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VI. EARLY HEAD START INFLUENCES ON ECONOMIC SELF-SUFFICIENCY, MENTAL HEALTH, AND FAMILY FUNCTIONING
Although the Early Head Start programs focus on the development of infants and toddlers and the relationship between parent and child, they strive to support the healthy functioning and economic self-sufficiency of families, building on their strengths and working with them to remove barriers. Early Head Start eligibility guidelines require that the income level of at least 90 percent of families admitted to the program be below the poverty line. While they may have many strengths, families at this income level often struggle for survival, and financial concerns can interfere with parenting or infant development. Therefore, to help support their children, many programs aim to help them become stabilized economically and move toward self-sufficiency.
The parent's ability to progress toward self-sufficiency and to develop a supportive relationship with the child may depend on mental health and family functioning. Mothers who are depressed or who live in families with high levels of conflict may have difficulty with both nurturing their children and functioning in the workplace. Programs attempt to address mental health and family functioning issues in a variety of ways, but removing these substantial barriers to economic self-sufficiency and the development of supportive parent-child relationships is very challenging.
A. HYPOTHESES AND BRIEF SUMMARY OF INTERIM FINDINGS
Early Head Start programs may have several reasons for wanting to help families improve their economic well-being (which the programs attempt to do by helping parents obtain education, find jobs, and maintain employment over time). First, an important part of the parenting role is to provide economic support for the family. When resources are insufficient, family members may lack food, housing, and other necessities. Programs may find that families turn to them to help address financial crises that arise when income is very low. Helping these families to stabilize by increasing their available income is a high priority for avoiding future crises of this nature. Second, welfare reform had reached all the states, at least to some extent, by the time the Early Head Start research programs were enrolling families. The new rules eliminated any entitlement to cash assistance, imposed work requirements, and established a time limit on welfare benefits. Therefore, helping families make progress toward long-term self-sufficiency became much more important. More immediately, in about half the states, parents of infants who were receiving cash assistance had to meet work requirements to continue receiving benefits. In the other states, the work requirements applied when the child was 1 year old. Thus, programs needed to help families make sound decisions about education and employment in the new welfare policy environment.
Third, programs are mindful of the established links between family income and children's well-being. Families with more resources to enhance children's home environments live in safer, healthier housing and neighborhoods and provide children with access to health care and opportunities to learn. Children in such families are more likely to perform better in school and have fewer behavioral problems that threaten their educational and social development (Blau 1999; Bradley and Coreway in press; Bradley and Whiteside-Mansell 1998; Duncan and Brooks-Gunn 1997; Mayer 1997). Helping parents toward employment and economic self-sufficiency would be another way to support children's development, one that would continue to influence children once they left Early Head Start.
At the same time, parents' mental health and family functioning may affect the extent to which they can move toward self-sufficiency and respond to program services designed to foster supportive parent-child relationships. State and local welfare agencies are currently struggling with mental health problems, abusive family relationships, and other issues as they seek to help families who are having difficulty with the transition from welfare to work. When parents are depressed, they often have a hard time responding to their infants and toddlers in positive and supportive ways, and some Early Head Start programs are finding that parenting education alone cannot substantially remedy the situation. Early Head Start programs are required to have a mental health component, but community mental health services to which they can refer parents are sometimes insufficient.
1. Hypotheses About, and Synopsis of Findings On, the Influences of Early Head Start on Families' Economic Self-Sufficiency
a. Hypotheses
For all families, the goal of economic self-sufficiency includes the ability of adults in the household to earn enough regular income to meet the family's needs for shelter, nutrition, clothing, medical care, child care, and the materials children need as they grow. Over time, the economic goals of the family may expand beyond mere economic self-sufficiency. Parents may wish to obtain an adequate foundation of education and job experience to enable them to raise their economic status further over time, so that they can keep improving their housing, access to education, medical services, child care, and materials to promote children's development.
Families enter Early Head Start programs in very different positions with respect to these goals. Some parents lack a high school education and have spotty or no job experience. Others enter the program with a high school education and a solid work record. Families also vary in the extent to which they have relied on welfare for income assistance. The education, employment, and welfare backgrounds that parents bring to the program affect the services that programs will need to provide in order to help them move toward self-sufficiency. What parents bring can also affect the likelihood of success of those efforts.
We would expect the programs to help parents who enter Early Head Start without a high school education and with little job experience take steps toward obtaining a high school diploma or GED. Parents in families receiving welfare may face work requirements, so we would expect programs to help them learn about such requirements and choose their work activities strategically. As Early Head Start programs are not employment services or welfare agencies, we would not expect them to emphasize a speedy transition to employment. Instead, because the programs intend to work with these families for two to three years, we would expect them to try to improve the prospects for long-term self-sufficiency by helping parents make long-range plans to improve education and skills before beginning a job. As parents are building skills and caring for their infants, we would expect the program to help them obtain adequate income and resources from government programs for which they are eligible. Thus, we have developed the following hypotheses about the impacts of Early Head Start on the self-sufficiency of families with lower levels of education and job experience:
- In the short term, Early Head Start families are expected
(1) to participate more than control families in education activities,
and (2) to complete high school and obtain additional education
credentials at higher rates than control families.
- In the short term, Early Head Start families are expected
to tap sources of income and benefits from government programs for
which they are eligible, including cash assistance, food stamps,
and health insurance.
- In the short term, Early Head Start families are not expected
to have higher levels of employment or earnings than the control
group.
- Over time, Early Head Start families are expected to have higher levels of employment, greater job stability, higher earnings, and lower levels of income and benefits from government sources than control families.
Parents who enter Early Head Start programs with a high school diploma and a strong record of employment may not need intensive services to become economically self-sufficient. Early Head Start programs may nevertheless play a critical role in helping them sustain self-sufficiency. High-quality child care can be difficult for low-income parents of infants and toddlers to find, and where it exists, it can be very expensive (Adams et al. 1998; Cost, Quality, and Child Outcomes Study Team 1995a and 1995b; Galinsky et al. 1994; Kontos et al. 1995; Long and Clark 1995; NICHD Early Child Care Research Network 1997; and Ross and Paulsell 1998). Early Head Start programs can help employed parents obtain subsidies to pay for child care in the community and to locate high-quality child care. Some of the programs offer center-based infant-toddler care that meets the Head Start Program Performance Standards. We have found that such care is better than the care that multisite studies have shown to be generally available in communities (see Pathways to Quality; ACYF 2001b). In addition to child care support, the programs can help these parents obtain additional education or training that will enable them to obtain stabler, higher-paying jobs. The child care and other support that Early Head Start programs can offer the parents who are more employment-ready is expected to contribute to the following impacts:
- In the short term, Early Head Start families should have
higher levels of employment, as well as more continuous employment,
than control families. This should lead to greater gains in family
income.
