Social Determinants of Economic Self-Sufficiency (ESS) in Health Profession Opportunity Grants (HPOG): Focusing on the Process of Health Care Career Pathways

The purpose of this dissertation was to investigate the social determinants of economic self-sufficiency among low-income jobseekers in a federally sponsored healthcare career pathways program. Particularly this dissertation focused on the effects of the process element of self-sufficiency called psychological self-sufficiency, which consist of perceived employment barriers (PEB) and employment hope (EH) (Hong 2013; 2016). Although many studies have evaluated the effectiveness of workforce development programs that focus on economic outcomes, little empirical research has been conducted to examine the psychological prerequisites for achieving economic self-sufficiency. To address this gap in the literature, this dissertation examined potential effect of psychological self-sufficiency (PSS) - representing diverse aspects of an individual\u27s circumstances - in a government-funded workforce development program.The purpose of the first study was to investigate the relationship between the rate of PSS change and one\u27s later levels of economic self-sufficiency. A lagged multivariate regression model was conducted using a sample of 350 participants in a government-sponsored health sector career pathway training program. Results showed that increased PSS score positively affects economic self-sufficiency outcome, controlling for other demographic and economic-related variables. The purpose of the second study was to examine the relationship between PSS score groups and economic self-sufficiency among workforce development program participants. Propensity score matching was used to eliminate selection bias and divide the participants into treatment and control groups based on the PSS score. Results indicated that the treatment group (increased PSS) is positively related to economic self-sufficiency. The purpose of the third study was to find distinct patterns of perceived employment barriers among welfare-to-work program participants. Four meaningful patterns of employment barriers - All high levels of employment barriers, Work-related barriers, Work-related + Community-related barriers, and Low levels of employment barriers - were found using latent class analysis (LCA). By examining the effect of PSS on ESS and finding patterns of employment barriers, these three present studies supported the importance of the processual element of self-sufficiency in workforce development evaluation. Each of the studies proposes a discussion of the implications for social work practice, research, and policy