One Step At A Time: Participant Perspectives On Career Pathways

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One Step at a Time:Participant Perspectiveson Career PathwaysHPOG 2.0 Participant Perspectives, Brief 1Hannah Thomas OPRE Report 2022-48 February 2022OverviewCareer pathways is a framework that combines education, occupational training, and supportservices to help participants enter and advance in a sequence of occupations within a specifcsector or occupational cluster. Such programs seek to address many of the challenges that mightprevent low-income and other disadvantaged adults from succeeding on a chosen pathway. Forexample, programs are fexible, with strong supports, and connect participants to employers andemployment, including work-based learning opportunities. The Health Profession OpportunityGrants (HPOG) Program funded local career pathways programs to prepare participants foroccupations in the healthcare feld that paid well and were expected to either experience laborshortages or be in high demand.Many impact evaluations of career pathways programs are ongoing, but frsthand accounts ofparticipants’ experiences are limited. This brief shares insights from such frsthand accounts andthereby adds to our understanding of participant experiences in career pathways programs.Qualitative analysis of interviews with participants in HPOG-funded programs found that: Interviewees frequently focused on taking the immediate next step in their career pathway; manyalso had a clear sense of their long-term career ambitions. Interviewees thinking about a next step on their career pathway faced a complex set of logisticaland fnancial considerations and moved forward in ways that accommodated those considerations. Interviewees persisted in their training for a variety of reasons, including to be a role model fortheir children, to earn more money, and to gain greater job satisfaction. Increased self-confdence from completing one training infuenced interviewees’ self-reportedinterest in completing a subsequent training. Guides—including interviewees’ HPOG case managers, instru ctors, and healthcare industrycolleagues—ofered advice about and examples of career pathways that infuenced howinterviewees navigated their career pathway.Abt Associates One Step at a Time: Participant Perspectives on Career Pathways1

IntroductionAbout HPOGCareer Pathways is a framework thatcombines education, occupational training,and support services that align with theskill demands of the local economy tohelp participants enter and advance in asequence of occupations within a specificsector or occupational cluster (Werner etal. 2018). Career pathways programs seekto address many of the challenges thatdisadvantaged adults face in succeedingin training and progressing along a careerpathway’s occupational steps. For example,career pathways training programs mightofer fexible schedules, provide fnancial andother assistance, and connect participants toemployers and employment, including workbased learning opportunities.1This frst brief in the HPOG 2.0 ParticipantPerspectives series presents insights from indepth, in-person interviews with participantsin career pathways programs funded by theHealth Profession Opportunity Grants (HPOG)Program2 (see box). The brief describesparticipant experiences navigating careerpathways and suggests implications for careerpathways program practice and for evaluationsof career pathways programs.ContextThe Health Profession Opportunity Grants(HPOG) Program funded local careerpathways programs to provide occupationaleducation and training to TemporaryAssistance for Needy Families (TANF)recipients and other low-income adults.The program aimed to prepare people foroccupations in the healthcare feld that paidwell and were expected to either experiencelabor shortages or be in high demand.To support training completion andadvancement along their chosen careerpathway, local HPOG programs providedcomprehensive support services such ascase management, academic and careercounseling, and personal and logisticalsupports including fnancial assistance.HPOG was administered by theAdministration for Children and Families(ACF) within the U.S. Department of Healthand Human Services. ACF awarded tworounds of fve-year grants (HPOG 1.0 in 2010and HPOG 2.0 in 2015).This brief focuses on participants in programsoperated by HPOG 2.0 grantees that are partof an HPOG 2.0 National Evaluation beingconducted by Abt Associates.To see the full portfolio of evaluation work onHPOG: n-portfolio.As might be expected with a relatively new policy approach, the current evidence about the extentto which career pathways programs lead to jobs with higher earnings is mixed. A recent scan ofcareer pathways impact studies found they reported more consistently positive results for educationand training outcomes than for employment and earnings (Sarna and Adam 2020). Consistent withthis, an impact study of the frst round of HPOG grants (Peck et al. 2019) found that compared toa randomly assigned control group, through three years, participants were more likely to completetraining and to be working in healthcare but did not have higher earnings. Several rigorous metaanalyses of career pathways impact studies are underway, which will shed more light on thesequestions, with results expected in 2021.Abt Associates One Step at a Time: Participant Perspectives on Career Pathways2

