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Spencer RA, Lemon ED, Komro KA, Livingston MD, Woods-Jaeger B. Women's Lived Experiences with Temporary Assistance for Needy Families (TANF): How TANF Can Better Support Women's Wellbeing and Reduce Intimate Partner Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1170. [PMID: 35162193 PMCID: PMC8834626 DOI: 10.3390/ijerph19031170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 02/04/2023]
Abstract
Women experiencing poverty are more likely to face intimate partner violence (IPV), poor health, and stigma. IPV survivors are overrepresented among those who receive Temporary Assistance for Needy Families (TANF), a conditional cash program serving families experiencing poverty. More generous TANF policies may be protective against IPV, but a greater insight into TANF's effect could be gleaned through a contemporaneous study that examines intersecting determinants of wellbeing and engages community interpretation of findings. Using an adapted Family Stress Model framework and analyzing data through an intersectional and community-based lens, we explore the impact of TANF on women's wellbeing through in-depth, semi-structured interviews during the COVID-19 pandemic with 13 women who had TANF experience in three U.S. states. Data were analyzed using thematic analysis in MAXQDA and researchers facilitated three member-checking events to enhance validity of result interpretation. Four themes emerged: (1) Low cash and conditional benefits provided limited short-term "relief" but contributed to poverty and hard choices; (2) TANF benefit levels and conditions increased women's dependence on others, straining relationships; (3) Women undertook extraordinary measures to access TANF, largely to fulfill their roles as mothers; and (4) TANF stigma creates psychological stress, differentially experienced by African Americans. Increasing TANF cash benefits and other cash transfers for those experiencing poverty, adopting solely state funded TANF programs, increasing funding for TANF administration, addressing TANF stigma and racialized narratives, and allowing optional child support participation or a larger "pass-through" of child support are important steps toward making TANF more protective against IPV.
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Affiliation(s)
- Rachael A. Spencer
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30329, USA
| | - Emily D. Lemon
- Department of Behavioral, Social, & Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30329, USA; (E.D.L.); (K.A.K.); (M.D.L.); (B.W.-J.)
| | - Kelli A. Komro
- Department of Behavioral, Social, & Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30329, USA; (E.D.L.); (K.A.K.); (M.D.L.); (B.W.-J.)
| | - Melvin D. Livingston
- Department of Behavioral, Social, & Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30329, USA; (E.D.L.); (K.A.K.); (M.D.L.); (B.W.-J.)
| | - Briana Woods-Jaeger
- Department of Behavioral, Social, & Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30329, USA; (E.D.L.); (K.A.K.); (M.D.L.); (B.W.-J.)
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Eriksson M, Ulmestig R. "It's Not All About Money": Toward a More Comprehensive Understanding of Financial Abuse in the Context of VAW. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP1625-1651NP. [PMID: 29295038 DOI: 10.1177/0886260517743547] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Men's violence against women (VAW) is multifaceted and complex. Besides physical, psychological, and sexual violence, women subjected to VAW often suffer from economic hardship and financial abuse. Financial abuse involves different tactics used to exercise power and gain control over partners. Experiences of financial abuse make it difficult for women to leave an abusive partner and become self-sufficient. From an intersectional perspective, applying the concept of the continuum of violence, the aim of this article is to develop a more comprehensive understanding of how women subjected to men's violence in intimate relationships experience the complexity of financial abuse in their lives, in the context of VAW. Based on 19 in-depth interviews with women surviving domestic violence, the study describes how intertwined women's experiences of financial abuse are with other forms of abuse, influencing each other, simultaneously experienced as a distinct form of abuse with severe and longstanding consequences. Women in the study describe how men's abuse affects them financially, causing poverty and affecting their ability to have a reasonable economic standard. Financial abuse also causes women ill health, and damages their self-esteem and ability to work, associate, and engage in social life. The interviewed women describe how experiences of financial abuse continue across time, from their past into their present situation and molding beliefs about the future. According to the interviews, financial abuse in private life sometimes continues into the public sphere, reproduced by social workers mimicking patterns of ex-partners' abuse. Bringing out a more comprehensive understanding of the dynamic continuum of financial abuse, our results deepen knowledge about the complexity of VAW in women's lives, and thereby are important in processes of making victims of violence survivors of violence.
