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Eligible study participants were women with substance dependence who met criteria for a substance-dependence diagnosis (using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). Participants also had to be eligible for TANF and in the New Jersey welfare-to-work program without a medical deferral, able to speak English, not diagnosed as psychotic, not receiving or seeking methadone treatment, not seeking long-term residential treatment, and not consistently engaged in substance abuse treatment. Eligible study participants were randomly assigned to the intensive case management intervention group or the usual care comparison group.
The study followed participants for two years after enrollment.
National Institute on Drug Abuse (Grant Number 5 R01 DA12256), ACF, the Assistant Secretary for Planning and Evaluation (Grant Number 90XP0002), and the New Jersey Department of Human Services.
All participants were women receiving TANF who screened positively for substance-use dependence. Most (96 percent) were Black, and 3 percent were Hispanic. The average age was 36. About half (48 percent) of participants had graduated from high school, and 4 percent were married at the time of random assignment.
New Jersey Department of Human Services (NJDHS) Division of Family Development, which administered TANF
The program did not exist before the start of this study.
Women enrolled in TANF who had substance dependence received intensive case management and vouchers to support their participation in substance use disorder treatment. Intensive case management involved working with case managers who identified barriers to entry into substance use disorder treatment and addressed those barriers. While participants were in treatment, case managers met with participants weekly and coordinated with treatment facility staff to provide other needed services. Participants received vouchers for items such as children's toys or cosmetics as an incentive to participate in treatment.
Women receiving TANF who had substance dependence were assigned to the comparison group (the usual care group). A clinical care coordinator screened and referred them to substance use disorder treatment. Participants who failed to attend treatment received minimal follow-up outreach.
None
Participants received case management services throughout the 24-month follow-up period.
National Institute on Drug Abuse, ACF, the Assistant Secretary for Planning and Evaluation, and the New Jersey Department of Human Services.
The study took place in TANF offices in Essex County, NJ.
Substance use