A career pathway consists of progressively higher educationand occupational steps within a specifc sector.Though many impact evaluations are ongoing,insights from frsthand accounts of participants’experiences in career pathways programs arelimited. Seefeldt, Engstrom, and Gardiner (2016)provided some evidence as to how participantsnavigate career pathways programs in theirstudy of the Pathways for Advancing Careersand Education (PACE) project.3 They report onthe competing priorities that PACE participantsmanaged and identifed motivations thathelped those participants to persist in theirtraining programs. Key challenges participantsexperienced included guilt about spending timeaway from their children, challenging homesituations such as domestic violence, and theneed to ensure they had sufcient fnancialresources to keep their household functioning.Despite those challenges, participants werehighly motivated, and those still in school hadenrolled in a second training, demonstratingpersistence in their career pathway.A smaller study of participant experiences inone HPOG grantee (IERE 2019) documentshow participants think about career aspirations.That study suggests that some of participants’motives in entering career pathways trainingare diferent from the program’s goals ofincreasing earnings. Participants are motivatedby the prospect of higher wages, in line withHPOG’s aims. However, other factors such asjob quality, autonomy, respect, and schedulefexibility are also important to participants inmaking decisions about their careers.This brief adds to the body of researchdocumenting participants’ lived experiencesin career pathways programs by exploringhow a sample of HPOG 2.0 participants madedecisions along their career pathways to reachtheir longer-term career goals.Program Insight:4Examples of Career PathwaysPima Community College has 14 trainingprograms organized into fve careerpathways. In four of these pathways,credentials are stackable—sequentialtrainings that build towards a specifccareer: Medical Ofce-Health InformationManagement:Medical Ofce Clerk Specialist Medical Records Technician orProfessional Medical Coding Specialist Nursing:Certifed Nursing Assistant Patient Care Technician Licensed Practical Nurse Medical And Physician Support:Phlebotomist Medical Assistant Emergency Medicine:Emergency Medical Technician Paramedic or Licensed Practical NurseStaf reported that program participantsmainly entered the Nursing and Medicaland Physician Support pathways. Inaddition to being stackable, some trainingprograms ofer accelerated courses andfexible scheduling. Pima’s program ofersinternships in some areas, helping toconnect participants to employers.Abt Associates One Step at a Time: Participant Perspectives on Career Pathways3

Methodology and SampleThis brief is based on in-depth, in-person interviews conducted between October 2019 and January2020 with a purposive sample of 153 program participants across 14 local HPOG 2.0 programs(Thomas, Locke, and Klerman 2018). This brief reports themes emerging from these interviews.We selected the 14 programs to refect diversity in grantee organization type,5 geography,6projected enrollment, prior HPOG grant experience, demographic characteristics of theirparticipants, and percentage of those participants receiving non-fnancial support services such asacademic coaching and career coaching. We recruited participants to refect each local programpopulation in demographic and socioeconomic characteristics, levels of healthcare training (entry,mid-, or high-level), and variation in progress through training.7Participation in the interviews was voluntary. Interviews usually lasted between 60 and 90 minutes.We gave interviewees a gift card to thank them for their time. We scheduled interviews as fexiblyas possible over 4 to 5 days in each program location. Interviews were semi-structured andcovered a common set of topics: career pathways; employment and education histories; experienceof the HPOG 2.0 training; managing work, family, and training; and fnances. Interviewers useda conversational approach to allow probing. Interviews were transcribed and analyzed usingqualitative software.Compared with HPOG 2.0 participants in the selected programs, our interview sample had slightlymore participants who identifed as White, slightly fewer participants who identifed as Black orHispanic, more women, slightly more participants receiving support services, and slightly fewerparticipants enrolling in multiple trainings.8For this brief we supplemented the interview data with information collected for theimplementation study associated with the broader HPOG 2.0 National Evaluation.Figure 1: Interviewee Characteristics (n 153)Abt Associates One Step at a Time: Participant Perspectives on Career Pathways4