- In the short term, Early Head Start families will probably
participate in education and job training activities to help them
get better jobs or advance in their current jobs in the longer term.
- Over the long term, more continuous employment should enable Early Head Start parents to improve their earnings, the quality of their jobs, and their family income relative to control group parents.
b. Synopsis of Findings
The interim findings reported in this chapter suggest that Early Head Start services may have helped build self-sufficiency in the long term, but they did not develop it in the short term. As we expected, the Early Head Start programs significantly increased participation in education or job training activities in the short term. However, they did not significantly increase either employment or overall participation in self-sufficiency activities (defined as participating in education/training or employment). This pattern of findings is consistent with program staff reports during site visits that they often counseled families not to take the first job they could find and advised them instead to get the education or training they needed to obtain a stable job that would pay higher wages. As expected, the Early Head Start programs also did not have a significant impact on poverty or welfare receipt in the short term.
Full implementation of program services appears to lead to slightly stronger impacts on family self-sufficiency. The programs that were early implementers significantly increased several measures of employment and education or job training during the first 15 months after random assignment. Later implementers did not increase employment or participation in education and training activities. The incomplete implementers also had some positive impacts on participation in education or job training, reflecting specific program characteristics or strategies that enabled them to achieve impacts despite the implementation challenges they faced.
The interim findings also show that in sites where welfare-reliant parents of infants were required to work, the Early Head Start programs helped some eligible parents obtain cash assistance and significantly increased welfare receipt in the short term. The programs did not have a significant impact on welfare receipt in the sites that did not have early work requirements. The Early Head Start programs increased participation in education or job training in both groups of sites.
2. Hypotheses About, and Synopsis of Findings On, the Influences of Early Head Start on Physical and Mental Health and Family Functioning
a. Hypotheses
Parent and family well-being are important underpinnings of progress toward self-sufficiency and supportive parent-child relationships. Good mental health is of course an important goal in its own right, and Early Head Start programs are often concerned about parents who face mental health challenges. Low-income mothers have a higher incidence of depression, which may interfere with their education and employment, which may in turn cause economic difficulties that intensify their mental health problems (Johnson and Meckstroth 1998; Kisker et al. 1998; Olson and Pavetti 1996; and Zedlewski 1999). The proportion of parents who have experienced domestic abuse is high among families who have received welfare, and it can lead to the loss of jobs and negative outcomes (Bloom et al. 2000; Friedman and Couper 1987; Gennetian and Miller 2000; Johnson and Meckstroth 1998; and Osofsky 1995).
Thus, Early Head Start programs are likely to face the challenges of mental health and family dysfunction to varying degrees. The extent of these problems, as well as the capacity of the programs to address them, may affect how well the programs can engage families in appropriate services and influence their success with other goals, including self-sufficiency, supportive parent-child relationships, and infant-toddler development. Early Head Start programs' case management services, and the intensity with which they work with families on issues that arise, may allow the programs both to alleviate family crises and to help parents avoid new ones. However, treating clinical depression requires a specific mental health intervention. Program staff in many sites reported during site visits that mental health services to which they could refer families were scarce in their community, and the data show that the Early Head Start programs did not have any impacts on the receipt of mental health services in the short term. Therefore, our hypotheses about the impacts of Early Head Start on parents' mental health are modest. In home-based and mixed-approach programs, home visitors who meet frequently with parents and focus on everyday issues affecting parenting may help alleviate stresses and negative feelings. Severe depression is unlikely to be cured unless the parent receives mental health services. Thus, we have the following hypotheses about Early Head Start impacts on health and family functioning:
- Early Head Start parents are expected to have lower levels
of parenting stress, lower levels of dysfunctional parent-child
interactions, and lower levels of family conflict than control group
parents, although these effects are likely to be modest.
- Early Head Start is not expected to reduce levels of depression
among parents, because there was no impact on receipt of mental
health services.
- Early Head Start programs with more-intensive home-based services are expected to have stronger impacts on parents' mental health and family functioning.
b. Synopsis of Findings
The interim findings reported in this chapter show that the Early Head Start programs significantly improved several aspects of family functioning. They reduced parental distress, dysfunctional parent-child interactions, and family conflict when children were approximately 24 months old. However, as expected, Early Head Start did not have a significant impact on the likelihood that parents had suffered a major depressive episode in the previous year. We did not find that the home-based programs had stronger impacts on family functioning.
Program impacts on mental health and family functioning varied by programs' pattern of implementation. Full implementation appears to be important for achieving reductions in parental distress and depression. However, only the incomplete implementers had significant impacts on parent-child dysfunctional interactions and family conflict. These impacts may reflect the strong family support focus of some of the incomplete implementers.
B. GLOBAL IMPACTS ON FAMILY WELL-BEING
We conducted global impact analyses to examine the hypotheses described above. Because the available data for analyzing self-sufficiency and family functioning cover only about 15 months after program enrollment and include measures of family functioning administered when children were 2 years old, the findings pertain to the short-term impacts of the Early Head Start programs on family well-being. Next, we describe the measures of family well-being we used and present the programs' short-term impacts on them.
1. Measures of Self-Sufficiency, Mental Health, and Family Functioning
Our estimates of the impact of Early Head Start on family well-being are based on parent interviews and come from two major sets of follow-up data used in this interim report (see Chapter II and Appendix C for details). Two sets of outcomes-receipt of services and self-sufficiency activities-are likely to be influenced by the length of the intervention. Therefore, information on these outcomes was collected at intervals after the family enrolled in Early Head Start. Another set of outcomes-children's development, some aspects of parenting, and features of child care arrangements-require standardization by the age of the child, and so they were collected at specific age levels. Outcomes that are closely related to child development outcomes, including parenting, mental health, and family functioning, were also collected in the birthday-related interviews.
