例如抑郁、低自我效能、经济困难），这些症状会影响他们维持就业和提高收入的能力；然而，目前尚不清楚专为 TANF 设计的创伤知情同伴支持干预措施是否会影响同时存在的障碍，例如抑郁和药物使用，这些障碍会抑制劳动力市场的恢复力。
本研究旨在探讨将创伤知情同伴支持课程纳入 TANF 计划是否与减少共病抑郁和药物使用以及提高自我效能和经济保障有关。
2015 年 10 月至 2018 年 5 月，369 名照顾者参加了为期 16 周的“建立财富和健康网络第二期”单组队列研究。参与者在基线和四次三个月随访调查中回答了关于他们的社会人口特征、心理健康、经济保障以及药物和酒精使用的问题。使用最大似然估计评估创伤知情同伴支持课程与健康结果之间的关联。
使用班级出勤率记录，参与者被分为低暴露组（<四节课；n=156）和高暴露组（≥四节课；n=213）。最大似然分析显示，高暴露组的中心流行病学研究抑郁量表（CES-D）评分较低（-1.245；p=0.027），经济困难指数评分较低（-0.499；p<0.001）。分析还表明，对于高暴露组，参加额外的课程与 CES-D 评分下降（-1.024；p=0.016）和 12 点酒精使用障碍识别测试评分下降（-0.557；p=0.012）有关。
这些发现表明，创伤知情同伴支持计划可改善经济保障和自我效能，并减少抑郁症状和酒精使用的共病发生。