FindingsThe frst set of fndings in this brief explore the ways that interview participants moved along theircareer pathway, and how they anticipated taking steps towards their career goals in the future.Interviewees understood career pathways even if they did not always move along a pathway asquickly as they might have wished. Participants had to balance training with a variety of competingdemands including working and caring for relatives or children. The second set of fndingsexplore how a participant’s ability to balance these competing demands then infuenced theirdecisions about and experiences of their career pathway. Interviewees reported that their localHPOG program’s design and their relationships with staf also played important roles in how theynavigated their career pathway.How did interviewees move along their career pathway?Following are key insights that interviewees shared:Interviewees moved forward along their career pathway mostly in “stacked” or “staggered” training.Interviewees often aspired to complete what we call “stacked” trainings—that is, going immediatelyfrom one training to the next, towards the fnal goal, without a break. Some were able to do this.Many others were pushed by life events and challenges into what we call “staggered” trainings—that is, completing a training, working for a period, then returning to training (see fgure 2).Penny Bouvet 9 wanted to be a Registered Nurse (RN). She followed a stacked trainingpathway. She entered into the HPOG training to get her Home Health Aide certifcate.She was now getting her associate’s degree in nursing, and hoped to move on to herBachelor’s of Science in Nursing (BSN). She was working while getting trained. Shegot help from her family with both childcare and housing.Figure 2: How Participants Moved along Career PathwaysRosalie Ryan wanted to be an RN. She followed a staggered training pathway. She completed her Certifed Nursing Assistant (can) training, then took time of of the HPOGtraining program after having a baby. Now back in training, she was doing the prerequisites for her Licensed Practical Nurse (LPN) degree, and ultimately wanted to get herRN. Rosalie had three young children, which she saw as a potential barrier to achievingher education goals. HPOG had provided her with childcare assistance, but taking herchildren to daycare and balancing class was still a challenge. At the time of the interview, she was working on hiring a babysitter.Abt Associates One Step at a Time: Participant Perspectives on Career Pathways5

Interviewees frequently focused on the immediate next step.Interviewees focused on the immediate step in front of them, rather than several steps ahead.Slightly less than one third of interviewees (n 47) talked about taking it “one step at a time” orequivalent language. They wanted to complete their current training then look for work. Workingallows them to get their fnances back in shape or gain experience in the workforce. Many hopedto return to complete additional training later.At the age of 16, Lyla Kelly had fnished her GED, earned her CNA license, and started college with the goal of earning an LPN/RN associate’s degree. But a car accidentleft her with broken bones and in rehab; it meant she struggled to do well in school.Then she had a child and decided to focus on parenting for fve years. At the time weinterviewed her, 11 years later at age 27, she enrolled in HPOG, with the initial goal ofrecertifying her CNA license so she could work. In talking with HPOG staf she realizedshe wanted to get additional nursing training to achieve her goal of becoming an RN.She explained her step-by-step process: “I guess it was just easier to do the step bystep, step up slowly. I always wanted to be a nurse. You have to have your CNA frst,before you can become an LPN or an RN. I got that frst. Then it took a little bit longerto get an LPN or RN, so I decided to be a Certifed Medication Aide. Then I just wantedto do the RN, but it was easier to get the LPN frst, so I got my LPN frst. Now I’m getting my RN. Whatever is easier to get frst.” Lyla’s family helped her with childcare,and her partner covered their living costs when she had to drop down to part-timework to continue with school. The local HPOG program covered part of her tuition.Program Insight:Program Insight:Program staf reported that for someparticipants the low wages of entry-levelhealthcare positions were a challenge. Inresponse they left healthcare employmentto fnd a better-paying position in a diferentoccupational sector. This may be one causeof the staggered nature of career pathways—participants whose training does not oferan increase in wages may wait to take thenext training before returning to work in thehealthcare sector—or more likely, it leads toan aborted career pathway in healthcare.In three programs examined in depth,staf reported a clear sequence (pathway)of education coursework and/or trainingcredentials. Program staf also perceived“career pathways” to encompass both“career ladders” (vertical progression alonga pathway) and “career lattices” (combiningcredentials at the same or similar level toimprove marketability or increase wages).Wages and Career PathwaysCareer Ladders and Career LatticesAbt Associates One Step at a Time: Participant Perspectives on Career Pathways6