The measures of economic self-sufficiency, including education, employment, welfare program participation, and family income, are based on data that were obtained at 7 and 16 months, on average, after enrollment in Early Head Start, and represent short-term impacts of the program. The measures of economic self-sufficiency are summarized in Box VI.1.
Measures of parent mental health and family functioning were obtained in the birthday-related interviews when children were approximately 14 and 24 months old. Children entered Early Head Start at a wide variety of ages, and such interviews could be conducted within an eight-month window around the child's birthday. As a result, the 14-month interviews occurred between 1 and 27 months after enrollment, and the 24-month interviews took place between 10 and 37 months after enrollment. The average 14-month interview was conducted about 12 months after enrollment, and the average 24-month interview about 22 months after enrollment. The measures of parent health and family functioning discussed in this chapter are summarized in Box VI.2.
| BOX VI.1 MEASURES OF ECONOMIC SELF-SUFFICIENCY Education: Parents were asked about education and job training programs that they had participated in during the follow-up period, including the start and end dates for those activities and the typical hours per day and days per week they spent in those activities. From that information we constructed a weekly timeline of education/training activities and indicators of whether parents were in education/training activities during each of the first five quarters following random assignment. We also combined information on hours per day and days per week for all education/training activities to obtain the average hours per week parents spent in education/training activities during the 15-month follow-up period. Averages include zero hours. Employment: Parents were asked about jobs that they had held during the follow-up period, including the start and end dates for those jobs and the typical hours per week they worked in those jobs. From that information we constructed a weekly timeline of employment activities and indicators of whether parents were employed during the first five quarters following random assignment. We also combined information on hours per day and days per week for all jobs to obtain the average hours per week parents spent in employment during the 15-month follow-up period. Averages include zero hours. Any Activity: The weekly histories of education/training activities and jobs were combined to create a timeline of participation in any of these self-sufficiency activities and indicators of whether parents participated in any self-sufficiency activities during each of the first five quarters following random assignment. We also added the average number of hours spent in education/training and jobs to get the average number of hours parents spent in any self-sufficiency activities during the first 15 months after random assignment. Averages include zero hours. Welfare Program Participation: Parents were asked about their receipt of AFDC/TANF cash assistance, food stamps, general assistance, and SSI or SSA benefits, including the amount they received and the months during which they received it. From this information we created a monthly timeline of welfare receipt and a timeline of AFDC/TANF cash assistance receipt, as well as indicators of welfare receipt and AFDC/TANF cash assistance receipt during each of the first five quarters after random assignment. We also added the welfare benefit amounts to obtain the total amount of welfare benefits received, the total amount of food stamps received, and the total amount of AFDC/TANF cash assistance received during the 15-month follow-up period. Averages include zero benefit amounts. Family Income and Resources: In the Parent Services Follow-Up Interviews, parents were asked about their family income during the last year. We compared information on their annual income and the number of children in their family with federal poverty levels to create an indicator of whether or not the family's income during the year prior to the second follow-up was above the poverty level or not. Family resources were assessed using the Family Resource Scale (Dunst and Leet 1987) plus items assessing additional resources, in which parents rated the adequacy of 39 specific resources on a scale of 1 (not at all adequate) to 5 (almost always adequate). The item values were summed to obtain a total family resources scale value. |
| BOX VI.2 MEASURES OF THE PARENT'S HEALTH AND FAMILY FUNCTIONING Parenting Stress Index - Short Form (PSI-SF) - measures the degree of stress in parent-child relationships stemming from three possible sources: the child's challenging temperament, parental depression, and negatively reinforcing parent-child interactions (Abidin 1995). We included two subscales of the PSI-SF: Parental Distress - measures the level of distress the parent is feeling in his or her role as a parent stemming from personal factors, including a low sense of competence as a parent, stress because of perceived restrictions stemming from parenting, depression, and lack of social support. The parent answers whether he or she agrees or disagrees with statements such as, "You often have the feeling that you cannot handle things very well," and "You feel trapped by your responsibilities as a parent," and "You feel alone and without friends." Responses are coded on a 5-point scale, with 5 indicating high levels of parental distress. Parent-Child Dysfunctional Interaction - measures the parent's perception that the child does not meet the parent's expectations and interactions with the child are not reinforcing the parent. The parent may perceive that the child is abusing or rejecting the parent or that the parent feels disappointed in or alienated from the child. The parent answers whether he or she agrees or disagrees with statements such as, "Your child rarely does things for you that make you feel good," and "Most times you feel that your child does not like you and does not want to be close to you," and "Your child seems to smile less than most children." Responses are coded on a 5-point scale, with 5 indicating high levels of parent-child dysfunctional interaction. Composite International Diagnostic Interview Short Form (CIDI-SF) - evaluates six Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; APA 1994) and two DSM-IIIR substance disorders (Nelson, Kessler, and Mroczek 1998). The CIDI-SF uses a stem-branch logic in which a small number of diagnostic stem questions are used to eliminate respondents who are least likely to be cases before they are asked further symptom questions. The CIDI-SF yields a score that can be converted to the probability of clinical caseness ranging from 0 to 1 for each disorder. We used one section of the CIDI-SF as an outcome measure: Major Depression - provides a probability of caseness for a DSM-IV major depressive episode experienced in the previous 12 months. Family Environment Scale - measures the social environments of families along 10 key dimensions, including family relationships (cohesion, expressiveness, and conflict); emphases within the family on aspects of personal development that can be supported by families (for example, achievement orientation; independence); and maintenance of the family system (organization and control) (Moos and Moos 1976). We measured one dimension: Family Conflict - measures the extent to which the open expression of anger and aggression and generally conflictual interactions are characteristic of the family. Parents respond to items on a 4-point scale, where 4 indicates higher levels of agreement with statements such as, "We fight a lot," and "We hardly ever lose our tempers." Items were recoded and averaged so that 4 indicates high levels of conflict. Health Status - measures the parent's perception of own health status on a five-point scale, where 1 indicates poor health and 5 indicates excellent health. |
2. Any Self-Sufficiency Activities
Although parents entering Early Head Start had children under 1 year old (or were pregnant), a very high proportion engaged in education, training, or employment activities during the first 15 months after enrollment (see Table VI.1). More than four out of five parents in both the Early Head Start and the control groups participated in one or more of these self-sufficiency activities during this period. Early Head Start had no overall impact on the proportion of parents participating in any self-sufficiency activity during the first 15 months after enrollment. Early Head Start also had no impact on the average hours of participation in any self-sufficiency activity during the first 15 months after enrollment.