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Cho H, Shamrova D, Han JB, Levchenko P. Patterns of Intimate Partner Violence Victimization and Survivors' Help-Seeking. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:4558-4582. [PMID: 29294808 DOI: 10.1177/0886260517715027] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Intimate partner violence (IPV) survivors often do not seek critically needed help. A good understanding of the relationship between the pattern of violence and help-seeking is critical to developing adequate services for the survivors, as well as for reaching out to those who do not seek help. This study used the National Intimate Partner and Sexual Violence Survey to examine how IPV survivor's help-seeking varies, depending on the characteristics of the survivors and the pattern of victimization. Logistic regression analyses were conducted, with the survivors' help-seeking and use of formal or informal help as the dependent variables. The study results show that women are the primary victims of IPV, that the pattern of victimization is associated with both whether survivors seek help or not, and which help sources they utilize, if any. IPV consequences are also associated with survivors' help-seeking, as are demographic factors such as age, gender, race, and immigration status.
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Affiliation(s)
- Hyunkag Cho
- Michigan State University, East Lansing, USA
| | | | - Jae-Bum Han
- Michigan State University, East Lansing, USA
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Behnken MP, Duan Y, Temple JR, Wu ZH. Injury and Psychiatric Disorder in Low-Income Women Experiencing Bidirectional Intimate Partner Violence. VIOLENCE AND VICTIMS 2018; 33:259-274. [PMID: 29609675 DOI: 10.1891/0886-6708.vv-d-15-00066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study compared severity of physical violence, intimate partner violence (IPV)-related injury, and lifetime diagnoses of psychiatric disorders among women in relationships with bidirectional, unidirectional, or no IPV. The sample includes 763 low-income women from community-based family planning clinics. Results showed that women in relationships with bidirectional IPV were more likely to experience severe physical violence and severe IPV-related injury compared to women in the unidirectional IPV category. These women were also more likely to be diagnosed with drug abuse and depression than women in relationships without IPV. Similarly, women in the bidirectional IPV category were more likely to be diagnosed with drug abuse when compared to women in the victim-only unidirectional IPV category. Recommendations for health-care providers are discussed.
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Booshehri LG, Dugan J, Patel F, Bloom S, Chilton M. Trauma-informed Temporary Assistance for Needy Families (TANF): A Randomized Controlled Trial with a Two-Generation Impact. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:1594-1604. [PMID: 29657515 PMCID: PMC5886995 DOI: 10.1007/s10826-017-0987-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Temporary Assistance for Needy Families (TANF) has limited success in building self-sufficiency, and rarely addresses exposure to trauma as a barrier to employment. The objective of the Building Wealth and Health Network randomized controlled trial was to test effectiveness of financial empowerment combined with trauma-informed peer support against standard TANF programming. Through the method of single-blind randomization we assigned 103 caregivers of children under age six into three groups: control (standard TANF programming), partial (28-weeks financial education), and full (same as partial with simultaneous 28-weeks of trauma-informed peer support). Participants completed baseline and follow-up surveys every 3 months over 15 months. Group response rates were equivalent throughout. With mixed effects analysis we compared post-program outcomes at months 9, 12, and 15 to baseline. We modeled the impact of amount of participation in group classes on participant outcomes. Despite high exposure to trauma and adversity results demonstrate that, compared to the other groups, caregivers in the full intervention reported improved self-efficacy and depressive symptoms, and reduced economic hardship. Unlike the intervention groups, the control group reported increased developmental risk among their children. Although the control group showed higher levels of employment, the full intervention group reported greater earnings. The partial intervention group showed little to no differences compared with the control group. We conclude that financial empowerment education with trauma-informed peer support is more effective than standard TANF programming at improving behavioral health, reducing hardship, and increasing income. Policymakers may consider adapting TANF to include trauma-informed programming.
