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Subgroups
To be eligible for HPOG 2.0, people had to be participating in the Temporary Assistance to Needy Families (TANF) program or otherwise meet locally defined criteria for having low income. Programs had significant discretion when establishing these local definitions and other eligibility criteria, and each submitted descriptions of their recruitment, referral, and eligibility processes to ACF. Programs randomly assigned eligible applicants to the intervention and comparison groups using a lottery-like process. When the study began, two people were assigned to the intervention group for every one person assigned to the comparison group. In December 2020, this ratio changed to three intervention group members to one comparison group member, in response to recruitment and service provision difficulties posed by the COVID-19 pandemic. The new ratio remained in effect through the end of the grant period in September 2021. This study review focuses on findings for three cohorts: full pre-survey, early pre-survey, and survey. The full pre-survey cohort includes all study members randomized from February 2016 to February 2017, with 10,132 participants total. The early pre-survey cohort includes all study members randomized from February 2016 to June 2016, with 2,878 participants total. All outcomes for the full and early pre-survey cohorts are drawn from administrative data, which is available through 10 quarters post-randomization for the full cohort and through 13 quarters for the early cohort. The survey cohort includes all study members randomized from March 2017 to February 2018, with 12,964 participants total. Survey and administrative data are available through five quarters post-randomization for this cohort. The full pre-survey and survey cohorts are pooled into one sample. The study also includes education and training outcomes that are only available for the pre-survey cohort. A fourth cohort (post-survey) is expected to be included in future manuscripts.
The program was launched in 2016 (at the beginning of the pre-survey cohort random assignment) and was rolled out from 2016 to 2021. Only people randomly assigned from 2016 to the beginning of 2018 are considered in this review. The follow-up period was 2.5 years from random assignment. For the pre-survey cohort, follow-up was through 10 quarters; for the survey cohort, follow-up was through 5 quarters.
ACF, U.S. Department of Health and Human Services
A majority (91 percent) of the sample was female. Forty-seven percent were Black or African American, not Hispanic; twenty-three percent were Hispanic or Latino of any race; and twenty-four percent were White, not Hispanic. The average age was 32. The majority (62 percent) of the sample had dependent children. At baseline, more than 60 percent of participants were receiving the Supplemental Nutrition Assistance Program and/or Medicaid, and more than 20 percent were receiving Temporary Assistance for Needy Families and/or the Special Supplemental Nutrition Program for Women, Infants, and Children.
HPOG 2.0 grantees included community colleges, community-based organziations, workforce system agencies (such as workforce investment boards and one-stop career centers), and other state agencies (including state Departments of Social Services).
HPOG 2.0 was the second round of grant awards for the HPOG Program. The Office of Family Assistance (OFA) of ACF, in the U.S. Department of Health and Human Services, issued the first round of grant funding (HPOG 1.0) in 2010. HPOG 2.0 began in 2015.
HPOG 2.0 was an employment and training program that aimed to prepare participants for careers in health care occupations that paid well and were expected to experience labor shortages or increased demand. The program drew on a career pathways framework with three core components: basic skills training, health care occupational training, and wraparound supports and services. Local HPOG 2.0 programs varied in how they implemented the career pathways framework. Most programs did not develop or provide HPOG-specific training courses. Rather, programs provided navigation services to facilitate participant enrollment in existing job training courses, education programs, and other services. Clients received combinations of basic skills training, education, training, work-based learning opportunities, and assistance connecting to employment. Local HPOG 2.0 programs also offered or connected participants to an array of additional services, including case management, academic supports (for example, financial aid counseling or tutoring), personal supports (for example, assistance connecting to or paying for child care), employment assistance, and other skills development activities.
People assigned to the comparison group did not have access to the HPOG programs but had access to education, training, and services available in the community. In some cases, comparison group members could enroll in the same courses as intervention group members if the courses were already taught at local community colleges.
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The manuscripts reviewed for this study review did not specify an intended duration for the HPOG 2.0 intervention. At 15 months after randomization, the intervention group had completed 5.7 months of training, on average, and 40.6 percent had completed at least 60 months of training.
The Office of Family Assistance of ACF, in the U.S. Department of Health and Human Services, funded HPOG 2.0.
HPOG 2.0 funded 27 non-Tribal grantees across the United States: Rochester, NY; San Antonio, TX; Buffalo, NY; Grand Island, NE; Milton, PA; Chicago, IL; Tulsa, OK; Pittsburgh, PA; Franklin, CT; Lynnwood, WA; Roanoke, VA; Bronx, NY; Topeka, KS; Jefferson City, MO; Tucson, AZ; Grants Pass, OR; Pasadena, TX; Schenectady, NY; Columbia, SC; Bridgeport, CT; Euless, TX; Southfield, MI; Seattle, WA; Monroe, LA; Portland, OR; and Toledo, OH. Some locations had multiple grantees or programs (for example, two grantees were based in Bronx, NY, each with its own program; one grantee based in Jefferson City, MO, had three distinct programs). Overall, the 27 non-Tribal grantees operated 38 distinct programs. Grantees varied in administrative structure; 10 grantees were higher education institutions, 7 were workforce system agencies, 6 were community-based organizations, and 4 were labeled as "other state agencies."
Starting training, basic skills education and course-taking, use of cognitive skills and self-directed learning, receipt of support services, cost to participant, educational progress, health care labor market outcomes, precursors of career success, well-being, and participant satisfaction