The time profile of the quarterly participation rates in self-sufficiency activities shows that parents steadily increased participation in self-sufficiency activities following enrollment in Early Head Start, from just under 60 percent in the first quarter to just over 70 percent in the fifth quarter (Figure VI.1). Early Head Start and control group parents had essentially the same pattern of participation overall in self-sufficiency activities throughout the 15-month period. In the next two sections, we separately examine participation in the two major component activities that we are referring to as "self-sufficiency activities," those related to (1) employment, and (2) education or training.
| Outcome | Program Group Participantsa | Control Groupb | Estimated Impact Per Participantc | Effect Sized |
|---|---|---|---|---|
| Any Self-Sufficiency Activities | ||||
| Percentage of parents ever employed or in an education or job training program in first 15 months | 85.1 | 82.6 | 2.5 | 6.6 |
| Average hours per week employed at all jobs and in any education or training in first 15 months | 20.1 | 19.7 | 0.4 | 2.2 |
| Employment Activities | ||||
| Percentage of parents ever employed in first 15 months | 72.2 | 71.9 | 0.2 | 0.5 |
| Average hours per week employed at all jobs in first 15 months | 14.6 | 15.4 | -0.8 | -5.5 |
| Education Activities | ||||
| Percentage of parents who ever participated in an education or training program in first 15 months | 48.4 | 43.7 | 4.7** | 9.5 |
| Average hours per week in an education program during first 15 months | 5.3 | 4.1 | 1.1*** | 14.6 |
| Sample Size | 1,139 | 1,097 | 2,236 | |
| SOURCE:
Parent Services Follow-Up Interviews conducted an average of 7
and 16 months after random assignment. NOTE: All impact estimates were calculated using regression models, where each site was weighted equally. aA participant is defined as a program group member who received more than one Early Head Start home visit, met with an Early Head Start case manager more than once, received at least two weeks of Early Head Start center-based care, and/or participated in Early Head Start group parent-child activities.(back) bThe control group mean is the mean for the control group members who would have participated in Early Head Start if they had instead been assigned to the program group. This unobserved mean was estimated as the difference between the program group mean for participants and the impact per participant.(back) cThe estimated impact per participant is measured as the estimated impact per eligible applicant divided by the proportion of program group members who participated in Early Head Start services (which varied by site). The estimated impact per eligible applicant is measured as the difference between the regression-adjusted means for all program and control group members.(back) dThe effect size was calculated by dividing the estimated impact per participant by the standard deviation of the outcome measure for the control group times 100 (that is, it is the impact expressed as a percentage of the standard deviation).(back) *Significantly different from zero at the .10 level, two-tailed test **Significantly different from zero at the .05 level, two-tailed test. ***Significantly different from zero at the .01 level, two-tailed test. |
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FIGURE VI.1
IMPACTS ON ANY SELF-SUFFICIENCY ACTIVITY, BY QUARTER
[D]| Source: Parent Services Follow-Up Interviews conducted
approximately 7 and 16 months after random assignment. Notes: All percentages are regression-adjusted means estimated using models that weight each site equally. The differences between program and control families are estimated impacts per participant. * Program impact is significantly different from zero at the .10 level, two-tailed test. ** Program impact is significantly different from zero at the .05 level, two-tailed test. ***Program impact is significantly different from zero at the .01 level, two-tailed test. |
3. Employment
The percentage of parents who ever participated in employment activities over the first 15 months after enrollment was high (72 percent of both the control group and Early Head Start participants). Thus, nearly all the parents who participated in any self-sufficiency activity worked at some point during the 15 months after enrollment (see Table VI.1). Moreover, about three-quarters of the 20 hours per week of self-sufficiency activities was time spent in employment.
The time profile of quarterly employment rates indicates that employment increased substantially for both the Early Head Start and the control groups during the first 15 months after enrollment (see Figure VI.2). The proportion of parents employed in both groups increased from about 40 percent to 60 percent over the period, which most likely reflects the influences of the strong economy, welfare-related work requirements, and parents' greater readiness to work as children got older.
Early Head Start did not increase any measure of employment activity, including the proportion ever employed during the 15 months after enrollment, the quarterly employment rates, and the average hours worked per week. This is not surprising, since it is not the focus of Early Head Start to provide its parents a quick entry into employment. Instead, it appears that the employment activities of both the Early Head Start and the control group were much more likely to be governed by the strong influences of welfare policy and the growing economy. Moreover, Early Head Start staff may have taken a longer-term perspective on the transition to self-sufficiency, one that emphasized first obtaining a stronger foundation of education, as we discuss in the next section.
FIGURE VI.2
IMPACTS ON EMPLOYMENT RATES, BY QUARTER
[D]| Source: Parent Services Follow-Up Interviews conducted
approximately 7 and 16 months after random assignment. Notes: All percentages are regression-adjusted means estimated using models that weight each site equally. The differences between program and control families are estimated impacts per participant. * Program impact is significantly different from zero at the .10 level, two-tailed test. ** Program impact is significantly different from zero at the .05 level, two-tailed test. ***Program impact is significantly different from zero at the .01 level, two-tailed test. |
4. Educational Activities and Attainment
More than 40 percent of parents who applied to Early Head Start participated in an education or job training program during the first 15 months after enrollment (see Table VI.1). Over this 15-month period, Early Head Start increased the proportion of parents who ever participated in education or training activities and increased the average number of hours per week of participation. Early Head Start programs appear to have encouraged and facilitated the activities of parents seeking further education to enhance their future prospects for employment and self-sufficiency.
The time trend of participation in education and training activities indicates that both the Early Head Start and the control groups started out with a participation rate of about 25 percent in the first quarter (see Figure VI.3). However, over the next two quarters, the participation rate for Early Head Start parents increased more sharply than for the control group and then leveled off at 32 percent. After the first two quarters, parents in the control group were slightly less likely to participate in education and training activities in each subsequent quarter. Thus, the impact of Early Head Start on participation in such activities was positive and significant in quarters 3 through 5, increasing from 26 to 32 percent (while control group families returned to their initial 25 percent participation level).
