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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.133553v1 99/2/328    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Morgenstern, J. Articles by McCrady, B. Search for Related Content PubMed PubMed Citation Articles by Morgenstern, J. Articles by McCrady, B. Related Collections Health Policy Socioeconomic Factors Government Alcohol Drugs Women's Health

Jon Morgenstern, PhD, Charles J. Neighbors, PhD, MBA, Alexis Kuerbis, MSW, Annette Riordan, PhD, Kimberly A. Blanchard, PhD, Katharine H. McVeigh, PhD, Thomas J. Morgan, PsyD and Barbara McCrady, PhD

Jon Morgenstern, Charles J. Neighbors, Alexis Kuerbis, and Kimberly A. Blanchard are with the National Center on Addiction and Substance Abuse, Columbia University, New York, NY. Annette Riordan is with the New Jersey Department of Human Services, Trenton. Katharine H. McVeigh is with New York City Department of Health and Mental Hygiene, New York, NY. Thomas J. Morgan is with the Center of Alcohol Studies, Rutgers, the State University of New Jersey, Piscataway. Barbara McCrady is with the University of New Mexico, Albuquerque.

Correspondence: Requests for reprints should be sent to Jon Morgenstern, PhD, The National Center on Addiction and Substance Abuse, Columbia University, 633 Third Ave, 19th Floor, New York, NY 10017 (e-mail: jm977{at}columbia.edu).

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 = 1.12, 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.