About half of interviewees were clear about the steps required to achieve their long-termcareer ambitions.To reach a goal requires frst understanding what you must do to get there, and then doing it.Interviewees ranged in their ability to clearly describe the steps on their path towards their long-termcareer ambitions. Some interviewees were very clear; others much less so.To quantify how many interviewees were able to clearly identify the career pathways steps they neededto take to reach their career goals, we set a scale: Interviewees with a “high” level of clarity couldarticulate clearly two or more of the following: (1) the steps necessary to pursue additional training, (2)the timeline for their additional training, and (3) what challenges they anticipated encountering andhow they would overcome those challenges.Slightly more than half of interviewees (n 84) had a high level of clarity—they could clearly articulatetheir plan. About one third of interviewees (n 56) could articulate goals, but not a clear plan to reachthem—a “low” level of clarity. The rest either could not speak the interviewers’ language well enough toarticulate their goals and plan (n 5), or their goals were not articulated in the interview (n 7).10Example of “High” Goal Articulation:Caitlin Vance is a single mother who used to work odd jobs and struggled to get backto school. She had tried to get her CNA certifcate before the HPOG program, butbefore completing it she got pregnant twice in quick succession and had to drop outof the training. Eventually she visited the local workforce program to see what opportunities she could fnd. Through HPOG she completed the Phlebotomy course and theMedical Assistant course.After graduating she was hired at Red Cross. Caitlin wanted to pursue a phlebotomyspecialty within nursing—apheresis. Her employer ofered some tuition support forgetting the LPN-level training. She had conversations with other staf at her employerabout how to take the next step and was waiting to hear back from her HPOG casemanagers about other options to attain this goal.Example of “Low” Goal Articulation:Sherman Meyer fnished the Patient Care Technician program and was currently in theLPN program. He thought he might go on to do an RN program, specifcally at thebehest of his aunt, who worked in healthcare.He wanted to make her proud, so he thought he would probably do it in the future,but for now he thought he wanted to work for a while as an LPN. He didn’t know whenhe would do further trainings; he said he just wants to be a “good nurse.”Abt Associates One Step at a Time: Participant Perspectives on Career Pathways7

What factors infuenced participants’ decisions to take the next stepalong their career pathway?A variety of factors infuence whether andhow interviewees moved along their careerpathway. These factors infuenced whetherparticipants could pursue any additionaltrainings and, among those who did takeadditional trainings, the timing and pace ofthose additional trainings.Interviewees faced a complex set of logisticaland fnancial considerations when deciding totake the next step in their education.Interviewees understood the concept of careerpathways, but their decisions about how totake the next step in their pathway took intoconsideration multiple logistical and fnancialfactors, including (1) understanding thechoices available (the “choice architecture”),(2) employment goals, (3) family and lifecircumstances, and (4) fnancial and personalresources.Figure 3—created from themes emergingfrom the interviews—provides examples ineach factor. Most interviewees mentionedconsidering at least one factor from each ofthe four categories in deciding whether ornot to enter the HPOG program or to take onsubsequent training.For example, with children in the family, someinterviewees wanted to model how to applyoneself, succeed in a program, and earn more.Program Insight:Participant BarriersGoodCare program staf reported thatparticipants struggled with a rangeof barriers, including limited Englishprofciency or lack of a high schooldiploma, single parenthood, childbirth,transportation, childcare, housing,food insecurity, and domestic violence.Additional barriers sometimes arose duringand after training when participants were: interested in healthcare jobs not indemand locally; focused on gaining immediateemployment, rather than progressingalong a career pathway; receiving benefts TANF to completeshort-term training through GoodCareand worried that they would lose theirTANF benefts if they found employmentwhile their new, relatively low wages inentry-level jobs would not ofset thatloss. (Staf reported that at least an LPNsalary is needed to ofset the loss ofTANF benefts.)About three quarters of interviewees intended to enroll in furthertraining (n 112). Asked to look fve years out, a majority hoped tocomplete longer-term training, such as Registered Nurse, Bachelor’sof Science in Nursing, or Licensed Practical Nurse.Abt Associates One Step at a Time: Participant Perspectives on Career Pathways8