The parents who applied to Early Head Start pursued many different types of education activities, but the most frequent were high school classes and vocational education, with about 10 to 16 percent of parents enrolled in each (Table VI.2). The participation of parents from both the Early Head Start and control groups in high school and vocational programs indicates a strategic interest in strengthening their educational backgrounds while their children were young, with the goal of obtaining better jobs in the future. A larger proportion of them were young parents enrolled in high school (rather than in GED preparation programs), which suggests that teenage parents may constitute an important subgroup of parents of young children seeking to strengthen their educational credentials.
Early Head Start increased high school attendance significantly (a 30 percent increase over the control group level of 9 percent). The programs also doubled participation in English as a Second Language (ESL) classes. Although the proportion of parents participating in these programs was small, expanding participation in these classes could help to improve the types of jobs parents can obtain when they lack fluency in English. None of the patterns of participation in other types of education was significantly different for the two groups.
Early Head Start had no impact on the receipt of degrees or credentials after random assignment. However, 15 months after enrollment in Early Head Start may have been too short a period to observe completion of educational activities. In the final report, we will look for impacts on degrees and credentials after 26 months.
FIGURE VI.3
IMPACTS ON PARTICIPATION IN EDUCATION AND TRAINING
PROGRAMS,
BY QUARTER
[D]| Source: Parent Services Follow-Up Interviews conducted
approximately 7 and 16 months after random assignment. Notes: All percentages are regression-adjusted means estimated using models that weight each site equally. The differences between program and control families are estimated impacts per participant. * Program impact is significantly different from zero at the .10 level, two-tailed test. ** Program impact is significantly different from zero at the .05 level, two-tailed test. ***Program impact is significantly different from zero at the .01 level, two-tailed test. |
| Outcome | Program Group Participantse | Control Groupf | Estimated Impact Per Participantg | Effect Sizeh |
|---|---|---|---|---|
| Types of Education Activities | ||||
| High School | 12.4 | 9.1 | 3.4*** | 11.5 |
| High School or Alternative | 12.7 | 10.6 | 2.1* | 6.9 |
| Adult Basic Education | 2.9 | 2.8 | 0.1 | 0.6 |
| English as a Second Language | 2.6 | 1.3 | 1.4** | 12.2 |
| GED Preparation | 6.7 | 6.5 | 0.2 | 0.7 |
| Any Vocational Education | 15.2 | 13.1 | 2.1 | 6.5 |
| 2-Year College | 7.6 | 7.0 | 0.6 | 2.4 |
| 4-Year College | 4.7 | 5.1 | -0.4 | -1.9 |
| Degrees and Credentials Received | ||||
| Highest Grade Completed at Second Follow-Up | 11.4 | 11.5 | -0.1 | -3.0 |
| GED Certificate | 9.4 | 9.4 | 0 | 0 |
| High School Diploma | 47.4 | 46.6 | 0.8 | 1.7 |
| Received a High School Degree or GED Between Enrollment and Second Follow-Up | 24.4 | 23.9 | .5 | 1.2 |
| Vocational, Business, or Secretarial Diploma | 15.9 | 15.2 | 0.7 | 1.9 |
| Associate's Degree | 3.5 | 4.0 | -0.5 | -2.7 |
| Bachelor's Degree | 3.4 | 4.3 | -1.0 | -4.9 |
| Sample Size | 1,139 | 1,097 | 2,236 | |
| SOURCE:
Parent Services Follow-Up Interviews completed an average of 7
and 16 months after random assignment. NOTE: All impact estimates were calculated using regression models, where each site was weighted equally. eA participant is defined as a program group member who received more than one Early Head Start home visit, met with an Early Head Start case manager more than once, received at least two weeks of Early Head Start center-based care, and/or participated in Early Head Start group parent-child activities.(back) fThe control group mean is the mean for the control group members who would have participated in Early Head Start if they had instead been assigned to the program group. This unobserved mean was estimated as the difference between the program group mean for participants and the impact per participant.(back) gThe estimated impact per participant is measured as the estimated impact per eligible applicant divided by the proportion of program group members who participated in Early Head Start services (which varied by site). The estimated impact per eligible applicant is measured as the difference between the regression-adjusted means for all program and control group members.(back) hThe effect size was calculated by dividing the estimated impact per participant by the standard deviation of the outcome measure for the control group times 100 (that is, it is the impact expressed as a percentage of the standard deviation).(back) *Significantly different from zero at the .10 level, two-tailed test **Significantly different from zero at the .05 level, two-tailed test. ***Significantly different from zero at the .01 level, two-tailed test. |
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5. Welfare Program Participation
Enrollment in Early Head Start programs for this study coincided with the implementation of the federal welfare reforms that ended the entitlement to cash assistance, instituted work requirements for parents of young children, and placed a five-year time limit on the receipt of cash assistance. Some of the states in this study began welfare reform much earlier than 1997, because they had obtained waivers to operate demonstration programs. This allowed them to test reforms that in many cases anticipated the federal reforms. For example, in 1993 Iowa implemented a welfare reform program that was consistent in most respects with the new federal rules. In other states, however, federal welfare reforms were implemented slowly. For example, as late as 1998, many of the counties in California had not fully implemented work requirements. Thus, the 17 sites in this study vary widely in their welfare-related work requirements and the extent to which these requirements are enforced.
With the substantial changes in welfare policy taking place at varying times in the states, it is not surprising that Early Head Start had no impact on any measure of welfare program participation during the first 15 months after enrollment in Early Head Start (see Table VI.3). Overall, about 65 percent of the families received some type of welfare benefit in the first 15 months after enrollment, including (1) Aid to Families with Dependent Children (AFDC) or Temporary Assistance for Needy Families (TANF), (2) Supplemental Security Income (SSI), (3) Food Stamps, and (4) General Assistance (GA). Most of these families received AFDC or TANF cash assistance at some point during the period. There was no difference between Early Head Start and control families in the percentage receiving any welfare benefits, the percentage receiving specific types of welfare benefits, or the average monthly amounts received from welfare programs.
The time trend in the quarterly participation rates for AFDC or TANF benefits indicates that participation increased slightly over the first three quarters, from about 30 percent to 35 percent, but then dropped back down to 30 percent in the fourth quarter and remained at that level for the fifth (see Figure VI.4). Thus, we do not observe the dramatic decline in AFDC or TANF program participation over the 15-month period that we have seen nationally and in some states since 1996. Reasons for this may include (1) the substantial variation in the extent to which welfare reform was implemented in these sites during the 1996-1998 period in which we measured welfare program participation, and (2) the fact that a substantial portion of sample families were exempt from the work requirements because of the age of their children. Participation in AFDC or TANF was significantly higher in the first quarter for Early Head Start families, but there was no impact on participation rates in any subsequent quarter.
