Do Holistic, Individualized Programs Really Make a Difference? Let’s Look at the Research.

SONYA STEARNS
Network Manager
Read more from Sonya

Listen to this article:

Scientific research is a valuable resource for learning about charitable programs’ best practices. Often, a well-designed study does a better job of confirming or disproving our assumptions than anecdotal observations or deliberate outcomes measurement. This synopsis addresses the findings of a 2023 working paper entitled Fighting Poverty One Family at a Time: Experimental Evidence from an Intervention with Holistic, Individualized, Wrap-Around Services.

What question does this research answer?

“How does holistic, individualized wrap-around intervention affect outcomes for a broad population of low-income individuals?”

This study examines the impacts of the Padua Program on individuals and families facing poverty. Its wrap-around services (or holistic support services) are characterized by a comprehensive, personalized approach that addresses participants’ primary needs (such as housing, employment, and financial stability). Padua’s case management is asset-based and relational, meaning case managers empower participants based on strengths and abilities they bring to the table. The findings reveal Padua participants experienced significant improvements in employment outcomes with higher rates of full-time employment and increased monthly earnings. It also positively affected housing stability and physical health; and reduced reliance on government programs. In short, the program demonstrates the value of interventions tailored to the unique needs of participants, emphasizing the importance of a holistic approach to poverty alleviation.

Study Design

Data Source:
Catholic Charities of Fort Worth (CCFW)
Padua Program asked Notre Dame’s Sheehan Lab for Economic Opportunities (LEO) to study participants who entered their program from February 2015 through October 2016.
Sample Size:
The study included 427 participants. Of those, 193 were placed in the treatment group and 234 in the control group. Participants were in the program for an average of seventeen months.
Type of Study:
This study was a “Randomized Controlled Trial (RCT),” which means researchers select a random sample of people who receive intervention (the treatment group) and a random group who do not (the control group).
For example, if your thesis is higher education causes higher income, you could provide free scholarships to a random group of students and compare their outcomes to students who do not receive a scholarship. RCT is considered the gold standard for proving intervention causes the outcome (versus being a correlation of it).
Limitations:
Due to the study’s small size, the components of the Padua program that drove positive outcomes could not be determined. Additionally, while the study proved the program’s efficacy, it did not settle the question of whether other organizations’ use of Padua would achieve similar results. Some elements, like the skill level of the case managers, could be difficult to replicate.

Key Findings

1. Unemployed individuals saw favorable workforce outcomes from the Padua program.
   Participants who entered the program without employment were 67% more likely than the control group to be employed full-time after twenty-four months. They also experienced a 46% increase in earnings, earning $420 more per month than individuals in the control group.
2. Families saw a stabilization in their situation through housing.
   Participants who entered the Padua program without stable housing saw a stabilization of their situation after 24 months. In fact, they were 60% more likely to achieve it than the control group.
3. Intense, asset-based case management helped increase their ability to participate more fully in a community (through jobs, stable housing, education, etc.) and improved their health.
   In a qualitative survey, forty-three percent self-reported improved mental, physical, relational, and emotional health. Even without objective data, the individuals perceived better overall well-being, indicating improved mental and emotional stability.
4. Targeted and longer durations of case management were initially more costly per individual but were likely more economical for service providers in the long run.
   Case management in the Padua program costs almost $23,000 per individual over two years. Initial upfront costs for relational case management are higher because each case is targeted (that is, each client’s unique assets, liabilities, and situation are considered). Pauda suggests that investment leads to fewer clients returning to the program, leading to cost savings over time.

Practical Application

The treatment group in the Padua Program achieved better long-term self-sufficiency than those in the control group. The success of the program suggests its holistic approach may produce similar results for your organization. Here are a few highlights to consider for your program:

1. Intense case management and small caseloads are the foundation for success because they foster commitment and relationship.
   Our Case Management Toolkit provides everything you need to implement asset-based, relational case management in your own context.
2. Prioritize stabilized living situations for job seekers.
   As demonstrated, those in the treatment group with stable housing secured jobs more readily and increased their wages more substantially than the control group. This suggests achieving overall stability is sequential–with housing a higher initial priority than boosting income. Long-term transitional housing can assist in meeting that need, and we’ve developed a toolkit to help you implement this model in your own setting. As well, it’s important to remember everyone can progress, but they will not do so at the same rate nor in every area simultaneously.

Conclusion

This research supports implementation of an asset-based, relational case management plan for individuals and families facing poverty. The findings highlight the value of tailoring care to meet the unique needs of participants, emphasizing the importance of using what we call subsidiarity to meet root cause needs. The Padua Program is a successful example of its effectiveness and thus a worthy model from which to learn. Its detailed assessment tools and case management plan support positive, long-term self-sufficient outcomes.

Read the Study
Fighting Poverty One Family at a Time: Experimental Evidence from an Intervention with Holistic, Individualized, Wrap-Around Services | NBER