Study Details | Pathways to Work

25448.01-Study of Health Prof

Study quality: High

High

Reason for the rating: This study received a high study quality rating because it is a low-attrition randomized controlled trial with no known issues that suggest the findings cannot be attributed to the intervention.

Intervention: Health Profession Opportunity Grants (HPOG) 1.0

Population and employment barriers:

Educational attainment (At least a high school diploma or equivalent), Public Benefits Recipients (Public benefits recipients)

Services provided:

Basic skills/bridge programs, Case management, Employment coaching, Financial education, Job placement, Job readiness, Job search assistance, Occupational or sectoral training, Peer mentoring, Post-employment participant follow-up, Soft skills training, Stipends, Tuition assistance/financial aid

Setting: Tested in multiple settings

Study design

Design:

Randomized controlled trial

Study group formation:

The HPOG programs aimed to recruit people with low incomes to participate in the study. To be considered eligible for the study at all programs, people had to have low income, as indicated by receiving public benefits or having income below a threshold based on the federal poverty line. (The threshold varied by program.) Most programs also required people to have some minimal level of basic skills, and many conducted criminal background checks and evaluated applicants' interests and skills to determine eligibility. Eligible people were randomly assigned to intervention and comparison groups from March 2013 to November 2014. For 20 of 23 grantees, 2 people were assigned to the intervention group for every person assigned to the comparison group. In 19 programs operated by 10 grantees, people in the intervention group were also assigned with equal probability to receive enhanced or standard services. This study review examines the contrast of the entire intervention and comparison groups. Other reviews examine those in the intervention group that were or were not eligible for enhanced services.

Time period of study:

The study randomly assigned participants from March 2013 to November 2014 and collected data at 15 months, 3 years, and 6 years after random assignment.

Primary outcome domains examined:

Increase short-term earnings, Increase long-term earnings, Increase very long-term earnings, Increase short-term employment, Increase long-term employment, Increase very long-term employment, Decrease short-term benefit receipt, Decrease long-term benefit receipt, Decrease very long-term benefit receipt

Other outcome domains examined:

Job quality, employment barriers, self-efficacy, financial hardship, psychological well-being, and child development and well-being

Study funded by:

ACF, U.S. Department of Health and Human Services

Results

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Outcome domain	Measure	Timing	Study quality by finding	Comparison group mean	Intervention group mean	Impact	Units	Sample size
Increase short-term earnings	Total earnings over follow-up period	Quarters 1–5	High	13,713.00	13,544.00	170.00	2014 dollars	13,717
Increase long-term earnings	Quarterly earnings	Quarter 20	High	5,885.00	5,831.00	-55.00	2018 dollars	13,716
Increase very long-term earnings	Quarterly earnings	Quarter 24	High	6,194.00	6,039.00	-154.00	2019 dollars	13,716
Increase short-term employment	Ever employed, quarterly	Quarter 6	High		73.10	-0.20	Percentage points	13,716
Increase short-term employment	Number of quarters employed, follow-up period	Quarters 1–5	High		3.20	-0.10	Quarters	13,430
Increase long-term employment	Ever employed, quarterly	Quarter 20	High	76.10	76.20	0.10	Percentage points	13,716
Increase very long-term employment	Ever employed, quarterly	Quarter 24	High	73.70	73.20	-0.50	Percentage points	13,716
Decrease short-term benefit receipt	Amount of UI payments, quarterly	Quarter 6	High	41.00	37.00	-4.00	2015 dollars	13,716
Decrease short-term benefit receipt	Received UI payments, quarterly	Quarter 6	High	2.90	2.60	-0.30	Percentage points	13,716
Decrease long-term benefit receipt	Amount of UI payments, quarterly	Quarter 20	High	44.00	48.00	4.00	2018 dollars	13,716
Decrease long-term benefit receipt	Received UI payments, quarterly	Quarter 20	High	2.50	2.50	0.10	Percentage points	13,716
Decrease very long-term benefit receipt	Amount of UI payments, quarterly	Quarter 24	High	234.00	251.00	16.00	2019 dollars	13,716
Decrease very long-term benefit receipt	Received UI payments, quarterly	Quarter 24	High	6.80	7.20	0.40	Percentage points	13,716

Short-term outcomes are those measured 18 months or fewer after participants are first offered services. Long-term outcomes are those measured between 18 months and 5 years after participants are first offered services. Very long-term outcomes are those measured 5 years or more after participants are first offered services.