Adrienne Benson, who was returning to the workforce after being a stay-at-homemom for 20 years, worked through the HPOG program to get her GED. She then enrolled in a Medical Assistant training with the goal of becoming a surgical technician.She was strongly motivated by both earning more after her training and being a rolemodel to her children. She described how her children motivated her to persist despite the challenges of caring for a young baby who was often sick: “I want to be amotivation to my family and my daughters and to my son, as well.” She described herchildren seeing the work she was putting in. “They’re like, ‘Mom, you’re amazing. Howdo you do this home, the baby, school, husband, all of that?’ It’s hard.”Figure 3: Consideration in Career Pathways Decision-MakingAbt Associates One Step at a Time: Participant Perspectives on Career Pathways9

Having young children in the household sometimes delayed a parent’s pursuit of subsequent training.A little more than one quarter of the interviewees (n 43) mentioned concerns about covering thecosts of childcare, managing the childcare schedule, or missing out on their children growing up.Marion Goode enrolled in the CNA training but then found that the training hours conficted with her needs for scheduling childcare and being with her kids. So she had todrop the class. She hoped to return to it, but explained that in order to do so, she wouldneed to work out a better childcare situation. Some students were able to rely on extended family, but Marion’s main support, her mother, was sick and unable to help.Resources—both personal and fnancial— were also important factors in interviewees’ decisions aboutfurther training. With limited resources, the choices available through HPOG (the choice architecture)constrained a program participant’s options.Mercedes Vaughn enrolled in her local HPOG program shortly before the grant wasscheduled to end.11 She understood she would only have time to complete a shorttraining program, so she chose Phlebotomy. Though her ultimate career goal was aMaster’s in Microbiology so she could work in a lab, she described feeling scared toenroll in another program because she couldn’t aford to pay for it without HPOG’sfnancial support.“The programs I want to do are going to fnish after HPOG is over. I thought about enrolling in the Surg[ical] Tech[nician] program or one of the Nursing programs, but like I said,HPOG is ending. If I still had them through the entire thing I would do another program. [HPOG staf] said I could enroll in another one, the Medical Technology program but I would still have, basically, a year without HPOG, which does not sound fun at all.”Interviewees had varied motivations to persist in their training.Interviewees reported a range of factors that motivated them to persist in their career pathway, fromwanting to be a role model to their children to seeking an increase in income. For example, manyparticipants who were also parents reported that their children were a big motivator.Prior to working towards becoming a pharmacy technician, Evangelina Copelandworked in a factory doing administrative support. She was motivated to completeher training by and because of her children. She said: “Thanks to my kids; they werethe biggest inspiration for me to say, ‘Hey, there is something wrong here, you’repaid the same rate since you began, you dedicated your life to this job, there has tobe something done.’ My paycheck comes weekly, but it doesn’t pay fully rent andbabysitter at the same time. I had to do something about this. I was always thinking that I cannot live like this no more. I’ve been struggling a lot with having a placeto live, a roof over my kids’ heads. I feel marvelously good because that is whatI wanted—to really feel like I’m there for my children.” Evangelina pushed throughan often difcult experience of being in school while also parenting and sometimesworking because she wanted to do better for her family.Abt Associates One Step at a Time: Participant Perspectives on Career Pathways10

