FINDINGS FROM SIX MOMS PARTNERSHIP® GOALS & NEEDS ASSESSMENTS B R I D G E P O R T, C T B U R L I N G TO N , V T LOUISVILLE, KY N E W H AV E N , C T N E W YO R K , N Y WA S H I N G TO N , D . C .
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WHAT IS THE MOMS GOALS & NEEDS ASSESSMENT? The MOMS Partnership is committed to meeting mothers where they are. The MOMS Goals & Needs Assessment (GNA) is a survey that the MOMS Partnership co-creates with local partners and distributes in order for mothers in a community to share what they want, what they need, and what goals they have for themselves and their families. Mothers, pregnant women, and adult female caregivers in five MOMS sites have participated in a GNA: Bridgeport, Connecticut; Burlington, Vermont; Louisville, Kentucky; New Haven, Connecticut; and New York City, New York. Additionally, in Washington, D.C., there has been a broader research effort — including parents and caregivers of any gender — that has served as an equivalent of the GNA. Findings from New Haven include data from 2,279 GNAs administered between 2012 and 2017. For qualitative data findings — open-ended responses from mothers about their goals, parenting experiences, and self-care activities — 150 responses were randomly selected for analysis. The Bridgeport MOMS GNA was administered in April and May 2019; findings include data from 135 eligible respondents, mothers of a child or children under 18 years of age from the Bridgeport community. The Vermont MOMS GNA was administered in May and June 2019; findings include data from 138 eligible respondents, mothers of a child or children under 18 years of age who were currently receiving benefits through Reach Up (Vermont’s TANF program), Reach Ahead, Reach First, or the Post-Secondary Education Program. The Kentucky MOMS GNA was administered in July 2019; findings include data from 176 eligible respondents. The Kentucky MOMS GNA was completed specifically by justice-involved mothers — those currently incarcerated or under community supervision, including parole or probation — who were living or planning to live in the Greater Louisville Area. The New York City MOMS GNA was administered in July and August, 2019; findings include data from 163 eligible respondents, mothers of a child or children under 18 years of age from the Brownsville neighborhood of Brooklyn, New York City. Findings from Washington, D.C., draw from 576 surveys designed and administered in collaboration with the D.C. Department of Human Services in early 2018. This survey research gathered baseline data on customers receiving TANF prior to the implementation of a new TANF policy in the District; customers were eligible if they were parents or primary caregivers of any gender. For purposes of simplicity, the survey is referred to here as the D.C. MOMS GNA. 1
WHO HAS PARTICIPATED IN THE MOMS GOALS & NEEDS ASSESSMENTS? The GNA asks respondents about basic demographic data, like their age and racial identity. Both of these characteristics vary significantly across MOMS sites (p < .001).
Racial Identity of Respondents across MOMS Sites 100%
6.4%
8.1%
90%
14%
30.7%
80%
8.9%
70% 56.3%
60% 50%
68.8%
53.4%
97.8%
92.0%
40%
65.9%
30% 20%
34.8%
24.8%
10%
35.6%
0%
Bridgeport, Burlington, CT VT
Louisville, New Haven, New York Washington, KY CT City D.C.
White
Black or African American
Asian
American Indian or Alaskan Native
Biracial or Other
Average Age of Respondents across MOMS Sites:
37.8
34.0
33.8
36.8
32.2
33.1
Bridgeport, CT
Burlington, VT
Louisville, KY
New Haven, CT
New York City
Washington, D.C.
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HOW DO THE NEEDS OF RESPONDENTS VARY ACROSS SITES? HOUSING AND FOOD INSECURITY 70% 60%
67.9%
65.9% 61.5%
51.4%
50%
63.9%
66.2%
62.2%
61.0%
52.8%
40%
35.6%
30% 20% 10%
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* Housing insecurity data is not available for New Haven, CT, and Washington, D.C.
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The percentage of respondents experiencing food insecurity was not significantly different across MOMS sites, but rates of housing insecurity varied significantly (p < .001).
Percentage of Respondents Experiencing: Housing Insecurity Food Insecurity
LOW SOCIAL SUPPORT 70%
61.6%
60% 50%
44.4%
40%
31.8%
32.9%
Louisville, KY
New York City
30% 20% 10% 0% Bridgeport, CT
Burlington, VT
Percentage of Respondents with Low Social Support 3
The percentage of respondents with low levels of social support varies significantly among sites (p < .001). Social support data is not available for New Haven, CT, and Washington, D.C.
HOW DO THE NEEDS OF RESPONDENTS VARY ACROSS SITES? BARRIERS TO HEALTH CARE 100% 80% 60%
60.0%
68.8% 48.9%
48.5%
40%
The percentage of respondents who have experienced barriers to health care varied significantly across MOMS sites (p < .001). Health care barrier data is not available for New Haven, CT, and Washington, D.C.
