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Summary

Enhanced EHS provided core EHS services plus program enhancements to families with low incomes, with the aim of addressing parents' employment and self-sufficiency needs.

Core EHS services, the early childhood developmental program services typically provided in pre-existing EHS programs, included intensive early childhood development services, family support, and health and mental health services. The program enhancements included partnerships with local agencies that provided employment and training services, on-site self-sufficiency specialists who worked directly with families on setting and achieving self-sufficiency and employment goals, and training for EHS child development staff on providing self-sufficiency support for EHS families.

All services were available at participants' homes or at the EHS center. Families that participated in enhanced home-based services received visits from child development staff up to four times a month. Families that participated in enhanced center-based services were required to have four parent education meetings per year.

All Enhanced EHS intervention participants could receive early childhood development services and employment and training services. Families were eligible for Enhanced EHS if they (1) were at or below the federal poverty threshold, (2) had a child younger than 3 or were expecting a child, and (3) lived in one of the areas served by the program. The average family participated in the enhanced program for 11 months. The program took place in south eastern Kansas and eastern Missouri.

0713-Evaluation of Enhanc
Populations and employment barriers: Parents

Effectiveness rating and effect by outcome domain

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Outcome domain Term Effectiveness rating Effect in 2018 dollars and percentages Effect in standard deviations Sample size
Increase earnings Short-term Little evidence to assess support unfavorable $-356 per year -0.017 597
Long-term Little evidence to assess support favorable $209 per year 0.010 597
Very long-term No evidence to assess support
Increase employment Short-term Little evidence to assess support 597
Long-term Supported This intervention was assessed as supported for this domain, meaning it achieved one or more statistically significant, favorable effects. However, the intervention has an average effect size that is unfavorable because the average includes all effects in this domain - both statistically significant and favorable effects and statistically insignificant but unfavorable effects. * -1% (in percentage points) -0.026 597
Very long-term No evidence to assess support
Decrease benefit receipt Short-term Little evidence to assess support unfavorable $6 per year 0.002 491
Long-term Little evidence to assess support unfavorable $99 per year 0.036 478
Very long-term No evidence to assess support
Increase education and training All measurement periods Little evidence to assess support unfavorable -2% (in percentage points) -0.039 491
* This intervention was assessed as supported for this domain, meaning it achieved one or more statistically significant, favorable effects. However, the intervention has an average effect size that is unfavorable because the average includes all effects in this domain - both statistically significant and favorable effects and statistically insignificant but unfavorable effects.

Effectiveness rating key:

  • Well-supported Well-supported   
  • Supported  Supported   
  • Not supported  Not supported   
  • Mixed support  Mixed support   
  • Insufficient evidence  Insufficient evidence   
  • No evidence  No evidence
Effectiveness rating terms?

Studies of this intervention

Study quality rating Study counts per rating
High High 1
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Implementation details

Dates covered by study

Enhanced EHS enrolled and randomly assigned new Enhanced EHS applicants between 2004 and 2006 at sites in Kansas and Missouri. The intervention provided services to participants between 2004 and 2007. The study measured participant impacts at 18 and 42 months after random assignment.

Organizations implementing intervention

Youth in Need implemented the intervention in eastern Missouri. Youth in Need was a multiservice agency located in St. Charles, MO, that served families and children with low incomes.

Southeast Kansas Community Action Program (SEK-CAP) implemented the intervention in southeastern Kansas. SEK-CAP was a community-based agency located in Girard, KS, that served families and children with low incomes.

Populations served

Enhanced EHS served families that (1) had income at or below the federal poverty level, (2) were expecting a child or had a child younger than age 3, and (3) were living in an Enhanced EHS service area. Enrollment in Enhanced EHS and participation in the intervention activities were voluntary (that is, participation was not required as a condition of receiving any public benefits).

Ninety percent of the parents who participated were female. Parent participants were an average age of 26, and children were an average age of 17 months. Eighty-six percent of parent participants were White, not Hispanic; 8 percent were Black or African American, not Hispanic; and 6 percent were reported as another race or ethnicity. Five percent of parent participants were Hispanic or Latino of any race. Seventy-five percent of parent participants had a high school diploma or GED or higher, including 8 percent with a postsecondary degree.

