Family & Social Policy

Examining Reproductive Health Services of Women, Female Youth, and Female Refugees in Northern Jordan with a Behavioral Economics Lens

February 28, 2020 Leave a Comment

Examining Reproductive Health Services of Women, Female Youth, and Female Refugees in Northern Jordan with a Behavioral Economics Lens
Authors: Heath Prince, PhD (University of Texas, Austin); Yousef Khader, PhD (Jordan University for Science and Technology); Yara Halasa, PhD (Brandeis University); Nihaya al-Sheyab, PhD (Jordan University for Science and Technology); and Kelley Ready, PhD (University of Texas, Austin)
Publication Type: Working Paper, 12pp.

Executive Summary:
Our study begins from the premise that favorable attitudes toward modern family planning methods (MFPM) among Jordanian and Syrian women do not always translate into behavioral changes, and that the availability and cost of MFPM are not factors in the apparent stall in Jordan’s total fertility rate. Accordingly, our intervention focuses on changing behavior through Behavioral Economics (BE)-based interventions, with the expectation that these interventions contribute to bringing attitudes and behavior into closer alignment.

Our results are positive and statistically, and perhaps socially, significant. Our BE-influenced revisions to the counseling guide used by mid-wives to counsel women on family planning appears to have contributed to a 6.3 percentage point reduction in pregnancy rates over the control group, while text messaging appears to have the potential to add to this decline—marginal improvements from text messaging are positive, but statistically insignificant. While considerably lower than pregnancy rates in the control group, the percentages of women in the two intervention groups who became pregnant did not differ significantly at 3, 6, and 9 months.

We were also interested in whether, and to what extent, our interventions could contribute to increases in the persistence in the use of family planning methods. The rate of family planning use among women in the two intervention groups was significantly higher than that among women in the control group at all follow up times. However, use of family planning at all follow up points did not differ between intervention groups.

The results of our study suggest that simple BE-inspired interventions can be effective methods for reducing Jordan’s fertility rate. Randomly assigning clinics to control and intervention arms ensured that the outcomes are attributable to the interventions. The differences in terms of persistence in the use of MFPM and the reduction in pregnancies are substantial and statistically significant. Additional research is required to understand more fully why the marginal impact of the text messaging was, at best, small and statistically insignificant, despite high rates of satisfaction reported.

Our study has significant policy relevance given its findings of the potential efficacy of cost-effective counseling and text-based interventions to improve maternal health promotion and reduce maternal health risks. We believe that these findings merit consideration for replication of the project on a larger scale and over a somewhat longer time-period to assess the long-term impacts of BE interventions on the persistence in use of MFPM, as well as on fertility rates.

CareerAdvance® Implementation Study Findings through FY 2019

February 18, 2020 Leave a Comment

CareerAdvance® Implementation Study Findings through FY 2019
Prepared for the Health Profession Opportunity Grant Program Administration for Children and Families
U.S. Department of Health and Human Services
Authors: Cynthia Juniper and Christopher T. King
Date: February 2020
Publication Type: Report, 63pp.

This report examines the evolution of CareerAdvance® and the implementation of the fourth year of HPOG II services in a five-year grant cycle, including post-HPOG sustainability planning for CareerAdvance®. This latest report focuses on changes made as partners work together to prepare for the final year of the HPOG II grant period, the efforts and issues salient to the sustainability of CareerAdvance®, and the impact the participation in CareerAdvance® has had on the partner organizations’ overall philosophy, strategic planning and service delivery.

First, this report briefly describes the organizations partnering to implement the HPOG II version of CareerAdvance®. It then examines changes made to the program components, including changes made in preparation for the final year of HPOG II funding. The report then describes the HPOG II FY 2019 (September 1, 2018–August 31, 2019) cohorts enrolled in training, as well as detailed demographic information on the participants and their families, program completion and certification attainment of all HPOG II participants (April 2016–August 31, 2019). A final section addresses CareerAdvance® sustainability planning issues, options and opportunities. This report draws from previous CareerAdvance® reports, information on the HPOG II program participants and their families, and interviews with leadership and staff with CAP, Tulsa Tech, Family and Children Services, Workforce Tulsa, and Tulsa Community WorkAdvance.

RMC researchers play roles in recently published Upjohn Institute book

January 30, 2020 Leave a Comment

RMC Senior Research Scientist Dr. Chris King joined Philip Young P. Hong of Loyola University Chicago as editors of a recently published WE Upjohn Institute for Employment Research book titled Pathways to Careers in Health Care. The book provides analyses and evaluations of the Health Professions Opportunity Grants (HPOG) program, a demonstration project aimed at providing training in health professions to low-income individuals. Dr. King also co-authored a chapter with RMC Director and Research Scientist Dr. Heath Prince titled “Career Pathways and Sector-Based Strategies: A Closer Look.” Publication information can be found on Upjohn’s site here, while the book can be purchased on Amazon here.

Abstract:
The Patient Protection and Affordable Care Act passed by Congress and signed into law by President Barack Obama in 2010 effected major changes in the financing and delivery of health care in the United States. It also authorized creation of the Health Profession Opportunity Grants program (HPOG), a demonstration effort within the U.S. Department of Health and Human Services to provide opportunities for education and training that lead to jobs and career advancement in health care for recipients of Temporary Assistance for Needy Families (TANF) and other low-income individuals and to respond to the increasing demand for health care professionals. As a demonstration program, HPOG also featured a mandated federal evaluation to assess its success and a corresponding research program—the HPOG University Partnership Research Grants (HPOG UP), a collaborative effort between the program operators and academic researchers from different disciplines—to observe various aspects of its operations.

HPOG unites two important innovations in workforce development programming for serving low-income populations in recent decades, career pathways and sector strategies, by actively fostering the use of the former in the context of one major sector—health care. Health care is one of the only sectors that continued to exhibit growth year after year in periods of general economic expansion as well as decline. Health care employment even continued to expand in most states and communities across the United States through the Great Recession in 2008–2009. In addition to offering insights into these strategies and their evolution, the authors in this book present the findings, lessons, and recommendations that emanated from HPOG research and evaluations for consideration by policymakers, program operators, and other researchers.

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