Study Details | Pathways to Work

28666-Study of Health Prof

Study quality: High

High

Reason for the rating: This study received a high study quality rating because it is a randomized controlled trial with low attrition, suggesting that findings can be attributed to the program.

Program: Health Profession Opportunity Grants (HPOG) 2.0

Characteristics of study participants:

At least a high school diploma or equivalent, Cash assistance recipients

Services provided:

Basic skills/bridge programs, Case management, Employment coaching, Integrated education and training, Job development, Job placement, Job search assistance, Occupational or sectoral training, On-the-job training, Tuition assistance/financial aid

Setting: Tested in multiple settings

Methods and Standards Protocol version used for impact review: Version 2.0

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Study design

Design:

Randomized controlled trial

Study group formation:

Health Profession Opportunity Grants (HPOG) 2.0 required that individuals either were Temporary Assistance for Needy Families (TANF) participants or otherwise met locally defined criteria for having low income. The study evaluated 38 HPOG 2.0 grantee programs in 17 states. Programs had significant discretion when establishing these local definitions and other eligibility criteria, and each program submitted descriptions of their recruitment, referral, and eligibility processes to the Administration for Children and Families. Programs randomly assigned eligible applicants to the program and comparison groups using a lottery-like process. This study review focuses on findings for three cohorts: (1) the early cohort (n = 10,117), (2) the middle cohort (n=12,951), and (3) the late cohort (n=20,089). For all three cohorts, two people were assigned to the intervention group for every one person assigned to the comparison group.

Time period of study:

The study ran from February 2016 to June 2021. Study enrollment ran from February 2016 to December 2019, with three enrollment cohorts included in this study: the early cohort (February 2016 to February 2017), the middle cohort (March 2017 to February 2018), and the late cohort (March 2018 to December 2019). Data collection occurred from February 2016 to June 2021. The follow-up periods varied by data source and cohort. Administrative data was available for all three cohorts, with the duration of follow-up varying by cohort, ranging from 15 months to four years after random assignment. Survey data was only collected for the middle cohort at 17-month and 37-month follow-up surveys.

Primary outcome domains examined:

Increase long-term earnings, Increase education and training

Other outcome domains examined:

Starting training, basic skills education and course-taking, use of cognitive skills and self-directed learning, receipt of support services, educational progress, health care labor market outcomes, precursors of career success, well-being, participant satisfaction

Study funded by:

This study was funded by the U.S. Department of Health and Human Services, Administration for Children and Families (Contract Number HHSP233201500052C).

Results

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Outcome domain	Measure	Timing	Study quality by finding	Comparison group mean	Program group mean	Impact	Units	Sample size
Increase short-term earnings	Total earnings over follow-up period	Quarter 6	High	23,364.00	22,915.00	-449.00	2018 dollars	22,443
Increase long-term earnings	Quarterly earnings	Year 3	High	4,971.00	5,064.00	93.00	2021 dollars	22,437
Increase short-term employment	Cumulative number of quarters employed	Quarter 6	High	5.10	5.00	-0.10	quarters	22,443
Increase short-term employment	Ever employed, quarterly	Quarter 5	High	75.10	76.00	0.90	percentage points	22,443
Increase education and training	Earned a certificate or degree from a training program	Year 4	High	8.90	9.60	0.70	percentage points	10,125
Increase education and training	Earned any college credential	Year 4	High	15.50	18.10	2.60	percentage points	10,125

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.

Means are not displayed when not reported or not aligned with the impact estimates. For example, if the impact estimate is regression-adjusted but only unadjusted means are reported in the study, the unadjusted means are not displayed as they are not aligned with the adjusted impact estimate.

Impact estimates are not shown when the estimate units cannot be converted to natural units.

Findings quality key:

High
Moderate

Study quality terms?

The findings quality describe our confidence that a given study’s finding is because of the program. 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 program, rather than due to chance. Findings are described as moderate-to-large if the program 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 study sample was composed of adults who were receiving TANF or otherwise met local eligibility criteria related to having low income. Most participants were female (91 percent) and had at least a high school diploma or GED (90 percent). The majority of participants were parents (62 percent) and had some postsecondary education (54 percent).

Characteristics may sum to greater than 100 percent due to rounding.

Age

Mean age	32 years
Young adults (age 16-24)	28%
Adults (age 25+)	72%

Sex

Female	91%
Male	9%

Race and ethnicity

Black or African American	48%
White, not Hispanic	23%
Hispanic or Latino of any race	23%
American Indian or Alaska Native	3%
Unknown, not reported, or other	4%

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

Parents

62%

Employment and public benefit status

Were employed	45%
Were unemployed	55%
Public benefits recipients	22%
Cash assistance recipients	83%

Education

Had a high school diploma or GED	90%
Did not have a high school diploma or GED	10%
Postsecondary credential	15%
English learners	7%

Specific employment barriers

Had a disability	9%
Were immigrants	16%
Were military veterans	3%

Program implementation

Implementing organization:

Community colleges; community-based organizations; workforce system agencies (such as workforce investment boards and one-stop career centers); other state agencies (including departments of social services)

Program history:

Health Profession Opportunity Grants (HPOG) 2.0 was the second round of grant awards for the HPOG Program. The Office of Family Assistance in the U.S. Department of Health and Human Services, Administration for Children and Families issued the first round of grant funding (HPOG 1.0) in 2010. HPOG 2.0 began in 2015.

Program services:

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.

Mandatory services:

None

Comparison services:

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.

Service receipt duration:

The program did not have a fixed intended duration. Participants were offered access to education, occupational training, and support services for healthcare career pathways where length varied by credential, ranging from short-term trainings (less than four months) to programs exceeding one year. The average participant received about 10 months of training.

Program funding:

This program was funded by HPOG 2.0 grants from the U.S. Department of Health and Human Services, Administration for Children and Families, Office of Family Assistance.

Study publications

Judkins, David Ross, Sarah Prenovitz, Gabriel Durham, Stas Kolenikov, Emily Roessel, Jacob Alex Klerman, and Gretchen Locke (2022). Health Profession Opportunity Grants (HPOG 2.0) Short-Term Impact Report Appendix. OPRE Report 2022-37. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services

Judkins, David Ross, Sarah Prenovitz, Gabriel Durham, Stas Kolenikov, Emily Roessel, Jill Hamadyk, Alec Wall, Jacob Alex Klerman, and Robin Koralek (2023). Health Profession Opportunity Grants (HPOG 2.0) Intermediate-Term Impact Report Appendix. OPRE Report 2023-202. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

Klerman, Jacob Alex, David Ross Judkins, and Gretchen Locke (2019). Impact Evaluation Design Plan for the HPOG 2.0 National Evaluation. OPRE Report 2019-82. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

Klerman, Jacob Alex, David Ross Judkins, Sarah Prenovitz, and Gretchen Locke (2022). Health Profession Opportunity Grants (HPOG 2.0) Short-Term Impact Report. OPRE Report 2022-37. 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/hpog2-stir-feb2022_0.pdf

Klerman, Jacob Alex, David Ross Judkins, Sarah Prenovitz, and Robin Koralek (2023). Health Profession Opportunity Grants (HPOG 2.0) Intermediate-Term Impact Report. OPRE Report 2023-201. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Available at https://acf.gov/sites/default/files/documents/opre/OPRE_hpog_report_aug2023.pdf

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Study of Health Profession Opportunity Grants (HPOG) 2.0