TABLE VI.3
IMPACTS ON WELFARE PROGRAM PARTICIPATION
| Outcome |
Program Group Participantsi |
Control |
Estimated Impact Per Participantk |
Effect |
|---|---|---|---|---|
| Types of Education Activities |
||||
| High School | 12.4 | 9.1 | 3.4*** | 11.5 |
| High School or Alternative | 12.7 | 10.6 | 2.1* | 6.9 |
| Adult Basic Education | 2.9 | 2.8 | 0.1 | 0.6 |
| English as a Second Language | 2.6 | 1.3 | 1.4** | 12.2 |
| GED Preparation | 6.7 | 6.5 | 0.2 | 0.7 |
| Any Vocational Education | 15.2 | 13.1 | 2.1 | 6.5 |
| 2-Year College | 7.6 | 7.0 | 0.6 | 2.4 |
| 4-Year College | 4.7 | 5.1 | -0.4 | -1.9 |
| Degrees and Credentials Received | ||||
| Highest Grade Completed at Second Follow-Up | 11.4 | 11.5 | -0.1 | -3.0 |
| GED Certificate | 9.4 | 9.4 | 0 | 0 |
| High School Diploma | 47.4 | 46.6 | 0.8 | 1.7 |
| Received a High School Degree or GED Between Enrollment and Second Follow-Up | 24.4 | 23.9 | .5 | 1.2 |
| Vocational, Business, or Secretarial Diploma | 15.9 | 15.2 | 0.7 | 1.9 |
| Associate's Degree | 3.5 | 4.0 | -0.5 | -2.7 |
| Bachelor's Degree | 3.4 | 4.3 | -1.0 | -4.9 |
| Sample Size | 1,139 | 1,097 | 2,236 | |
| SOURCE:
Parent Services Follow-Up Interviews conducted an average of 7
and 16 months after random assignment. NOTE: All impact estimates were calculated using regression models, where each site was weighted equally. iA participant is defined as a program group member who received more than one Early Head Start home visit, met with an Early Head Start case manager more than once, received at least two weeks of Early Head Start center-based care, and/or participated in Early Head Start group parent-child activities.(back) jThe control group mean is the mean for the control group members who would have participated in Early Head Start if they had instead been assigned to the program group. This unobserved mean was estimated as the difference between the program group mean for participants and the impact per participant.(back) kThe estimated impact per participant is measured as the estimated impact per eligible applicant divided by the proportion of program group members who participated in Early Head Start services (which varied by site). The estimated impact per eligible applicant is measured as the difference between the regression-adjusted means for all program and control group members.(back) lThe effect size was calculated by dividing the estimated impact per participant by the standard deviation of the outcome measure for the control group times 100 (that is, it is the impact expressed as a percentage of the standard deviation).(back) *Significantly different from zero at the .10 level, two-tailed test **Significantly different from zero at the .05 level, two-tailed test. ***Significantly different from zero at the .01 level, two-tailed test. AFDC = Aid to Families with Dependent Children TANF = Temporary Assistance for the Needy Fund |
||||
FIGURE VI.4
IMPACTS ON AFDC/TANF RECEIPT, BY QUARTER
[D]| Source: Parent Services Follow-Up Interviews conducted
approximately 7 and 16 months after random assignment. Notes: All percentages are regression-adjusted means estimated using models that weight each site equally. The differences between program and control families are estimated impacts per participant. * Program impact is significantly different from zero at the .10 level, two-tailed test. ** Program impact is significantly different from zero at the .05 level, two-tailed test. ***Program impact is significantly different from zero at the .01 level, two-tailed test. |
6. Family Income and Resources
Since Early Head Start had no impact on levels of employment or welfare receipt during the first 15 months after enrollment, it is unlikely that the programs would have had significant impacts on families' economic position, either. This expectation was confirmed: although more families had incomes above the poverty level by the second followup, there was no difference between the program and control groups in the proportion of families with income above the poverty line at that time (approximately 35 percent; see Table VI.4). Moreover, the perceived level of family resources was the same, on average, for both the Early Head Start and control groups at the first and second follow-up interviews.
| Outcome | Program Group Participantsm | Control Groupn | Estimated Impact Per Participanto | Effect Sizep |
|---|---|---|---|---|
| Percentage of Families with Income Above the Poverty Line at Second Follow-Up | 33.8 | 36.4 | -2.5 | -7.0 |
| Total Family Resources Scale | ||||
| First follow-up | 150.3 | 149.1 | 1.2 | 5.5 |
| Second follow-up | 153.1 | 152.2 | 0.8 | 4.3 |
| Sample Size | 1,139 | 1,097 | 2,236 | |
| SOURCE:
Parent Services Follow-Up Interviews completed an average of 7
and 16 months after random assignment. NOTE: All impact estimates were calculated using regression models, where each site was weighted equally. mA participant is defined as a program group member who received more than one Early Head Start home visit, met with an Early Head Start case manager more than once, received at least two weeks of Early Head Start center-based care, and/or participated in Early Head Start group parent-child activities.(back) nThe control group mean is the mean for the control group members who would have participated in Early Head Start if they had instead been assigned to the program group. This unobserved mean was estimated as the difference between the program group mean for participants and the impact per participant.(back) oThe estimated impact per participant is measured as the estimated impact per eligible applicant divided by the proportion of program group members who participated in Early Head Start services (which varied by site). The estimated impact per eligible applicant is measured as the difference between the regression-adjusted means for all program and control group members.(back) pThe effect size was calculated by dividing the estimated impact per participant by the standard deviation of the outcome measure for the control group times 100 (that is, it is the impact expressed as a percentage of the standard deviation).(back) *Significantly different from zero at the .10 level, two-tailed test **Significantly different from zero at the .05 level, two-tailed test. ***Significantly different from zero at the .01 level, two-tailed test. |
||||
7. Parent Health, Mental Health, and Family Functioning
Because of the relatively high level of health services available in the community and the absence of program impacts on receipt of family health services, we did not expect strong impacts on the parent's physical health. We also did not expect strong impacts on mental health and family functioning, because infant and parent mental health services were often lacking in the communities, and because the programs did not have a significant impact on receipt of parent mental health services. Nevertheless, the relationship of these outcomes to the parent's ability to function well as a provider and a parent led us to examine Early Head Start's impacts on these outcomes.