Findings quality key:

High
Moderate

Study quality terms?

The findings quality describe our confidence that a given study’s finding is because of the intervention. We do not display findings that rate low.

Findings key:

A moderate-to-large favorable finding that is unlikely to be due to chance
A moderate-to-large favorable finding that might to be due to chance
A small favorable finding that is unlikely to be due to chance
A small favorable finding that might be due to chance
A favorable finding that is unlikely to be due to chance, but we cannot determine the standardized effect size
A favorable finding that might be due to chance, but we cannot determine the standardized effect size
A moderate-to-large unfavorable finding that is unlikely to be due to chance
A moderate-to-large unfavorable finding that might to be due to chance
A small unfavorable finding that is unlikely to be due to chance
A small unfavorable finding that might be due to chance
An unfavorable finding that is unlikely to be due to chance, but we cannot determine the standardized effect size
An unfavorable finding that might be due to chance, but we cannot determine the standardized effect size
A finding that is unlikely to be due to chance, but we cannot determine the standardized effect size or direction
A finding of no effect that might be due to chance

Favorable findings are impacts in a direction that is socially desirable. Statistical significance indicates the likelihood that a study finding is due to the intervention, rather than due to chance. Findings are described as moderate-to-large if the intervention produced a sufficiently large change in the outcome. An impact receives this designation if the standardized effect size is equal to or greater than 0.25 or equal to or less than -0.25.

Sample characteristics

The HPOG programs aimed to recruit Temporary Assistance for Needy Families recipients and other people with low incomes. Across all 42 programs, 89 percent of study participants were female, 63 percent had one or more children, and 84 percent were not married. About one-quarter (24 percent) were Hispanic, and about one-third (34 percent) were Black and not Hispanic. The average age was 32. At baseline, 12 percent of participants lacked a high school diploma or equivalent certification, whereas 20 percent had a postsecondary degree or certificate. Forty-three percent were working, and 26 percent were in school. Fifty-six percent received the Supplemental Nutrition Assistance Program or the Special Supplemental Nutrition Program for Women, Infants, and Children, and 13 percent received Temporary Assistance for Needy Families.

Age

Mean age	32 years
Young adults	32%
Adults (age 25+)	68%

Sex

Female	89%
Male	11%

Participant race and ethnicity

Black or African American	34%
White, not Hispanic	36%
Hispanic or Latino of any race	24%
Another race	7%

The race and ethnicity categories may sum to more than 100 percent if the authors reported race and ethnicity separately; in these cases, we report the category White, rather than White, not Hispanic.

Family status

Single parents

63%

Participant employment and public benefit status

Were employed	43%
Were unemployed	57%
Public benefits recipients	100%
Had low incomes	100%

Participant education

Had some postsecondary education	54%
Had a high school diploma or GED	88%
Did not have a high school diploma or GED	12%

Specific employment barriers

Had a substance abuse disorder	1%
Were immigrants	18%

Intervention implementation

Implementing organization:

Multiple organizations implemented HPOG programs, including community and technical colleges, local workforce agencies, state agencies, and nonprofit institutions.

Program history:

Programs received grants about 2.5 years before the study began. Many had a long history of providing employment and training services.