During the interview, Hattie Brownlow expressed how she wanted to get her RN,then her BSN, then her MSN, then potentially her Nursing Practitioner degree. A major motivation for her continuing on her career path was to demonstrate to her kidsthe value of hard work and an education. She discussed challenges with her kids being older and having a lot of extracurricular activities. But she described being “usedto juggling a million things.” She said: “I want my kids to understand hard work anddedication. You will strive so hard to get to these places, but it’s well worth it in theend. You can never be educated enough. There’s always something to learn—youneed to continue to learn and work hard. Nothing will be given to you. You’re goingto have to work hard for it.”More than one third of participants described being motivated to join an HPOG training by the promiseof greater fnancial stability. Prior to enrolling in HPOG courses, many interviewees were unemployed;receiving TANF; working in unsatisfying, dead-end jobs; or relying on a partner’s income.Betty Osborne was motivated to fnd a new job that paid more. She was not able tosupport herself and her children on the 13 per hour that she earned as a medicalassistant. So she decided to pursue Radiologist training. She said: “That was actually one of my bigger factors in going back to school, too, was being able to have acareer that I could actually support myself with.”Self-confdence gained from completing atraining increased participants’ self-reportedlikelihood of taking the next step in theircareer pathway.Interviewees described boosts in motivationand self-confdence from completing a program,which in turn increased their interest in takingadditional steps towards their long-term goals.Of those interviewees who talked about thistopic (n 88),12 the overwhelming majority (n 83)reported gains in self-confdence and selfesteem along with meaningful skills that will likelyincrease their success in any current or futuretraining program.13Program Insight:Participant BarriersGoodwill Industries of the Valleys is anon-proft organization that providesjob training, employment placementservices, and community-based programsto individuals who face barriers toemployment. Goodwill leads a multiagency, multi-jurisdictional collaborativein western Virginia that is responsible forthe GoodCare Career Pathways Program,an HPOG-supported program providingtraining in nursing, health information,and healthcare support. Program staf atGoodCare reported that its participantsoften focused on completing one training toimprove their immediate fnancial situation.Anika Pierce, talking about what her friends and family thought about her doing theprogram, said, “They’re super proud of me. ’Cause I had a rough life before then, andI couldn’t just sit down and be still. And once I got into the program, it really calmedme down. Like, I’m a better mom, I’m a better person. I’m actually an adult now. AndI’m almost 30. So it did a lot for my life.”Abt Associates One Step at a Time: Participant Perspectives on Career Pathways11

Candida Lynwood explained how as a result of the HPOG program, “I’m getting ofmy butt more and I’m doing more, but at least the main thing that [the HPOG program] and [her HPOG case manager] taught me is always to keep striving, keepmoving, and more importantly, keep plugging along. Sooner or later, it’s going tohappen. That’s what I like. I’m determined to keep plugging along.”Guides infuenced how interviewees navigatedtheir career pathway.Where people get their career informationmay afect when and whether they learn aboutopportunities and resources that can move themtowards their goals. For example, intervieweesreported hearing about “career pathways” fromnon-HPOG sources (n 48) such as high schoolor other training programs, the internet, family,friends, and colleagues as well as from HPOGprogram staf (n 79).14Program Insight:Career Pathway DiscussionsPrograms reported discussing careerpathways as soon as participants enteredthe HPOG program. Discussing careerpathways early helped participants setgoals and think through their pathwaysteps. Some program staf explained thatone of the best strategies for encouragingparticipants to pursue a career pathwaywas to discuss it with them early in theirparticipation in the program and then oftenthroughout the program.Interviewees also reported that one or twoindividuals most strongly infuenced how theythought about their career pathway. In this brief,we call those who infuence decision-makingabout programs and occupations “guides.”Guides helped participants think through theirnext steps or ofered inspiration, which, evenwhen facing barriers, could spur a participant to keep going in training.Talking about her career pathway, Adrienne Benson said, “Meeting the right peoplethat actually know what they’re doing and can guide you through, I think that’s theroot of a pathway. Knowing what you’re looking for, and how to guide you.”Based on interviews, we identifed two kinds of guides: the “hand-holding guide” and the“ambassador guide.” The hand-holding guide was usually an HPOG case manager, coach or advisor,who ofers detailed support to he

Abt Associates One Step at a Time: Participant Perspectives on Career Pathways 1 One Step at a Time: Participant Perspectives on Career Pathways HPOG 2.0 Participant Perspectives, Brief 1 . Hannah Thomas OPRE Report 2022-48 February 2022 . Overview . Career pathways. is a framework that combines education, occupational training, and support

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