Community-based participatory research (CBPR) to reduce women's health disparities thru TANF study: Focus group and survey findings to redesign a clinical health screening questionnaire

The Temporary Assistance for Needy Families (TANF – or ‘welfare') program reflects federal policy that is omnipresent in the lives of roughly two million disadvantaged women. While considered ‘social' and not ‘health' policy, there are numerous implications of TANF for the health of individual women and the health disparities observed by socioeconomic status (SES) among women in the U.S. Women receiving TANF have a prevalence of physical and mental health problems at least twice as high as that found in the general population of women, and it is estimated poor health accounts for 30% of ‘re-entry' into TANF after leaving welfare. Despite this, federal and state policy guiding the implementation of TANF does not adequately address services for women with health conditions in the program, and data suggest TANF offices across states do a poor job of meeting the health needs of this population. This presentation provides a brief overview of an ongoing, 4-year study funded by the National Institute of Nursing Research using a CBPR approach to test a public health nursing (PHN) intervention with women transitioning from TANF into employment. The first of two study aims was to redesign the current Welfare Transition Program (WTP) clinical health screening tool so that it is culturally relevant, sensitive, and acceptable for use in testing the efficacy of a Welfare Participant Centered Health Program (WPCHP) using a participatory research methodology. The findings from 10 focus groups with n=60 women and a survey of n=111 women to meet Aim 1 will be presented, with the major focus group finding being women are concerned not only about the wording, content, and/or presentation of the questions in a screening tool, but are as if not more concerned about details around the screening process. Findings from the survey indicate the tool is one that is relevant, sensitive, and acceptable to the population of interest. The tool is currently being used in the final part of the overall study, which tests the PHN intervention. Findings from the study will inform policymakers, with the ultimate goals of improving welfare policy, the health of women, and reducing health disparities.