Poor health can undermine sustainable employment, particularly among vulnerable populations. Additionally, exposure to early adversity and trauma is not only highly prevalent among low-income groups, but has also been shown to interfere with job-related outcomes. ÌýTo address this problem in the State of Wisconsin, the Community Advocates’ Public Policy Institute has partnered with the Institute for Child and Family Well-being on the Improving Health Through Enhanced Work project, which will build on the success of the State of Wisconsin’s Transitional Jobs Program by integrating new program components intended to increase its effectiveness.

Joblessness and poverty contribute to poor physical and mental health outcomes. ÌýLikewise, poor physical and mental health undermine employment access and sustainability.Ìý This project aims to enhance existing transitional employment services in urban and rural communities by promoting access to primary and behavioral health care for job-seeking adults. ÌýSpecifically, in addition to promoting access to subsidized employment, the enhanced program will help participants: (a) obtain health insurance coverage and establish care with a primary care physician, and (b) complete a trauma screening protocol that is followed by, if indicated, a referral to mental health services.

The project evaluation will use a mixed-methods approach. Qualitative data will be gathered at multiple time points through semi-structured interviews aimed at understanding participants’ social histories and their experiences in both the conventional and enhanced transitional jobs programs.Ìý For the quantitative arm of the evaluation, an experimental design will be employed.Ìý Potential program participants will be randomly assigned to either the enhanced transitional jobs programs or the conventional jobs program.Ìý Longitudinal data will be collected and analyzed to test whether program enhancements are associated with significant change in participant outcomes, including sustained employment, access to health care and mental health services, and improved psychosocial functioning.

Funding

Wisconsin Partnership Program, University of Wisconsin School of Medicine and Public Health

Project Partners

Community Advocates, Public Policy Institute

Conor Williams

Julie Kerksick

David Reimer

Kari Lerch

ICFW Academic Partners

James Topitzes

David Pate

Joshua Mersky

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Background

A stable, healthy, and affordable home provides a foundation for well-being and prosperity for children, families and communities. Stable housing can positively affect a broad spectrum of outcomes for children and families, including academic performance, physical, and mental health. Families that struggle to achieve or maintain housing stability are at elevated risk for a wide range of poor child outcomes, including child abuse and neglect. Disentangling the risk factors for child maltreatment and housing instability, such as including crowding, eviction, and homelessness, is difficult and requires a multi-system approach.

The Housing Opportunities Made to Enhance Stability (HOMES) initiative began when Children’s Community Health Navigators and Well-Being Assessment programs both identified housing as a needed resource and driver of well-being outcomes in the populations they served. HOMES is focused on developing partnerships across health, child welfare, housing and other systems to integrate and streamline services and policies to support stable housing for families facing complex challenges.

HOMES is engaging the community through community cafes, surveys, and other resident participation, to establish partnerships across health care, child welfare, housing, and other systems. The HOMES team will combine this feedback with research and other evidence to advance program changes at Children’s and broader policy solutions that support stable housing for families.

Team

Gabriel McGaughey

Gabe Doyle

Peter Power

Bregetta Wilson

Fiona Weeks

Robert Walker

Christie Guertin

Penelope Dixon

Christopher Morgan

Myra Werner

Kate Angers

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Dates:Ìý 7/1/15 to 12/31/16

Community Partner:Ìý Central Racine County Health Department

Academic Partners:Ìý Joshua Mersky and Dimitri Topitzes, 51ÁÔÆæ

Summary

This project aims to translate research on adverse childhood experiences into prevention and intervention applications within the context of home visiting services in order to improve population health outcomes. Home visiting program data from the Central Racine County Health Department and other agencies statewide will be used to explore the link between a mother’s own childhood adversity and her children’s risk of unwanted outcomes such as pregnancy loss, infant mortality, and child maltreatment.Ìý Results will be disseminated to a network of family, program, and policy stakeholders in the local communityÌýand statewide. ÌýThis community-university partnership holds the potential of improving the quality of home visiting services and other interventions that promote the health and well-being of Wisconsin’s most vulnerable children and families.

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