Pathways to Empowerment for Persons Living in Persistent Poverty
Study Details
Study Description
Brief Summary
The general purpose of this study is to examine a form of support that reduces stress and poverty and improves perceived health and well-being for persons living in persistent poverty. Based on in-depth interviews about appropriate support, a literature search, and participatory action research in which the wishes of each participating municipality were explored, Pathways to Empowerment (PTE) was chosen for evaluation. PTE is a strengths-based methodology for vulnerable individuals. It is implemented by social care professionals. This study will evaluate whether professional support based on PTE will have a positive impact on the situation of persons living in persistent poverty.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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N/A |
Detailed Description
This study is conducted in two different service settings:
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In various municipalities in the Netherlands, social workers of a care organization called 'Santé Partners' provide intensive, temporary, practical, professional and ambulatory support for vulnerable individuals who lost control over their lives. Social workers from three of these community service teams, situated in the municipalities of Nieuwegein, Houten and IJsselstein, will recruit participants for this study. One team of social workers will be trained in PTE while the other two teams will continue to provide support-as-usual.
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In various municipalities in the Netherlands, reintegration organizations employ participation coaches to guide social assistance recipients to (paid or volunteer) work, in order to improve their financial situation and participation in society. A team of participation coaches from the municipality of Nijmegen will be trained in PTE and will recruit participants for this study.
Participants are persons living in persistent poverty who started a support trajectory with a professional (i.e., a social worker or a participation coach). Professionals will conduct personal conversations with potential participants, during which they will explain what this study entails, and will hand them an information letter. When potential participants express interest in participation, an interviewer will contact them by phone to provide more information about the study, to answer any questions and to schedule an interview.
Data will be collected using computer-assisted personal interviews (CAPI). These interviews will mainly be conducted by video conferencing, although participants can also be interviewed by phone or in person if they prefer. Participants are interviewed at the start of their professional support trajectory, and nine months later (Nieuwegein, Houten en IJsselstein) or seven months later (Nijmegen). When the provision of professional support ends within this period, participants are called to answer some survey questions regarding their experiences with the received support.
Data will be collected on participants' well-being in various domains and on their experiences with the professional support they received. In addition, a survey will be administered among professionals to map their individual and job characteristics (e.g., years of working experience, caseload), and qualitative in-depth interviews will be held with both participants and professionals about the experienced impact of support based on PTE.
All data will be stored on secured servers of Radboudumc, for a period of 15 years. Only researchers affiliated with this project will have access to these data.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Intervention group Participants in this group will receive support from professionals trained in Pathways to Empowerment (PTE). These professionals received a four-day training program with two weeks in between each training day, allowing them to immediately implement their acquired set of knowledge and skills. At the end of the training program, professionals had to successfully pass an end assignment to become PTE-certified. In order to ensure the implementation of PTE, the training will be supplemented with a learning cycle. This cycle consists of several workshops and on-the-job coaching. A part of this cycle is predetermined (e.g., a workshop on the lived experiences of poverty); the other part is tailored to the wishes and needs of each team. |
Other: Pathways to Empowerment
Pathways to Empowerment (PTE) is a program for person-centered intervention. The general aim of PTE is to improve the quality of the daily lives of persons who experience loss of control in their lives by focusing on their strengths and stimulating their personal agency, participation in society, and self-direction in life. The main task of professionals is to help create the conditions in which growth and recovery are likely to occur.
Other Names:
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| No Intervention: Control group Participants in this group receive support as usual (i.e., social domain professionals are not trained in Pathways to Empowerment). This pretest-posttest control group design is used in the area of Nieuwegein only. In the municipality of Nijmegen, a one-group pretest-posttest design is used (i.e., no control group). |
Outcome Measures
Primary Outcome Measures
- Change in score on Perceived Stress Scale (PSS) [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
The PSS is a 10-item instrument that measures frequency of thoughts and feelings related to perceived stress. Answers are expressed on a scale ranging from (0) "never" to (4) "very often". The PSS has been validated and widely used in the general population.
Secondary Outcome Measures
- Change in score on Quality of Life (QoL) instrument [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
Quality of life is measured using two items of the Lehman Quality of Life instrument.
- Change in score on Mental Health Inventory 5 (MHI-5) [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
MHI-5 is a 5-item instrument that measures mental health status. The instrument includes items on (1) anxiety, (2) general positive affect, (3) depression, and (4) behavioral/emotional control.
- Change in subjective health score [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
Subjective health is measured by asking participants to rate their general health on a scale from (0) "very good" to (4) "very bad".
- Change in score on Brief Resilience Scale (BRS) [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
The BRS is a 6-item instrument that measures the ability to bounce back or recover from stress (i.e., psychological resilience).
- Change in score on Cognitive Emotion Regulation Questionnaire short (CERQ-short) [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
The CERQ-short is an 18-item instrument that measures the emotion regulation strategies individuals use when faced with stressful life events. It distinguishes nine subscales: (1) self-blame, (2) other-blame, (3) rumination, (4) catastrophizing, (5) positive refocusing, (6) planning, (7) positive reappraisal, (8) putting into perspective, and (9) acceptance. Each subscale is represented by two items.
- Change in score on Pearlin Mastery Scale (PMS) [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
The PMS is a 7-item instrument that measures the degree to which people perceive they can control factors that influences their lives (i.e., sense of mastery).
- Change in score on Rosenberg Self-Esteem Scale (RSES) [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
The RSES is a 10-item instrument that measures self-esteem.
- Change in score on Perceived Stigma of Poverty Scale (PSPS) [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
The PSPS is an 8-item instrument that measures internalized stigma and experienced stigma associated with individuals' financial status.
- Change in sense of societal belonging [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
Sense of societal belonging measures how strongly participants feel part of society on an 11-point Likert scale, ranging from 0 to 10. A higher score indicates a stronger sense of societal belonging.
- Change in score on Multidimensional Scale of Perceived Social Support (MSPSS) [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
The MSPSS is a 12-item instrument that measures social support from (1) family, (2) friends, and (3) a significant other.
- Change in social participation [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
Social participation measures whether participants engage in daily activities such as paid employment, volunteer work, education and caregiving.
- Change in score on financial stress [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
Financial stress is measured using one item of the InCharge Financial Distress / Financial Well-Being Scale.
- Change in care needs [Baseline, 9 months (area of Nieuwegein) or 7 months (area of Nijmegen)]
Care needs are measured on several domains, including housing & daily life, finances & daily activities, physical & mental health, and social relationships. For each domain, participants were asked to indicate whether they wanted help, whether they received help (and if yes, from whom), and whether this was the right help.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Participants are 18 years of age or older;
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Participants started a support trajectory at one of the participating teams during the recruitment period;
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Participants are living in persistent poverty. This means that participants have been having insufficient means for minimum living expenses and social participation for at least three years.
Exclusion Criteria:
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Being unable to provide reliable answers (e.g., having a psychotic episode);
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No informed consent.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Radboud university medical center | Nijmegen | Gelderland | Netherlands | 6500 HB |
Sponsors and Collaborators
- Radboud University Medical Center
- Movisie
- Municipality of Meppel, the Netherlands
- Municipality of Midden-Groningen, the Netherlands
- Municipality of Nieuwegein, the Netherlands
- Municipality of Nijmegen, the Netherlands
- Municipality of Oss, the Netherlands
- Stichting Lezen en Schrijven
- Vereniging Valente
- Voedselbanken Nederland
- Wageningen University and Research
Investigators
- Principal Investigator: Judith Wolf, PhD, Impuls - Netherlands Center for Social Care Research, Radboudumc
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- R0005311
- NWA.1239.18.003