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- What intervention was actually implemented? Did it deviate from plans or expectations?
- What were students’ participation patterns and experiences with program services?
- What were the effects of Carreras en Salud on educational attainment, including hours of occupational training and basic skills instruction received and receipt of credentials, and other educational outcomes?
This report documents the implementation and early impacts of the Carreras en Salud (Careers in Health) program, operated by Instituto del Progreso Latino, in Chicago, Illinois. The Carreras en Salud program is one promising effort aimed at helping low-income, low-skilled adults access and complete occupational training that can lead to increased employment and higher earnings. A distinctive feature of this program is its focus on training for low-income Latinos for employment in healthcare occupations, primarily Certified Nursing Assistant (CNA) and Licensed Practical Nurse (LPN). It is among nine career pathways programs being evaluated in the Pathways for Advancing Careers and Education (PACE) study sponsored by the Administration for Children and Families.
The Carreras en Salud program consists of five elements: (1) a structured healthcare training pathway, starting at low skill levels; (2) contextualized and accelerated basic skills and ESL instruction; (3) academic advising and non-academic supports; (4) financial assistance; and (5) employment services.
Using a rigorous research design, the study found that the Carreras en Salud program increased hours of occupational training and basic skills instruction received and the attainment of education credentials within an 18-month follow-up period. The program also increased employment in the healthcare field and resulted in a reduction of participants reporting financial hardship. Future reports will examine whether these effects translate into gains in employment and earnings.
The federal government projects that over the next decade, the fastest-growing occupations will be in healthcare. This demand also creates opportunities for low-income, low-skilled adults to gain entry-level employment, as well as advance to higher-skilled, higher-paying jobs. Almost all jobs in healthcare require some level of postsecondary education or training. But, many low-income, low-skilled adults face considerable barriers to completing even short-term training for entry-level jobs. Many are “nontraditional” students—that is, older, often parents, lacking adequate basic academic skills, and with few economic resources. Being from a minority population, not speaking English as their primary language, and/or being the first in their family to attend college can exacerbate these difficulties in completing the training.
Career pathways programs are designed to address these issues by providing well-articulated training and employment steps targeted to locally in-demand jobs, combined with a range of supports. Policymakers and practitioners have shown great interest in the career pathways approach. But, to date, limited rigorous research is available on its effects on participants’ educational and economic outcomes. To assess the effectiveness of a career pathways program such as Carreras en Salud, the PACE evaluation uses an experimental design—that is, randomly assigning study participants to a “treatment” group who can access the program and a “control” group who cannot, then comparing their outcomes.
Key Findings and Highlights
- The Carreras en Salud program operated largely as designed. Students were placed in courses depending on their basic skills level along a seven-step career pathway, beginning with an English as a Second Language course for those as low as fourth-grade skill levels and continuing through the college-level LPN course. Carreras also provided a range of supports including academic advising, assistance with support services, employment assistance, and tuition support.
- The vast majority of treatment group members participated in at least one Carreras course, and completion rates for many of programs were high. A significant portion of students progressed to the next course. The most common courses attended were in the “middle” of the Carreras pathway, and few reached the upper level LPN course within the study’s 18-month follow-up period.
- The Carreras program increased the hours of occupational training (the confirmatory outcome measured in this report) and basic skills instruction received over the follow-up period. The treatment group was also more likely than the control group to receive career counseling, help arranging supports, and job search assistance.
- The treatment group earned more credentials than the control group, primarily from a licensing or certification organization.
- The Carreras program increased employment in the healthcare field and reduced the proportion experiencing financial hardships.
The Carreras en Salud evaluation includes an implementation study that examines the design and operation of the program and enrolled students’ participation patterns, and an impact study that uses an experimental design to measure differences in educational and employment outcomes.
Between November 2011 and September 2014, the evaluation randomly assigned 800 program applicants to either the treatment or the control group. Data were collected from a follow-up survey conducted approximately 18 months after random assignment and from administrative records from Instituto del Progreso Latino. The evaluation also included site visits to document program implementation and operations. Prior to estimating Carreras en Salud impacts, the research team published an analysis plan specifying key hypotheses and outcome measures.
Martinson, K., Copson, E., Gardiner, K. and Kitrosser, D. (2018). Instituto del Progreso Latino, Carreras en Salud Program: Implementation and Early Impact Report, OPRE Report # 2018-06, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.