20% 0% Bridgeport, Burlington, CT VT
Louisville, KY
New York City
Percentage of Respondents with At Least One Barrier to Health Care
BARRIERS TO MENTAL HEALTH CARE The percentage of respondents who have experienced barriers to mental health care varied significantly among MOMS sites (p = .0056).
100% 80% 60% 40%
26.7%
32.6%
41.5% 25.1%
20% 0% Bridgeport, Burlington, CT VT
Louisville, KY
New York City
Percentage of Respondents with At Least One Barrier to Emotional Health Treatment 4
Mental health care barrier data is not available for New Haven, CT, and Washington, D.C.
HOW DO THE NEEDS OF RESPONDENTS VARY ACROSS SITES? DIAPER NEED 80% 60%
61.9%
58.1% 44.1%
40%
27.1%
40.1%
35.4%
The percentage of respondents who experienced diaper need varied significantly across MOMS sites (p = .0062). Percentages reflect diaper need among respondents who reported having a child or children in diapers.
20%
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0%
Percentage of Respondents Experiencing Diaper Need
TRANSPORTATION BARRIERS 100% 80%
61.6%
60% 40%
61.4%
40.7%
36.8%
20% 0% Bridgeport, CT
Burlington, VT
Louisville, KY
New York City
Percentage of Respondents with At Least One Transportation Barrier 5
The percentage of respondents who have experienced barriers to transportation varied significantly among MOMS sites (p < .001). Transportation barrier data is not available for New Haven, CT, and Washington, D.C.
HOW DO THE NEEDS OF RESPONDENTS VARY ACROSS SITES? EMPLOYMENT
The percentage of respondents who were employed varied significantly across MOMS sites (p < .001).
100% 80%
68.4%
60%
43.4%
40%
45.9%
54.2%
23.9%
18.8%
20%
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0%
Percentage of Respondents Working for Pay
FULL-TIME AND PART-TIME EMPLOYMENT 100% 80%
31.5% 54.5%
38.7%
25.3% 52.1%
60% 40% 20% 0%
68.5% 45.5%
61.3%
74.7% 47.9%
Bridgeport, Burlington, Louisville, New Haven, New York CT VT KY CT City
Percentage of Employed Respondents Working: Full-time Part-time 6
The percentage of employed respondents who reported working full-time or part-time varied significantly among MOMS sites (p < .001). Full- vs. part-time employment data is not available for Washington, D.C.
HOW DO THE NEEDS OF RESPONDENTS VARY ACROSS SITES? HEALTH INSURANCE
The percentage of respondents who reported having no health insurance varied significantly across MOMS sites (p < .001).
30%
20%
10%
17.2% 8.5%
8.1% 2.7%
2.5%
4.5%
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VT
Bu rli ng to n,
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CT
0%
Percentage of Respondents without Health Insurance
CHILD HEALTH INSURANCE 30%
20%
17.2%
Child health insurance data is not available for Washington, D.C.
10%
1.5% 0%
4.3% 0.7%
The percentage of respondents who reported having no health insurance for their child varied significantly among MOMS sites (p < .001).
3.2%
Bridgeport, Burlington, Louisville, New Haven, New York CT VT KY CT City
Percentage of Respondents Who Reported that Their Child Has No Health Insurance 7
HOW DO THE NEEDS OF RESPONDENTS VARY ACROSS SITES? RISK FOR DEPRESSION 70%
59.5%
60% 50% 40%
50.7% 39.2%
55.7%
60.4%
43.8%
30% 20%
The percentage of respondents at risk for clinical depression — indicated by CES-D score ≥ 16 — varies significantly among sites, including when controlling for race and age (p < .001).
10% 0%
Bridgeport, Burlington, CT VT
Louisville, New Haven, New York Washington, KY CT City D.C.
Percentage of Respondents with CES-D score ≥ 16
DEPRESSIVE SYMPTOMS 25 20 15
15.4
16.0
18.0
20.5 17.6
15.1
10 5 0
Bridgeport, Burlington, CT VT
Louisville, New Haven, New York Washington, KY CT City D.C.
Average CES-D Score among Respondents 8
Average level of depressive symptoms — indicated by CES-D scores — varies significantly among sites (p < .001). Controlling for the effects of race and age on CES-D, however, these differences are no longer significant.
WHAT CHALLENGES DO RESPONDENTS ACROSS SITES EXPERIENCE? In describing the challenges that they face as parents, mothers across sites share a number of experiences in common, like financial difficulties; other challenges, like addiction, varied more widely across sites. 30% 25%
27.9% 25.0%
26.0%
20.9%
20% 15%
26.1%
17.1% 12.4%
11.8%
13.9%
12.7% 12.7%
14.9%
17.2%
9.0%
10%
6.1%
5% 0%
Bridgeport, Burlington, Louisville, New Haven, New York CT VT KY CT City Percentage of Respondents who Mentioned: Financial Insecurity Child Behavior and Discipline Lack of Time 30% 25% 18.4%
20%
13.9%
15% 10% 5% 0%
11.2%
9.7% 7.3%
6.2% 2.3%
3.7% 0.8%
8.0% 2.0%
0.7%
0.8%
Bridgeport, Burlington, Louisville, New Haven, New York CT VT KY CT City Percentage of Respondents who Mentioned: Single Motherhood Housing Instability Addiction Data is not available for Washington, D.C.