Parents in both the Early Head Start and the control groups reported that their health status was, on average, "good" to "very good," with no significant difference between the two groups (see Table VI.5). Early Head Start had no impact on the average likelihood that parents had suffered a major depressive episode in the previous year. However, Early Head Start had favorable impacts on aspects of parenting-related stress and negative feelings. This pattern of impacts may result from the fact that, with a few exceptions, programs did not have an intensive mental health focus and often found it difficult to help parents gain access to mental health services, but they were able to address issues associated with parenting. Early Head Start reduced parental distress, or feelings of stress, in the parenting role. Parent-child dysfunctional interaction was also lower, which suggests that Early Head Start parents were less likely than control parents either to feel that their child was rejecting them or to feel disappointed with or alienated from their child.
Early Head Start also reduced the level of family conflict in program families. As part of their work with parents to support parent-child relationships, or through mental health they provided directly, programs may have helped parents learn new ways of handling situations of conflict, both with their children and with other adults. In-depth research by the Harvard University researchers indicates the importance of programs assessing parents' emotional health and parenting stress in order to deliver services most effectively (see Box VI.3).
| Outcome | Program Group Participantsq | Control Groupr | Estimated Impact Per Participants | Effect Sizet |
|---|---|---|---|---|
| Parent's Physical Health | ||||
| Parent's Health Status | 3.5 | 3.5 | 0 | 2.3 |
| Parent's Mental Health | ||||
| Parental Distress | 25.0 | 25.9 | -1.0 ** | -10.2 |
| Parent-Child Dysfunctional Interaction | 16.9 | 17.4 | -0.6 * | -9.4 |
| CIDI-Depression-Average Probability | 15.3 | 15.6 | -0.3 | -0.8 |
| Family Functioning | ||||
| Family Environment Scale-Family Conflict (Average Score) | 1.7 | 1.7 | -0.1 ** | -11.0 |
| Sample Size | 1,092 | 1,021 | 2,113 | |
| SOURCE:
Parent interviews conducted when children were approximately 24
months old. NOTE: All impact estimates were calculated using regression models, where each site was weighted equally. qA participant is defined as a program group member who received more than one Early Head Start home visit, met with an Early Head Start case manager more than once, received at least two weeks of Early Head Start center-based care, and/or participated in Early Head Start group parent-child activities.(back) rThe control group mean is the mean for the control group members who would have participated in Early Head Start if they had instead been assigned to the program group. This unobserved mean was estimated as the difference between the program group mean for participants and the impact per participant.(back) sThe estimated impact per participant is measured as the estimated impact per eligible applicant divided by the proportion of program group members who participated in Early Head Start services (which varied by site). The estimated impact per eligible applicant is measured as the difference between the regression-adjusted means for all program and control group members.(back) tThe effect size was calculated by dividing the estimated impact per participant by the standard deviation of the outcome measure for the control group times 100 (that is, it is the impact expressed as a percentage of the standard deviation).(back) *Significantly different from zero at the .10 level, two-tailed test **Significantly different from zero at the .05 level, two-tailed test. ***Significantly different from zero at the .01 level, two-tailed test. |
||||
| BOX VI.3 ENTRY CHARACTERISTICS OF RURAL FAMILIES
WITH YOUNG CHILDREN: Catherine Ayoub, Barbara Alexander Pan, and
Valeria Rocha Research carried out by the Harvard Graduate School of Education research team, in collaboration with Early Education Services in Vermont, suggests that child, parent, and family characteristics that reflect risk and resilience are central to designing interventions. Parenting stressors, family strengths and problems, child-rearing attitudes and practices, and maternal emotional health were examined in 133 families eligible for Early Head Start services. The rural families in this sample are exposed to many of the risks that urban families experience, including isolation, poverty, and single parenting. Most are white native English speakers. In spite of the relatively uniform demographic picture these families present, they differ widely in risk and resilience factors such as parenting stress, parenting values and beliefs, emotional health, and interpersonal relationships. In this study, parenting stress was measured by the Parenting Stress Index (PSI), a well-validated instrument used to evaluate stressors in both parent and child domains. Parents were considered at high levels of stress based on clinically validated cutoff values established by the author of the measure (85th percentile). Mothers in the sample found parenting more stressful than the average parent in the general population. More than a fourth (28 percent) experienced high levels of parenting stress. However, perceptions of parenting stress among the mothers in the sample varied from very little stress experienced in the role (stress score at the 7th percentile) to stress experienced regularly in almost every domain of parenting (total stress score at the 98th percentile). Sources of parenting tension measured by the PSI included a focus both on the child as difficult (28 percent) and on the mother's feelings of lack of competence as a parent (22 percent). The most common source of parenting stress for these mothers was their child's inability to adapt to change (43 percent). Mothers reported difficulties with their child's distractibility and hyperactivity (26 percent), demandingness (26 percent), acceptability (43 percent), and negative mood (11 percent). One-fifth (20 percent) of the parents in the sample felt that their child did not reinforce her competence as a parent. Another set of risk factors, based on the Child Abuse Potential Inventory (CAP), focused on the mother's role in ensuring her child's safety and care. This assessment indicates the potential for abusive or neglectful parenting, as well as more specific indexes of distress, rigidity, unhappiness, problems with child and self, problems with family, and problems with others. The clinical cutoff at the 95th percentile was taken as an indicator of high-risk parenting. Maternal responses reflecting the potential to act in a physically abusive way toward the child varied from the 1st to the 99th percentile. More than a fourth (26 percent) of the mothers expressed potentially abusive values and beliefs. Problems most frequently identified as influencing negative parenting and the potential for child abuse included emotional health indicators of unhappiness (26 percent) and emotional distress (22 percent). In contrast, a sizable group of women (88 percent) showed remarkable ego strength on the CAP. Many mothers saw their relationships with their infants and toddlers as positive (95 percent) and felt that their lives were relatively stress-free in terms of their parenting (PSI 19 percent) and emotional health (CAP 21 percent). This kind of information is central to supporting parents' resilience. In spite of the geographical, socioeconomic, and ethnic similarities in this group of mothers, their needs and goals for intervention vary considerably. Programs serving families like these need to be able to assess each family's risks and strengths in order to develop an individualized intervention plan. |
C. VARIATIONS IN IMPACTS ON FAMILY WELL-BEING BY PROGRAM APPROACH1
The three program approaches, center-based, home-based, and mixed, include different configurations of services available to families and different types of support that may lead to varying impacts on self-sufficiency, parent mental health, and family functioning. Center-based programs offer all families infant-toddler care that meets the Head Start Program Performance Standards and is on average better than the care generally available in communities (see Pathways to Quality; ACYF 2001b). Parents may find that this high-quality, reliable child care provides stronger and more consistent support for their employment and education activities, and leads to higher levels of employment and education. Similarly, because mixed-approach programs offer center-based care to at least a subset of families in the program, and because they often offer program activities to promote employment, we may find an overall impact on employment and education in this subgroup. Home-based programs and mixed-approach programs may offer parents more social support, because staff meet with parents more often in their own homes. Thus, we may find a stronger impact on mental health and family functioning among parents in these programs. In addition, if more frequent contact with parents enables program staff of home-based and mixed-approach programs to plan strategy about routes to self-sufficiency and support the parents' efforts in this area, Early Head Start may have an impact on self-sufficiency activities among parents in these programs.
