Federal legislation in the mid 1990s related to social welfare programs, including welfare reform, was arguably the most important policy development in recent times to impact substance abuse treatment services for low-income Americans. Over the last 8 years, our work has focused on two broad issues: one policy and one scientific as well as the intersection between them. From a policy perspective, we developed a strong and ongoing partnership with the New Jersey Department of Human Services (NJDHS) and a myriad of providers to implement a statewide screening and assessment program for AOD clients located in welfare settings and conduct a two-county welfare demonstration project. From a scientific perspective, we have examined whether science-based interventions can be adapted for delivery in routine care settings and lead to improved outcomes as compared to usual care. Results of our randomized clinical trial indicated that intensive case management (ICM) delivered within a welfare setting increased access, engagement, and retention in substance abuse treatment as well as improved outcomes for drug abusing TANF mothers when compared to usual care (UC). This competitive continuation R01 proposes to take two next important steps in this line of research to provide policy-makers and scientists with crucial information needed for dissemination: 1) conducting an economic evaluation of ICM including a cost of illness study and cost benefit study;and 2) increasing adoption of evidence-based practice by examining the effectiveness of ICM as delivered in a real-world setting. Methods to accomplish these aims include analysis of cost data collected as part of the earlier trial, collection of additional administrative data on clients from the original trial, recruiting and following for 9 months a new sample of TANF women with substance use disorders, and collecting administrative data on the newly recruited sample. Results from this study should guide dissemination of this promising intervention.
|Kuerbis, Alexis N; Hagman, Brett T; Morgenstern, Jon (2013) Alcohol use disorders among substance dependent women on Temporary Assistance with Needy Families: more information for diagnostic modifications for DSM-5. Am J Addict 22:402-10|
|Dauber, Sarah; Neighbors, Charles; Dasaro, Chris et al. (2012) Impact of Intensive Case Management on Child Welfare System Involvement for Substance-Dependent Parenting Women on Public Assistance. Child Youth Serv Rev 34:1359-1366|
|Kuerbis, Alexis N; Neighbors, Charles J; Morgenstern, Jon (2011) Depression's moderation of the effectiveness of intensive case management with substance-dependent women on temporary assistance for needy families: outpatient substance use disorder treatment utilization and outcomes. J Stud Alcohol Drugs 72:297-307|
|Morgenstern, Jon; Neighbors, Charles J; Kuerbis, Alexis et al. (2009) Improving 24-month abstinence and employment outcomes for substance-dependent women receiving temporary assistance for needy families with intensive case management. Am J Public Health 99:328-33|
|Morgenstern, Jon; Blanchard, Kimberly A; Kahler, Christopher et al. (2008) Testing mechanisms of action for intensive case management. Addiction 103:469-77|
|Morgenstern, Jon; Blanchard, Kimberly A; McCrady, Barbara S et al. (2006) Effectiveness of intensive case management for substance-dependent women receiving temporary assistance for needy families. Am J Public Health 96:2016-23|
|Morgenstern, Jon; McCrady, Barbara S; Blanchard, Kimberly A et al. (2003) Barriers to employability among substance dependent and nonsubstance-affected women on federal welfare: implications for program design. J Stud Alcohol 64:239-46|