Intervention services:

This study examines the effects of 42 local programs funded by HPOG to 23 grantees. Each of the 42 HPOG programs had flexibility in developing unique programs based on local community needs but used ACF guidelines. Programs were required to (1) develop skills relevant to the health care industry; (2) support career pathways through flexible delivery, multiple entry and exit points, successive levels of education and training, and work-based learning; (3) provide training leading to credentials recognized by employers and the health care industry; (4) provide supportive services to help participants overcome barriers to employment and training participation; and (5) provide training at accessible times and locations. The most common occupational training programs were six- to eight-week courses to become a nursing aide, orderly, or attendant, but a diverse array of programs in the health care industry were offered. Programs typically offered pre-training activities, such as orientations, basic skills classes, computer and financial literacy classes, and soft skills training. Many programs also provided prerequisite courses in health-related subjects such as biology. Participants could also receive a variety of supportive services, including the following: case management; academic supports (academic and career counseling, mentoring, peer support groups, and tutoring); financial assistance for training and employment expenses such as child care and transportation; assistance with household expenses; tuition assistance; and employment services, including job search assistance, employment retention assistance, job development and placement, and counseling. In several programs, a randomly selected subset of the intervention group received enhanced services. Enhanced services included emergency assistance to cover unexpected expenses, noncash incentives (such as a gift card for completing a course), and facilitated peer support groups.

Mandatory services:

None

Comparison services:

The comparison group did not have access to the HPOG programs but could access similar services in the community. Often, comparison group members could enroll in the same vocational training programs as the intervention group but without the financial and other assistance offered to the intervention group.

Service receipt duration:

Trainings varied greatly in length, from six weeks to four years. Most people enrolled in short-term programs (six to eight weeks), but the career pathways approach encouraged people to enroll in multiple programs over time.

Intervention funding:

ACF, U.S. Department of Health and Human Services

Study publications

Harvill, Eleanor, Daniel Litwok, Shawn Moulton, Alyssa Rulf Fountain, and Laura R. Peck. (2018). Technical supplement to the Health Profession Opportunity Grants (HPOG) impact study interim report: Report appendices, OPRE Report #2018-16b, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Available at https://www.acf.hhs.gov/sites/default/files/images/opre/hpog_interim_appendices_revised_nov_2019.pdf

Litwok, Daniel, Douglas Walton, Rebecca Jackson, and Laura R. Peck (2019). Health Profession Opportunity Grants (HPOG 1.0) impact study: Three-year impacts report appendices, OPRE Report #2019-114, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Available at https://www.acf.hhs.gov/sites/default/files/documents/opre/hpog_three_year_impacts_nov_2019_0_0.pdf

Peck, Laura R., Alan Werner, Eleanor Harvill, Daniel Litwok, Shawb Moulton, Alyssa R. Fountain, and Gretchen Locke (2018). Health Profession Opportunity Grants (HPOG 1.0) impact study interim report: Program implementation and short-term impacts, OPRE Report #2018-16a, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Available at https://www.acf.hhs.gov/sites/default/files/documents/opre/hpog_interim_report_revised_nov_2019.pdf

Peck, Laura R., Daniel Litwok, Douglas Walton, Eleanor Harvill, and Alan Werner (2019). Health Profession Opportunity Grants (HPOG 1.0) impact study: Three-year impacts report, OPRE Report #2019-114, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Available at https://www.acf.hhs.gov/sites/default/files/documents/opre/hpog_three_year_impacts_nov_2019_0_0.pdf

Peck, Laura, Daniel Litwok, and Douglas Walton (2022). Health Profession Opportunity Grants (HPOG 1.0) impact study: Six-year impacts report, OPRE Report #2022-45, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Available at https://www.acf.hhs.gov/sites/default/files/documents/opre/hpog-impact-study-six-year-impacts-report-feb-2022.pdf

View the glossary for more information about these and other terms used on this page.

The Pathways Clearinghouse refers to interventions by the names used in study reports or manuscripts. Some intervention names may use language that is not consistent with our style guide, preferences, or the terminology we use to describe populations.

Study of Health Profession Opportunity Grants (HPOG) 1.0

25448.01-Study of Health Prof

Study design

Design:

Study group formation:

Time period of study:

Primary outcome domains examined:

Other outcome domains examined:

Study funded by:

Results

Sample characteristics

Age

Sex

Participant race and ethnicity

Family status

Participant employment and public benefit status

Participant education

Specific employment barriers

Intervention implementation

Implementing organization:

Program history:

Intervention services:

Mandatory services:

Comparison services:

Service receipt duration:

Intervention funding:

Study publications