Improving 24-Month Abstinence and Employment Outcomes for Substance-Dependent Women Receiving Temporary Assistance for Needy Families With Intensive Case Management

Objective. We examined abstinence rates among substance-dependent women receiving Temporary Assistance for Needy Families (TANF) in intensive case management (ICM) over 24 months and whether ICM yielded significantly better employment outcomes compared with a screen-and-refer program (i.e., usual care). Methods. Substance-dependent (n=302) and non-substance dependent (n = 150) TANF applicants in Essex County, New Jersey, were recruited. We randomly assigned substance-dependent women to ICM or usual care. We interviewed all women at 3, 9, 15, and 24 months. Results. Abstinence rates were higher for the ICM group than for the usual care group through 24 months of follow-up (odds ratio [OR]=2.11; 95% confidence interval [CI] = 1.36, 3.29). A statistically significant interaction between time and group on number of days employed indicated that the rate of improvement over time in employment was greater for the ICM group than for the usual care group (incidence rate ratio=1.03; 95% CI=1.02, 1.04). Additionally, there were greater odds of being employed full time for those in the ICM group (OR=1.68; 95% CI=11.12, 2.51). Conclusions. ICM is a promising intervention for managing substance dependence among women receiving TANF and for improving employment rates among this vulnerable population. (Am J Public Health. 2009;99:328-333. doi: 10.2105/AJPH.2007.133553)