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Affiliation(s)
- Layla G. Booshehri
- College of Nursing & Health Professions, Drexel University, 1601 Cherry Street, Philadelphia, PA 19102 USA
| | - Jerome Dugan
- College of Nursing & Health Professions, Drexel University, 1601 Cherry Street, Philadelphia, PA 19102 USA
| | - Falguni Patel
- Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | - Sandra Bloom
- Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | - Mariana Chilton
- Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
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Sun J, Patel F, Kirzner R, Newton-Famous N, Owens C, Welles SL, Chilton M. The Building Wealth and Health Network: methods and baseline characteristics from a randomized controlled trial for families with young children participating in temporary assistance for needy families (TANF). BMC Public Health 2016; 16:583. [PMID: 27421287 PMCID: PMC4947340 DOI: 10.1186/s12889-016-3233-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 06/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Families with children under age six participating in the Temporary Assistance for Needy Families Program (TANF) must participate in work-related activities for 20 h per week. However, due to financial hardship, poor health, and exposure to violence and adversity, families may experience great difficulty in reaching self-sufficiency. The purpose of this report is to describe study design and baseline findings of a trauma-informed financial empowerment and peer support intervention meant to mitigate these hardships. METHODS We conducted a randomized controlled trial of a 28-week intervention called Building Wealth and Health Network to improve financial security and maternal and child health among caregivers participating in TANF. Participants, recruited from County Assistance offices in Philadelphia, PA, were randomized into two intervention groups (partial and full) and one control group. Participants completed questionnaires at baseline to assess career readiness, economic hardship, health and wellbeing, exposure to adversity and violence, and interaction with criminal justice systems. RESULTS Baseline characteristics demonstrate that among 103 participants, there were no significant differences by group. Mean age of participants was 25 years, and youngest child was 30 months. The majority of participants were women (94.2 %), never married (83.5 %), unemployed (94.2 %), and without a bank account (66.0 %). Many reported economic hardship (32.0 % very low household food secure, 65.0 % housing insecure, and 31.1 % severe energy insecure), and depression (57.3 %). Exposure to adversity was prevalent, where 38.8 % reported four or more Adverse Childhood Experiences including abuse, neglect and household dysfunction. In terms of community violence, 64.7 % saw a seriously wounded person after an incident of violence, and 27.2 % had seen someone killed. Finally, 14.6 % spent time in an adult correctional institution, and 48.5 % of the fathers of the youngest child spent time in prison. CONCLUSIONS Baseline findings demonstrate that caregivers participating in TANF have suffered significant childhood adversity, adult violence exposure, and poverty-related stressors that can limit workforce success. High prevalence of housing and food insecurity, exposure to adversity, violence and criminal justice systems demands comprehensive programming to support families. Trauma-informed approaches to career readiness such as the Building Wealth and Health Network offer opportunities for potential success in the workforce. TRIAL REGISTRATION This study is retrospectively registered with ClinicalTrials.gov. The Identifier is: NCT02577705 The Registration date is October 13, 2015.
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Affiliation(s)
- Jing Sun
- />Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 2213 McElderry St, Room M139, Baltimore, MD 21205 USA
| | - Falguni Patel
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | | | - Nijah Newton-Famous
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | - Constance Owens
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | - Seth L. Welles
- />Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market Street, 5th Floor, Room 535, Philadelphia, PA 19104 USA
| | - Mariana Chilton
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
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Alsaker K, Moen BE, Baste V, Morken T. How Has Living with Intimate Partner Violence Affected the Work Situation? A Qualitative Study among Abused Women in Norway. JOURNAL OF FAMILY VIOLENCE 2016; 31:479-487. [PMID: 27217615 PMCID: PMC4844633 DOI: 10.1007/s10896-016-9806-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A qualitative study was conducted among 18 abused women from different parts of Norway to explore what paid work means for women exposed to partner violence and how living with an abusive partner affected their working life. Based on systematic text condensation analyses of their experiences as described in individual and focus group interviews, the study's findings reveal two major themes. The first is about recovery and survival, and the other about the spillover of problems caused by a violent partner into paid work. Work was important to the women, as it represented time off from violence, contact with others who cared for them, and maintenance of self-esteem and self-confidence. Having their own money provided security and strengthened the belief that they could manage on their own. The spillover of intimate partner violence problems appeared through feelings of fear, shame and guilt at work.
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Affiliation(s)
- Kjersti Alsaker
- />Department of Social Education and Social Work, Faculty of Health and Social Sciences, Bergen University College, Møllendalsveien 6-8, Postboks 7030, 5020 Bergen, Norway
- />National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway
| | - Bente E. Moen
- />Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Tone Morken
- />National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway
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