Description of services implemented

The Enhanced EHS intervention consisted of both core EHS services and enhanced self-sufficiency services focused on employment, educational, and self-sufficiency needs and goals. As part of core EHS services, families participated in either home-based or center-based early childhood development services. Families could choose a preferred option and switch between the service delivery modes as needed but could not receive both at the same time.

  • Home-based services. Children and families received weekly home visits from EHS home-visiting staff who engaged children in child development activities and discussed parenting skills and social services needs with parents. Families receiving home-based services also participated in group socialization sessions with other EHS families.

  • Center-based services. Children received EHS care and education in a center. Center teachers addressed social services needs with parents at pickup and drop-off, parent–teacher conferences, or quarterly home visits.

  • Parent involvement. Parents with children receiving EHS services attended a monthly parent education meeting at SEK-CAP and a quarterly meeting at Youth in Need. Parents invited guest speakers to these meetings. Parents could also participate in the Head Start (HS) policy council as leaders who make decisions about their HS program.

  • Specialized services. EHS provided health, mental health, nutrition, and child disability services to all EHS families.

Enhancements to the EHS program model provided all families with opportunities for self-sufficiency services to help parents obtain employment, increase education levels to support employment and financial goals, advance professionally, and earn higher wages. These services are not the focus of typical EHS programs. EHS programs hired self-sufficiency specialists—on-site resource experts—to build their capacity to focus on and provide services related to self-sufficiency. Self-sufficiency specialists provided some case management services to families directly and created partnerships with local programs that specialized in providing employment, training, and education services. Self-sufficiency services included the following:

  • Referrals to employment, training, and education services. EHS staff could refer intervention participants to job search assistance agencies, one-stop career centers, welfare agencies, vocational rehabilitation agencies, and GED course providers. Self-sufficiency specialists used their external partnerships to create resource binders containing local employment and training opportunities. EHS staff used the binders to refer families to services or share information about job searching (for example, interviewing and resume building).

  • Financial education. Enhanced EHS participants had the opportunity to receive financial literacy sessions using a national curriculum (“Money Smarts” at Youth in Need and “Money in Motion” at SEK-CAP).

  • Case management. EHS staff provided parents with case management focused on self-sufficiency. EHS child development staff helped parents with employment, training, and educational goals using goal-setting guides created by self-sufficiency specialists. Home visitors reviewed family goals, made plans for families to work toward goals, and referred families to other wraparound services. Teachers that provided center-based care primarily worked with parents on self-sufficiency issues at monthly parent education meetings in SEK-CAP and quarterly parent education meetings in Youth in Need. Teachers could also discuss employment when parents picked up and dropped off their children. EHS child development staff could also refer parents to the self-sufficiency experts to discuss employment, training, and educational goals and resources. Alternatively, parents could make an appointment directly with a self-sufficiency specialist.

Challenges. Evaluators identified four challenges in implementing the self-sufficiency enhancements in the Enhanced EHS intervention.

  • EHS child development staff providing home- and center-based services resisted focusing on employment, training, and education goals because it required additional time, and these staff felt they lacked expertise in these topics given their focus on child development.

  • The interests and needs of parents receiving home-based and center-based services differed, which meant that some parents may have been less interested in employment and training services, depending on their situations. For example, families receiving home-based services were primarily interested in learning about and supporting their child’s development, and some parents wanted to care for their young children rather than work. Families receiving center-based services primarily needed child care because they were already employed or in school.

  • High EHS child development staff turnover, which is common among child care providers, caused implementation delays.

  • Fewer resources were available for Enhanced EHS participants in rural areas, and transportation was a barrier to accessing employment, training, and education services.

Service intensity

Home-based services were expected to consist of 90-minute home visits, once a week. Home visitors were intended to engage in 60 minutes of child development activities and modeling positive parenting behaviors and parent–child interactions. Thirty minutes were intended to be dedicated to discussions about the family’s social services needs and referrals, family self-sufficiency goals, and guidance on goal achievement. Families receiving home-based services could also attend group socialization sessions with other EHS families twice a month.