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WHAT GOALS DO RESPONDENTS ACROSS SITES HAVE? In describing the goals that they face as parents, mothers across sites share a number of aims in common, like finding employment; other goals, like improving parenting skills, varied more widely across sites. 50% 40% 30%
41.1%
40.0% 31.9%
29.6% 19.3%
20%
32.6%
37.3%
37.5%
32.7%
27.8% 23.6%
25.4% 17.3%
17.3%
Louisville, KY
New Haven, CT
15.3%
10% 0%
Bridgeport, CT
Burlington, VT
Percentage of Respondents who Mentioned: Employment Financial Security
New York City
Housing Security
47.6%
50% 40% 30%
24.4%
29.6%
26.2% 26.2%
24.6%
28.7%
27.3%
17.4%
20%
16.7% 16.7%
10% 0%
Bridgeport, CT
1.3%
1.4%
1.5%
Burlington, VT
Louisville, KY
Percentage of Respondents who Mentioned: Improving Parenting Further Education Data is not available for Washington, D.C.
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New Haven, CT Sobriety
0.0%
New York City
WHAT BRINGS JOY TO RESPONDENTS ACROSS SITES? In the GNA, respondents were asked to share the last activity they did for themselves. Mothers across sites share a number of self-care activities, including cosmetic activities like a manicure or hair cut, while others, like outdoor activities, vary by community. 40% 28.3%
30%
24.5%
22.9%
18.9%
20% 13.2%
19.3% 12.0%
10.4%
7.2%
10%
22.6%
14.0% 13.2% 11.8%
17.6%
6.6%
0%
Bridgeport, Burlington, Louisville, New Haven, CT VT KY CT Percentage of Respondents who Mentioned: Cosmetic Activities Family Time Food and Dining
New York City
40% 30%
24.5%
20% 10%
14.5% 8.4%
8.4%
15.1% 6.6%
24.5% 14.1% 10.4%
11.3%
15.3% 4.0%
7.3% 7.3%
5.9%
0%
Bridgeport, CT
Burlington, VT
Louisville, KY
New Haven, CT
Percentage of Respondents who Mentioned: Time with Friends Shopping Outdoor Activities Data is not available for Washington, D.C.
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New York City
WHERE DO RESPONDENTS ACROSS SITES FEEL WELCOME AND COMFORTABLE? In listing places in the community where they feel welcome and comfortable, mothers across sites expressed different preferences: more than half of mothers in Bridgeport, Louisville, and New York City mentioned churches, while more mothers in Vermont preferred grocery stores than any other location. 80% 70% 60%
60.7%
61.5%
58.5%
57.1%
54.2%
50% 40%
36.8%
30% 20% 10%
24.3% 17.1%
16.8%
5.1% 6.8%
20.8%
14.3% 8.4% 3.3%
2.1%
0%
Bridgeport, CT
Burlington, VT
Louisville, KY
Percentage of Respondents who Mentioned: Churches Grocery Stores Libraries
Data is not available for Washington, D.C.
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New York City
Health Providers or Clinics
WHAT ARE THE NEXT STEPS FOR THE MOMS PARTNERSHIP®? The findings of the MOMS Goals & Needs Assessments have strongly informed the delivery of the MOMS intervention in New Haven, CT and Washington, D.C., where MOMS services are underway. Similarly, the findings of the Goals & Needs Assessments will be used to tailor MOMS services in Burlington, VT and Louisville, KY — both set to launch in early 2020 — as well as in Bridgeport, CT and New York City. The Goals and Needs Assessments offer a window into the diverse needs, goals, and experiences of mothers in each site, laying the foundation for each program’s Impact Evaluation: the rigorous, multi-generational evaluation of the impact of MOMS services for participants and their families. The role of the Impact Evaluation is to surface reliable evidence that MOMS causes changes in the lives of the women served— in areas where change is needed, and wanted, most. Looking forward, the comparative analysis of Impact Evaluations across sites— in the context of these Goals and Needs Assessments— will help to furnish the body of knowledge on how to most effectively generate outcomes for families through mental health. Ultimately, Elevate aims for the MOMS Partnership to be a useful and sustainable resource in each community and to help improve the lives, mental health and wellbeing, and connectedness of mothers who live there. The rigorous research and analysis at the core of MOMS are critical to achieving this mission.
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For more information, please visit elevate.yale.edu and moms.yale.edu
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