Tailoring services to promote family economic self-sufficiency and continued enrollment in maternal and early childhood home visiting programs

maternal and early childhood home visiting;home visiting;retention;TANF;Temporary Assistance for Needy Families;social services evaluation;Public Health Studies

Gatewood, Amanda K.Gielen, Andrea C. ;

Johns Hopkins University

关键词: maternal and early childhood home visiting;    home visiting;    retention;    TANF;    Temporary Assistance for Needy Families;    social services evaluation;    Public Health Studies;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/59197/GATEWOOD-DISSERTATION-2018.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Objectives:Many families and young children enrolled in home visiting (HV) experience health and social benefits, but HV programs often have difficulty retaining families in services.HV provides services to diverse families, but little is known about how services vary based on family needs. The goal of this study was to investigate the association of participation in the Temporary Assistance for Needy Families (TANF) program and receipt of economic self-sufficiency (ESS) services with duration of enrollment in HV.Methods:A retrospective cohort study assessed duration of enrollment up to one year for expectant women and mothers with a child under three years old who enrolled in Healthy Families New Jersey in 2014-2015.Survival analyses tested the association of 1) participation in TANF with duration of enrollment in HV; 2) participation in TANF with the receipt of ESS services; and 3) receipt of ESS services with duration of enrollment.Models were clustered by site, adjusted for demographic characteristics, and stratified by TANF participation.Results:Among the 2,779 enrolled families, 856 (31%) families participated in TANF.The average duration of enrollment was 175 days for families participating in TANF and 216 days for non-participating families (p<0.001).After adjusting for covariates, there was no association between TANF participation and duration of enrollment in HV (p=0.90).Less than one-third of families received ESS services in their first three months of enrollment, and only half of families received ESS services even after one year of enrollment.There was no difference in the rate of ESS service receipt when comparing TANF participants to non-participants (p=0.47).Families who received ESS services remained enrolled in HV for nearly three weeks longer than those who did not receive ESS services (235.8 vs. 214.4 days, p<0.001).However, ESS service receipt was not associated with a larger effect on TANF participants when compared to non-participants (p=0.63).Conclusion:Few families received ESS services in the first three months after enrolling in HV. Many families enrolled in HV also participated in TANF, but the rate of ESS service receipt did not differ between TANF participants and non-participants.Few families remained enrolled in HV for a full year, and TANF participants enrolled in HV for shorter durations than TANF non-participants.When families received services related to ESS, they remained enrolled in HV for longer durations.The effect associated with ESS services was not greater for TANF participants.Both TANF participants and non-participants may benefit from the receipt of ESS services early in enrollment.