Executive Summary


Throughout the world, war, persecution and natural disasters often force people to flee their country to find safety elsewhere. In fact, last year, 70,000 people sought refuge in the United States alone. Refugees often encounter significant challenges in their efforts to become integrated into the United States. After a long, arduous process to receive official refugee status, when these individuals come to the United States, they are guided through integration into the country with the assistance of the services and benefits of Refugee Resettlement Programs.

Finding meaningful employment, becoming fluent in English, and acclimating to American culture are considerable hurdles refugees face as they strive to adjust and transition into their new community. Ascentria Care Alliance is a non-profit organization based in Worcester, Massachusetts, that provides Refugee Resettlement Programs to assist refugees in their integration process. From 2006-2010, more than 10,900 refugees were resettled in Massachusetts. Ascentria Care Alliance has resettled more than 1,700 of these refugees in the Worcester area alone (Refugee Arrivals to Massachusetts by Country of Origin, 2006-2010).

Ascentria follows resettlement guidelines provided by the Cultural Orientation Resource Center (COR) and governed by Lutheran Integration and Refugee Service (LIRS). Unfortunately, the current infrastructure of these programs is centered around the federal funding provided and can force organizations to be more concerned with deadlines and time frames than achievement and understanding. The programmatic focus of federal funding greatly affects the delivery of care and services and can have a negative impact on the refugees as they try to adapt to their new lives in the United States.

Ascentria Care Alliance has recognized the deficiencies this programmatic focus causes in the delivery of refugee services and is working to solve these issues. Ascentria created Project ACE (Achieving Client-centered Engagement) to address these issues by focusing on the client’s individual needs throughout service delivery and client experience. Ascentria believes that a better understanding of each individual’s progress through the integration process will help them to better serve the needs of all their clients. Ascentria requested that students from Worcester Polytechnic Institute’s Worcester Community Project Center collaborate with their Services for New Americans program to develop a system of measurable indicators to track the progress of their clients through resettlement programs.

Goal, Objectives and Methods

The goal of our project was to find indicators to measure the success of Ascentria Care Alliance’s refugee clients. For our project, indicators of success are defined as specific milestones that contribute to successful integration into the United States. To achieve our project goal, we completed four objectives.

  1. Develop an understanding of Ascentria’s refugee clients’ experiences.
  2. Identify the appropriate definition of success for Ascentria Refugee Clients.
  3. Identify the key indicators of successful integration.
  4. Develop a basic assessment tool to evaluate a refugee client’s progress.

Objective 1: Develop Understanding of Ascentria’s Refugee Clients’ Experiences

Our first objective was to gain an understanding of the resettlement experience for Ascentria Care Alliance’s refugee clients. We conducted interviews with Ascentria executives and caseworkers; as well as Faith Tendo, Outreach Coordinator from the African Community Education (ACE) program; Meredith Walsh, the Executive Director of the Worcester Refugee Assistance Program (WRAP); Adnan Zubcevic, the Executive Director of the Bosnian Community Center for Resource Development (BCCRD); Mette Brogden, the Director for Program Evaluation, Michael Mitchell, Vice President for Programs and Protection and William Swanson, Vice Chairman of the Board of Directors for Lutheran Immigration and Refugee Service (LIRS); and Worcester City Councilor, Sarai Rivera.

These interviews, along with content analysis of government reports from the Office of Refugee Resettlement, materials provided by the Cultural Orientation Resource Center, and research published by the United Nations High Commissioner for Refugees and research about the resettlement process and the programs offered by Ascentria, increased our understanding of the integration process, milestones, and challenges refugees face.

Objective 2: Define Success for a Refugee Client

Our second objective was to learn how caseworkers, executives and refugees defined the success of an individual. Over seven weeks, we gathered this information through focus groups and interviews with the personnel listed in Objective 1. The information received was compiled into a list comprised of every single factor that our interviewees felt contributed to success. We found commonalities throughout different interviews and published reports regarding refugee integration. We were able to condense our data into one, generalized definition of success. We validated our results by consulting Ascentria employees and other interviewees.

Objective 3: Identify Indicators

We used the definition of success we developed in Objective 2 to analyze our data and find the specific indicators that contribute to this success. We were able to break down the list of factors that contributed to a refugee’s success and divide them into categories. The categories were based on general ideas that multiple factors involved or encompassed. Finally, the categories were simplified in order to clearly produce four categories in which a client’s progression indicated a potentially successful integration. We called these four categories the “Indicators”.

Objective 4: Develop System to Assess Client Success Levels

We utilized the Full Frame Initiative’s “Five Domains of Wellbeing” alongside the list of factors that contribute to success to create a system of assessment from the indicators developed in Objective 3. We evaluated each indicator against the following five Domains, Safety, Stability, Mastery, Meaningful Access to Relevant Resources, and Social Connectedness. We created questions from the list of specific factors, as well as each of the five domains, for each indicator in order to ensure that we measured success in an applicable and impactful manner. To ensure that the questions would be accurately interpreted, we sent the questions to employees of Ascentria for approval.

We completed our final objective to create a system for Ascentria to implement in their refugee resettlement programs using the questions we developed. We compiled the questions into an excel program and created a survey-like evaluation that caseworkers can use with their refugee clients. We revised the format after receiving feedback from caseworkers, management and executives at Ascentria in order to ensure that the product is easily implementable, sustainable, and beneficial to their organization.

Findings and Recommendations

Our research regarding the refugee resettlement process and the best ways to ensure success for the individuals involved led to five findings and recommendations.