1. Impacts on Family Self-Sufficiency
Employment rates by quarter rose steadily, by about 20 percentage points during the first 15 months after random assignment, in all three subgroups defined by program approach (Figure VI.5). Notably, the parents in center-based programs started out with higher employment rates (about 55 percent in quarter 1) than did parents in home-based (about 35 percent) or mixed-approach programs (about 40 percent), which reflects both differences in the characteristics of families entering the various types of programs and efforts to adapt program models to community and family needs. Nevertheless, over this 15-month period of rising employment rates, Early Head Start had no positive impacts on employment in any of the subgroups defined by program approach. Thus, the high-quality infant and toddler care offered by center-based and some mixed-approach Early Head Start programs did not appear to encourage a higher level of employment among parents enrolled in these programs.
FIGURE VI.5
IMPACTS ON QUARTERLY EMPLOYMENT RATES,
BY PROGRAM APPROACH
[D]| Source: Parent Services Follow-Up Interviews conducted
approximately 7 and 16 months after random assignment. Notes: All percentages are regression-adjusted means estimated using models that weight each site equally. The differences between program and control families are estimated impacts per participant. * Program impact is significantly different from zero at the .10 level, two-tailed test. ** Program impact is significantly different from zero at the .05 level, two-tailed test. ***Program impact is significantly different from zero at the .01 level, two-tailed test. |
In contrast, Early Head Start parents in center-based and home-based programs participated in education and training activities at higher rates than did parents in the control group for these programs (Figure VI.6). As with employment rates, parents who enrolled in center-based programs started out with higher participation rates in education and training activities in the first quarter (about 30 percent) compared with parents in home-based and mixed-approach programs (between 20 percent and 25 percent). However, over time, parents in the center-based and home-based programs increased their rates of participation in education and training activities, while the rates of parents in the control group remained steady or declined. The participation rate in education and training activities was significantly higher for Early Head Start parents in center-based programs in the fifth quarter, and for Early Head Start parents in home-based programs in the fourth and fifth quarters.
Perhaps because the impact of Early Head Start on education and training activities among parents in center-based programs did not emerge until the fifth quarter, there was no impact on the proportion of these parents who ever participated in these activities (see Figure VI.7), or on any specific educational activities (not shown). Among parents in home-based programs, however, Early Head Start had a significant impact on the proportion who ever enrolled in education and training programs overall, as well as the proportion enrolled in several specific types of education programs. Moreover, Early Head Start significantly increased the average hours per week that parents spent in education or training activities during the 15-month follow-up period. Parents participating in home-based Early Head Start programs were more likely than parents in the control group to take part in high school classes, ESL classes, and vocational courses. There were no impacts on degrees or credentials received during the first 15 months after enrollment in Early Head Start, but it may have been too early for such impacts to emerge. Early Head Start did not significantly increase overall participation in education and training programs among parents in mixed-approach programs, but the pattern of impacts was similar to that of home-based programs, and the programs did significantly increase average hours per week that parents spent in education or training activities (not shown).
FIGURE VI.6
IMPACTS ON QUARTERLY EDUCATION AND TRAINING,
BY PROGRAM APPROACH
[D]| Source: Parent Services Follow-Up Interviews conducted
approximately 7 and 16 months after random assignment. Notes: All percentages are regression-adjusted means estimated using models that weight each site equally. The differences between program and control families are estimated impacts per participant. * Program impact is significantly different from zero at the .10 level, two-tailed test. ** Program impact is significantly different from zero at the .05 level, two-tailed test. ***Program impact is significantly different from zero at the .01 level, two-tailed test. |
FIGURE VI.7
IMPACTS PER PARTICIPANT ON EDUCATION AND TRAINING
ACTIVITIES BY
THE SECOND FOLLOWUP, BY PROGRAM APPROACH
[D]
| Source: Parent Services Follow-Up Interviews conducted
approximately 7 and 16 months after enrollment. Notes: All percentages are regression-adjusted means estimated using models that weight each site equally. * Program impact is significantly different from zero at the .10 level, two-tailed test. ** Program impact is significantly different from zero at the .05 level, two-tailed test. ***Program impact is significantly different from zero at the .01 level, two-tailed test. |
2. Impacts on Parents' Mental Health and Family Functioning
We would expect that, in general, the ongoing support and information provided by Early Head Start staff, as well as crisis intervention when necessary, would help to reduce parenting stress and family conflict. However, the different program approaches vary in their opportunities to interact with parents. Center-based program staff interact with parents on a daily basis, as they drop off and pick up their children, but these interactions may be brief and not provide opportunities for delving into difficult family issues. These staff also interact with parents during group parenting education activities. Home-based program staff, in contrast, may not see parents daily, but time spent with parents during home visits and group parent-child socialization activities offers greater opportunity for intensive discussions of parenting and family development. These in-depth discussions may occur more frequently in home-based than in center-based programs. Parents in mixed-approach programs may have experiences more like those in center-based programs if they use center-based services, and more like those in home-based programs if they receive home-based services. They may experience something in between if they receive both.
Early Head Start had no impacts on parents' mental health or levels