Center-based services were expected to consist of EHS care and curriculum-based education for children in a center for at least six hours a day, five days a week.
Eighty-one percent of participants received home-or center-based Enhanced EHS services within 18 months of random assignment. Families received Enhanced EHS services for 11 months, on average. Seventy-two percent of participants ever received home-based services, and the average number of home visits per month was one. In some cases, families received fewer than the average number of home visits because the families or home visitors canceled visits or because families switched to center-based services. Seventy-eight percent of participants discussed employment or education in a meeting with a self-sufficiency specialist, parent education meeting, or home visit. Eighty-seven percent of participants set at least one goal with EHS staff, and 76 percent of those goals were related to education, training, or employment. Seventy-two percent of participants received a referral to other services from EHS staff, and 10 percent of referrals were related to employment, education, or self-sufficiency. Other referrals were for needs related to health, child development, or social services needs.

Forty-four percent of participants ever received center-based services, and children attended center-based care 14 days a month, on average, at Youth in Need. SEK-CAP attendance information was not available.

Comparison conditions

Individuals randomly assigned to the comparison group could receive other services in their communities but were not eligible for EHS or Enhanced EHS services.

Partnerships

Before January 2007, when SEK-CAP began providing center-based services themselves, SEK-CAP funded EHS slots for center-based services at community child care centers.

Self-sufficiency specialists built partnerships with local employment and educational agencies that provided services at one-stop career centers, welfare agencies, and vocational rehabilitation organizations. Local banks or credit unions provided budgeting and finance sessions.

In a county that did not typically offer GED courses, some Youth in Need participants received GED courses through an EHS partnership with the local school district. EHS child development staff provided child care during classes. Classes were held at an EHS center, and the school district paid the GED course teachers. In the same county, a program supporting teens to earn a GED or high school diploma while learning construction job skills also held a few slots for teen parents in Enhanced EHS.

The SEK-CAP program developed a relationship with Temporary Assistance for Needy Families (TANF). EHS staff completed a form for participants who were also TANF recipients, indicating which Enhanced EHS activities counted toward TANF work participant requirements. However, EHS staff did not discuss a family’s TANF case with TANF staff.

Staffing

EHS child development staff provided core EHS services at Youth in Need and SEK-CAP. Most of these staff held a college degree in child development and education disciplines, and some had or were working toward an advanced degree in those fields. Child development staff were trained in the Parents as Teachers Born-to-Learn curriculum or the Creative Curriculum. Self-sufficiency specialists trained EHS child development staff to conduct case management activities with parents, including setting and monitoring employment and education goals.

Two self-sufficiency specialists at Youth in Need and one self-sufficiency specialist at SEK-CAP provided services related to employment and training. The two specialists at Youth in Need split responsibilities, with one focused on establishing partnerships and the other focused on working with families.

Fidelity measures

The study did not discuss any tools to measure fidelity to the intervention model.

Funding source

The Enhanced EHS intervention was part of the federal Enhanced Services for the Hard-to-Employ Demonstration and Evaluation Project. The Hard-to-Employ Demonstration was funded through a federal grant from the U.S. Department of Health and Human Services and additional funding from the U.S. Department of Labor.

Cost information

The average cost per participant was $21,049 in 2018 dollars.

This figure is based on cost information reported by authors of the study or studies the Pathways Clearinghouse reviewed for this intervention. The Pathways Clearinghouse converted that information to a single amount expressed in 2018 dollars; for details, see the FAQ. Where there are multiple studies of an intervention rated high or moderate quality, the Pathways Clearinghouse computed the average of costs reported across those studies.

Cost information is not directly comparable across interventions due to differences in the categories of costs reported and the amount of time interventions lasted. Cost information is not an official price tag or guarantee.

The information contained here reflects how the intervention was implemented at the time of the evaluation.

Local context

The intervention took place in one rural and three suburban counties in eastern Missouri and in 12 rural counties in southeastern Kansas. These locations were selected because the EHS programs at these locations delivered high quality EHS services, offered home- and center-based services, and had the capacity to build a waiting list to facilitate random assignment. The EHS policy councils were supportive of random assignment and enhancements to traditional EHS services.

Characteristics of research participants
Black or African American
8%
White
86%
Unknown, not reported, or other
1%
Hispanic or Latino of any race
5%

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.

State(s) where implemented

AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Canada

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

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