Study Details | Pathways to Work

24989.01-Study of Patient Car

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 the findings can be attributed to the program.

Program: Patient Care Pathway Program (PCPP)

Characteristics of study participants:

At least a high school diploma or equivalent

Services provided:

Case management, Integrated education and training, Occupational or sectoral training, Unconditional cash transfers

Setting: Urban only

Methods and Standards Protocol version used for review: Version 1.0

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Study design

Design:

Randomized controlled trial

Study group formation:

Madison Area Technical College recruited students with low skills who were interested in careers in the health care sector. Individuals first attended a study intake appointment, during which staff confirmed their eligibility for PCPP (based on skill level and interest). After completing a baseline information form and baseline survey and providing informed consent, people were randomly assigned to the program and comparison groups via an online system. A total of 499 people were randomly assigned from December 2011 to January 2014.

Time period of study:

Random assignment took place from December 2011 to January 2014, with impacts of the PCPP program studied at 18 months, 3 years, and 4 years following random assignment. Future reports will examine outcomes 6 years following random assignment.

Primary outcome domains examined:

Increase long-term earnings, Increase long-term employment, Decrease long-term benefit receipt, Increase education and training

Other outcome domains examined:

Psychosocial skills, life stressors, career progress, and family structure

Study funded by:

The Pathways for Advancing Careers and Education evaluation was funded by the Office of Planning, Research, and Evaluation in 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	Program group mean	Impact	Units	Sample size
Increase long-term earnings	Annual earnings	Three years	High	18,339.00	17,133.00	-1,206.00	2014 dollars	486
Increase long-term employment	Currently employed	Three years	High	74.40	75.10	0.70	Percentage points	326
Decrease long-term benefit receipt	Individual receipt of Medicaid (%)	Three years	High	24.00	23.60	-0.40	Percentage points	321
Decrease long-term benefit receipt	Received AFDC/TANF, annual	Three years	High	1.40	3.20	1.80	Percentage points	321
Decrease long-term benefit receipt	Received any public assistance benefits, annual	Three years	High	45.40	50.10	4.70	Percentage points	321
Decrease long-term benefit receipt	Received Food Stamps/SNAP, annual	Three years	High	25.10	27.50	2.40	Percentage points	321
Increase education and training	Received any college credential	Four years	High	26.10	32.90	6.90	Percentage points	499
Increase education and training	Received exam-based certification or license	Month 18 and Year 3	High	33.00	30.70	-2.30	Percentage points	310
Increase education and training	Received health care credential from a college	Four years	High	22.90	30.60	7.70	Percentage points	499

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 consisted of people with low skills, as determined by test scores, past coursework, or past course performance. Most study sample members were women (84 percent) and White, not Hispanic (67 percent). Few people (3 percent) did not have a high school diploma or equivalent certificate, 44 percent had a high school diploma or equivalent certificate only, and 53 percent had at least some postsecondary education. Average annual family income was about $33,000. In the year prior to study enrollment, about one-third (36 percent) of the sample population had received benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children or the Supplemental Nutrition Assistance Program. About three-quarters (72 percent) were working at the time of study enrollment.

Age

Young adults (age 16-24)	45%
Adults (age 25+)	55%

Sex

Female	84%
Male	16%

Race and ethnicity

Black or African American	21%
White, not Hispanic	67%
Hispanic or Latino of any race	9%

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

37%

Employment and public benefit status

Public benefits recipients	36%
Had low incomes	100%

Education

Had some postsecondary education	53%
Had a high school diploma or GED	97%
Did not have a high school diploma or GED	3%

Specific employment barriers

Were involved with the justice system

21%

Program implementation

Implementing organization:

Madison Area Technical College

Program history:

PCPP operated from 2011 to 2014 in conjunction with this study. The program was an adaptation of other training programs offered at Madison Area Technical College before the evaluation.

Program services:

People who enrolled in PCPP received accelerated instruction and academic advising by participating in one or more of three health care skills academies. Each of the academies provided basic skills remediation and occupational training along with academic advising, instructional supports, access to emergency funds for one-time expenses (such as car repairs), and continued support after program completion. The programs packaged courses to provide people with a clear path to enrollment in higher-level courses. PCPP also shortened the typical period of basic skills acquisition that was necessary for people with low skills to enter health care degree programs. Each skills academy lasted for one semester, although students were able to enroll in up to three academies for a possible total duration of 1.5 academic years.

Mandatory services:

None

Comparison services:

People in the comparison group had access to all regular courses and advising offered at Madison Area Technical College but could not access PCPP skills academies or PCPP advising services.

Service receipt duration:

Each skills academy under the PCPP lasted for one academic semester. It was possible for students to enroll in one, two, or three academies from the time of random assignment, for a total of 6 months to 1.5 years of services. Participants received follow-up support for an unspecified duration.

Program funding:

Madison Area Technical College, with support from the Open Society Foundations (via Abt Associates) and the Joyce Foundation

Study publications

Cook, Rachel, Jill Hamadyk, Matthew Zeidenberg, Howard Rolston, and Karen Gardiner (2018). Madison Area Technical College Patient Care Pathway: Implementation and early impact report, OPRE Report #2018-48, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services. Available at https://files.eric.ed.gov/fulltext/ED618156.pdf

Gardiner, Karen, and Randall Juras (2019). Pathways for Advancing Careers and Education (PACE): Cross-program implementation and impact study findings, OPRE Report #2019-32, 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/opre/report/pathways-advancing-careers-and-education-pace-cross-program-implementation-and-impact.

Walton, Douglas, Daniel Litwok, Gabriel Durham, and David Judkins (2020). Madison Area Technical College’s Patient Care Pathway Program: Appendices for three-year impact report, OPRE Report #2020-161, 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/madison_3-year_impact_report_11-2020.pdf

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Study of Patient Care Pathway Program (PCPP)