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Working toward Wellness: Early results from a telephone care management program for Medicaid recipients with depression. (Kim et al 2009)

Citation

Kim, S., LeBlanc, A. and Michalopoulos, C. (2009). Working toward Wellness: Early results from a telephone care management program for Medicaid recipients with depression. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

Highlights

  • The study’s objective was to examine the impacts of a telephone care management program, Working toward Wellness (WtW), on low-income depressed parents’ employment and earnings.
  • The study used a randomized controlled trial design, assigning eligible parents to either the WtW program or existing services. Authors used data from a six-month follow-up survey to estimate program impacts, accounting for parents’ characteristics before random assignment.
  • The study did not find any statistically significant effects of the WtW program on employment or earnings.
  • The quality of causal evidence presented in this report is high because it was based on a well-implemented randomized controlled trial. This means we would be confident that any estimated effects would be attributable to WtW and not to other factors. However, the study did not find statistically significant effects.

Intervention Examined

Working toward Wellness (WtW)

Features of the Intervention

The WtW program was implemented in Rhode Island, by United Behavioral Health, a Medicaid provider. People were eligible for the program if they were parents, were on Rhode Island Medicaid, and passed a screener indicating depressive symptoms.

Individuals in the WtW group received intensive outreach from case managers to enter and remain in treatment. Master’s degree-level care managers placed telephone calls to WtW participants to encourage them to seek treatment for their depression. The care managers also helped coordinate health appointments, encouraged and monitored follow-through on appointments and treatment plans, and provided supplemental information and counseling. During the calls, care managers also asked participants about their employment status and goals, and about barriers to employment, such as needing child care. The average participant had almost monthly contact with her care manager and received nine phone calls over the course of the year.

Participants who resisted seeking professional treatment were offered a structured psycho-educational program that the care manager administered over the phone. The goal of the phone program was to establish a positive relationship between care managers and participants and maintain participants’ engagement with WtW.

Features of the Study

From November 2004 to October 2006, evaluators randomly assigned 253 parents to the treatment group and 254 to the control group. Authors collected employment and earnings data from a survey administered six months after random assignment (six months before program end). The authors compared the outcomes of treatment and control group members, accounting for their characteristics before random assignment.

Findings

  • The study did not find any statistically significant effects of the WtW program on employment or earnings.

Considerations for Interpreting the Findings

None.

Causal Evidence Rating

The quality of causal evidence presented in this report is high because it was based on a well-implemented randomized controlled trial. This means we would be confident that any estimated effects would be attributable to WtW and not to other factors. However, the study did not find statistically significant effects.

Additional Sources

Bloom, D., Redcross, C., Hsueh, J., & Martin, V. (2007). Four strategies to overcome barriers to employment: An introduction to the Enhanced Services for the Hard-to-Employ Demonstration and Evaluation project. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

Reviewed by CLEAR

November 2016

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