Absence of conflict of interest.
Citation
Highlights
- The study’s objective was to examine the implementation of the Enhanced Services for the Hard-to-Employ Demonstration and Evaluation Project (the Hard-to-Employ project) which sought to address the educational and employment needs of the parents of children in early Head Start programing.
- The study authors conducted an implementation evaluation using data collected at baseline and 18-month follow up as well as direct assessments of children’s developmental outcomes, data from the National Directory of New Hires and program participation, and field interviews.
- The study found that implementation of parental employment and educational enhancements was weak, and there was lower-than-expected take up for these enhancement services.
- It is important to note that there are significant differences between the two implementation sites, including in employment (quarters 1-6), use of formal childcare, use of education related services, and likelihood of receipt of childcare and or family development services. There also were large differences in costs per participant between the two sites.
- The companion impact study was reviewed by CLEAR in August of 2016.
Intervention Examined
Enhanced Services for the Hard-to-Employ Demonstration and Evaluation Project (the Hard-to-Employ project)
Features of the Intervention
- Type of organization: Early Head Start Agencies
- Location/setting: Sites in Kansas and Missouri
- Population served and scale: Low-income family with children or infants and or pregnant women; 305 families
- Industry focus: Child Day Care Services
- Intervention activities: Enhanced Early Head Start services (parent education, family support, early childhood developmental and social service assistance) offered at home or centers.
- Organizational Partnerships: DHSS, DOL, Local School Districts, and local workforce agencies
- Cost: Expenditures per participant: $9,205 to $9,661; Expenditures per control group member: $3,776 to $7,049
- Fidelity: Not Included
The intervention was a multi-state implementation (Kansas and Missouri). The program model was an enhanced version of the Early Head Start (EHS) program that included services offered by traditional EHS programs such as parent education, family support services, early childhood developmental services and social service assistance as well as services specific to this program that aimed to address parental employment, educational and self-sufficiency needs. The program used a mixed approach to service delivery that offered services at participants homes or at a center, however, participants can only receive services at one site but can change delivery forms if needed. The target population was families eligible for EHS. The intervention was funded by the U.S. Department of Health and Human Services with supplemental funding from the Department of Labor.
Features of the Study
The study included a randomized controlled trial and program implementation analysis. The program was implemented at Southeast Kansas Community Action Program (SEK-CAP) EHS Program (Girard, KS) and Youth in Need EHS (St. Charles, MO). The sites were chosen based on their history of being able to provide high quality EHS services, their previous use of mixed approach program administration, the support of the local EHS policy council, and their ability to build sufficient waitlists to sustain and justify the use of random assignment. Program staff received formal trainings on curriculum, conducting assessments, home visitation, sexual harassment and other issues that emerged. The majority of program staff had a bachelor’s degree, and some had or were working towards an advanced degree. The most common degrees held were in early childhood development and education with common past work experiences including childcare, education, and social work. The authors used information obtained from several site visits, a review of case files in Spring 2007 and analyses of program data for the implementation study data sources. There were only 270 case files which they used to measure program participation which is approximately 88% of the full sample.
Findings
Intervention activities/services
- The study found that despite the increased focus on parental employment and educational needs, implementation of these enhancements was weak and there was lower than expected take up for these enhancement services.
- The program did have increased receipt of child focused developmental services, but it is important to note that those in the control group also reported high levels of assistance.
- The review of the case files found that there was a lesser focus than intended on self-sufficiency during the home visits and parent education meetings along with great variations in how self-sufficiency was addressed in home visits.
- The field research interviews found staff members to be resistant to "buying in to" the changes that needed to implement this program. The authors found that staff resistance decreased as time went on along with additional training, however, this may be due to increased referrals to the self-sufficiency specialists.
Implementation challenges and solutions
- The participants had different needs and interests, which was made apparent in the differences in those who choose at home services versus center services. Those who choose to receive at home services were more likely to be interested in the services related to child development and parental education, however, were less likely to be interested in the employment related services as they preferred to stay at home with their children. Those who choose to use center-based programming were more likely to already be employed or enrolled in school and therefore were often considered a lower priority for self-sufficiency staff.
- The program also faced implementation delays due to staffing issues.
- The authors also note that participants living in the rural counties often had fewer resources available to them when compared to their counterparts in the suburban counties.
- The authors changed processes during the study in the hopes to increase participation as only about 80% of those randomly assigned to the program group participated in the program. The authors decided to start contacting the parents before assignment was made to reaffirm their interest in participation. This only increased participation by about 4 percent following implementation.
Cost/ROI
- On average, the self-sufficiency enhancements cost $72 dollars per month per participant with an average total cost per group member of $636 for those receiving services from the Youth-in-Need program.
- The average cost of services at SEK-CAP was $30 per person per month with an average total cost of $249 per person. The large difference in cost between the two sites is in part due to the Youth in Need program contributing additional funding to the program which was used to hire an additional staff member focused on self-sufficiency.
- The gross cost for the whole program per program group member was $9,205 in SEK-CAP and $9,661 for those receiving services from Youth in Need. SEK-CAP and Youth in Need chose to spend this money differently, with Youth in Need spending a higher percentage on self-sufficiency enhancements (7% compared to 3%) and SEK-CAP spending a higher percentage on non-EHS/HS childcare services (24% compared to 13%).
Considerations for Interpreting the Findings
This was a short-term implementation study which looked at the effectiveness of enhanced early head start programing. It is important to note that there are significant differences between the two implementation sites, including in employment (quarters 1-6), use of formal childcare, use of education related services, and likelihood of receipt of childcare and or family development services