Absence of conflict of interest.
Gardiner, K., Rolston, H., Fein, D., & Cho, S-W. (2017). Pima Community College Pathways to Healthcare Program: Implementation and early impact report (Report No. 2017-10). Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.
- The study’s objective was to assess the impact of the Pathways to Healthcare program on students’ education and employment outcomes.
- The study used a randomized controlled trial to compare outcomes of students enrolled in the Pathways to Healthcare program with non-participants.
- The study found that Pathways to Healthcare program participants had significantly higher average total hours of college occupational training, higher rates of certification receipt, and higher rates of credential receipt from a college than the control group.
- The quality of causal evidence presented in this study is high because it is based on a well-implemented randomized controlled trial with low attrition. This means we are confident that the estimated effects are attributable to the Pathways to Healthcare program and not to other factors.
The Pathways to Healthcare Program
Features of the Intervention
In 2010, Pima Community College (PCC) and Pima County One Stop (PCOS) in Tucson, Arizona were awarded a 5-year Health Profession Opportunity Grant (HPOG) to launch and implement the Pathways to Healthcare program. The program is designed to help low-income, low-skilled adults access and complete training specific to gaining employment in the healthcare sector. The program maps PCC’s 16 existing occupational training programs into five pathways allowing students to obtain stackable credentials. The program also provides advising services, financial support in the form of scholarships to program participants, two short-term bridge programs to help ramp-up students’ competencies in basic skills prior to program enrollment, and workshops and professional development activities to help students gain employment post-program completion. Pathways to Healthcare program eligibility includes being a resident of Pima County, having an income at or below 70% of the Lower Living Standard Income Level, being eligible to work, and having an interest in pursuing a healthcare-related career. Program services and courses were offered at Pima Community College’s Center for Training and Development and across the community college’s six campuses.
Features of the Study
The authors used a randomized controlled trial, recruiting eligible participants from information sessions at PCC and PCOS. Pathways to Healthcare program staff randomly assigned 609 students to the treatment group and 608 students to the control group. Those in the treatment group had access to all Pathways to Healthcare services but were not required to use them while those in the control group did not have access to these resources. Both the treatment and control group could access other comparable services available in the community, including those generally offered by PCC and PCOS. Given this, the study evaluated the impact of the Pathways to Healthcare program and its respective services beyond what was already available elsewhere in the community. Data sources included administrative records from PCC, study intake (baseline) survey, follow-up survey (15-months after random assignment), and data from the HPOG management information system. The authors used statistical models to compare the differences in education and employment outcomes between the two groups 18 months after random assignment. Education outcomes included the total hours of college occupational training received, total college-level credits earned, and credential receipt. Employment outcomes included working in a job paying $12/hour or more, working in a job requiring at least mid-level skills, and working in a healthcare occupation.
Education and skills gain
- The study found that the treatment group had significantly higher average total hours of college occupational training than the control group (190 hours versus 127 hours).
- The study also found that the treatment group had significantly higher rates of certification receipt (35% versus 29%) and of credential receipt from a college (23% versus 10%) than the control group.
- However, the study did not find any significant differences between the groups in total college- level credits earned.
- The study did not find statistically significant relationships between participation in the Pathways to Healthcare program and employment outcomes.
Considerations for Interpreting the Findings
The authors reported intent-to-treat findings, which can be interpreted as the impact of being offered the treatment. The treatment group was not required to use any of the services provided by the Pathways to Healthcare program; these services were simply offered to those in the treatment group. Participants assigned to the treatment group may not have used the resources provided by this intervention. Therefore, the program’s impact on those who actually used the services being offered might be higher than the study’s estimates.
Causal Evidence Rating
The quality of causal evidence presented in this report is high because it was based on a well-implemented randomized controlled trial with low attrition. This means we are confident that the estimated effects are attributable to the Pathways to Healthcare program, and not to other factors.