Effects of a trauma-informed curriculum on depression, self-efficacy, economic security, and substance use among TANF participants: Evidence from the Building Health and Wealth Network Phase II
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 abil...
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| Veröffentlicht in: | Social science & medicine (1982) 2020-08, Vol.258, p.113136, Article 113136 |
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| creator | Dugan, Jerome Booshehri, Layla G. Phojanakong, Pam Patel, Falguni Brown, Emily Bloom, Sandra Chilton, Mariana |
| description | 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 ( |
| doi_str_mv | 10.1016/j.socscimed.2020.113136 |
| format | Article |
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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.
•Examined the effectiveness of a trauma-informed peer intervention designed for TANF.•The high-exposure group reported lower depression and higher economic security.•Increased class attendance associated with declines in depression and alcohol use.</description><identifier>ISSN: 0277-9536</identifier><identifier>EISSN: 1873-5347</identifier><identifier>DOI: 10.1016/j.socscimed.2020.113136</identifier><identifier>PMID: 32585543</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adversity ; Alcohol related disorders ; Alcohol use ; Alcoholism ; Caregivers ; Cohort analysis ; Cohort Studies ; Comorbidity ; Curricula ; Curriculum ; Demography ; Depression ; Depression - therapy ; Disorders ; Drug use ; Earnings ; Economic hardship ; Economic security ; Employment ; Epidemiology ; Health problems ; Health status ; Humans ; Labor market ; Maximum likelihood method ; Mental depression ; Mental health ; Peer tutoring ; Peers ; Psychological trauma ; Public assistance programs ; Resilience ; School attendance ; Security ; Self Efficacy ; Social support ; Sociodemographics ; Substance abuse ; Substance use ; Substance use disorder ; Substance-Related Disorders - complications ; Substance-Related Disorders - therapy ; Symptoms ; TANF ; Trauma ; Trauma-informed ; Wealth ; Welfare policy ; Welfare recipients ; Welfare services</subject><ispartof>Social science & medicine (1982), 2020-08, Vol.258, p.113136, Article 113136</ispartof><rights>2020 The Authors</rights><rights>Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><rights>Copyright Pergamon Press Inc. Aug 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-98f4368a0c662ca37a90cc31eb6074438e26b45b1145595f8cdc11bd5ff8ac823</citedby><cites>FETCH-LOGICAL-c448t-98f4368a0c662ca37a90cc31eb6074438e26b45b1145595f8cdc11bd5ff8ac823</cites><orcidid>0000-0001-9747-2597 ; 0000-0001-6881-8034</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.socscimed.2020.113136$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27866,27924,27925,33774,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32585543$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dugan, Jerome</creatorcontrib><creatorcontrib>Booshehri, Layla G.</creatorcontrib><creatorcontrib>Phojanakong, Pam</creatorcontrib><creatorcontrib>Patel, Falguni</creatorcontrib><creatorcontrib>Brown, Emily</creatorcontrib><creatorcontrib>Bloom, Sandra</creatorcontrib><creatorcontrib>Chilton, Mariana</creatorcontrib><title>Effects of a trauma-informed curriculum on depression, self-efficacy, economic security, and substance use among TANF participants: Evidence from the Building Health and Wealth Network Phase II</title><title>Social science & medicine (1982)</title><addtitle>Soc Sci Med</addtitle><description>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.
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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.
•Examined the effectiveness of a trauma-informed peer intervention designed for TANF.•The high-exposure group reported lower depression and higher economic security.•Increased class attendance associated with declines in depression and alcohol use.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>32585543</pmid><doi>10.1016/j.socscimed.2020.113136</doi><orcidid>https://orcid.org/0000-0001-9747-2597</orcidid><orcidid>https://orcid.org/0000-0001-6881-8034</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Social science & medicine (1982), 2020-08, Vol.258, p.113136, Article 113136 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; PAIS Index; Sociological Abstracts |
| subjects | Adversity Alcohol related disorders Alcohol use Alcoholism Caregivers Cohort analysis Cohort Studies Comorbidity Curricula Curriculum Demography Depression Depression - therapy Disorders Drug use Earnings Economic hardship Economic security Employment Epidemiology Health problems Health status Humans Labor market Maximum likelihood method Mental depression Mental health Peer tutoring Peers Psychological trauma Public assistance programs Resilience School attendance Security Self Efficacy Social support Sociodemographics Substance abuse Substance use Substance use disorder Substance-Related Disorders - complications Substance-Related Disorders - therapy Symptoms TANF Trauma Trauma-informed Wealth Welfare policy Welfare recipients Welfare services |
| title | Effects of a trauma-informed curriculum on depression, self-efficacy, economic security, and substance use among TANF participants: Evidence from the Building Health and Wealth Network Phase II |
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