Our first finding is that the Full Frame Initiative’s Five Domains of Wellbeing is a useful tool for analyzing Ascentria Care Alliance’s refugee client’s success. Angela Bovill, Chief Executive Officer of Ascentria, recommended that we research the Five Domains and consider using it as a framework for the assessment tool we were developing. The Full Frame Initiative (FFI) is a national nonprofit organization aimed at promoting change in the way systems respond to people and communities living at the intersection of poverty, violence and trauma. The FFI developed the “Five Domains of Wellbeing”as aspects of life that every person needs to thrive. The Five Domains of Wellbeing framework is utilized by many different programs and systems including the State of Missouri’s Juvenile Justice System, Massachusetts state agencies integrating domestic and sexual violence programs with housing programs, and the Greater Boston Full Frame Network which addresses poverty, violence, trauma, and other obstacles (Full Frame Initiative, 2014).

After researching the Five Domains of Wellbeing using published factsheets and definitions, we found that the information and reasoning was very flexible. This flexibility is vital to the utility of the FFI since its widespread use depends on its ability to adapt to different needs, circumstances and populations. The Full Frame Initiative strives to make systematic changes to the delivery of social services by helping agencies, organizations and programs to impact the lives of clients. We found that we could use the information in the Five Domains of Wellbeing to build cohesive and expansive questions to assess each of the four indicators.

For our second finding, we discovered four indicators of success for Ascentria’s Refugee Clients. These indicators are Employment, Housing, English Literacy and Integration. Through the participants in the focus group and others that we interviewed we discovered salient factors that contribute specifically to a client’s success. We compiled, brainstormed, and organized these factors into four general categories or indicators. We then confirmed these indicators in follow up interviews. The factors affecting Employment include: attainment of any form of employment; progressing to stable, non-seasonal employment; earning a livable wage; job satisfaction; and familial support of a client’s employment.

Success within the Housing indicator is determined by comfortable communication with landlords, understanding rent and utilities and the client’s overall satisfaction with where they are living. English Literacy is directly affected by the level of English required for employment and prior exposure to the English language. Integration success is the client’s ability to self-advocate and utilize the services available to them and is determined by the rate of the client’s integration into society. We created an assessment tool for Ascentria Care Alliance to use to assess their refugee client’s progress through the resettlement programs. The assessment consists of questions pertaining to each of the four indicators of refugee success. We recommend that Ascentria expand on the basic assessment that we created to develop a more in-depth evaluation procedure.

Our third finding is that the 48 hour orientation for Ascentria’s refugee clients upon arrival is problematic. Upon arrival in the United States, Ascentria’s refugee clients begin a funder mandated cultural orientation program that must be completed within 48 hours. This orientation is part of the Reception and Placement services organized by the Cultural Orientation Resources Center and overseen by LIRS. Resettlement agencies are provided materials to present and teach necessary information, such as laws pertaining to their refugee status, the necessity of learning English and how to apply for a job. However, resettlement agencies do not have the time or the funding to investigate and discover if refugees have comprehended the large sum of required topics in such a short period of time. We recommend additional research measuring comprehension and implementation of orientation principles.

Fourth, the time frame in which Refugees can receive support from resettlement programs is not long enough to become successfully integrated into the community. Currently, government funding allows refugees access to assistance from refugee resettlement programs for up to six months. After speaking with caseworkers and Ascentria executives, we found that most believe that this limited time frame is not long enough. There is too much for the refugee client to accomplish and learn. There are too many variables involved for such a specific and strict time frame to meet every client’s needs. We recommend further research into a more realistic and responsive time frame for the client to be able to make progress. All refugee clients are different. Some clients will need a lot of time to transition into their new life in America due to severe trauma, lack of prior education, and cultural differences while others may need significantly less time. If caseworkers feel that the client requires more assistance, they can suggest the client continue the program for several more months after which they will re-evaluate the client’s progress. We also recommend caseworkers be given the flexibility to provide Ascentria Care Alliance clients with a monthly check-in after completion of the program that continues until the client feels comfortable on their own.

Finally, Worcester, Massachusetts needs city level advocacy. There are many different organizations and agencies that impact a refugee’s life. Our interviews showed that city and community organizations can provide additional services that refugees may require, such as summer programs for English, transportation for the elderly and disabled, and before and after school programs for youth. These services are often not provided until a need has been shown. Ascentria is fortunate enough to have the ability to know the needs of the refugee community and should therefore take the responsibility to communicate them to these potential community partners. Sarai Rivera, a Worcester City Councilor, informed us that the Worcester City Council is currently bringing together many community partners as part of the Refugee Roundtable. We believe that this is the perfect opportunity for Ascentria to use their valuable and extensive knowledge of the refugee community. To do this, we recommend that Ascentria create a position with the responsibility to advocate for refugee needs and services on a city level. This new position should be able to interact with government agencies such as the school board, housing inspections, and city council, as well as advocate for refugees and their care.

About the Assessment Tool

The assessment tool that we developed is a five tab excel file questionnaire. The first four tabs consist of questions that we developed based on input from our interviewees and focus group to analyze education, employment, housing and integration. The fifth tab is a “ResultsDashboard”where all the indicator graphs are shown at the same time. The questions are weighted equally and there is a pie chart at the end of each section comparing the number of questions answered “yes”and “no”. A detailed example and explanation of the assessment tool is available in Chapter 5.

This questionnaire should be used as a snapshot diagnostic tool for the caseworkers. It is meant to guide the family through the programs and will reveal potential challenges of integration. Initially, the questions should be answered on the spreadsheet by the caseworker as they collect information directly from the client, followed by the client filling out the spreadsheet themselves. The assessment tool can be administered to establish a baseline of a client’s needs. The family’s integration progress can be tracked by following their ability to achieve the markers of successful integration throughout their time in Ascentria. Ideally, the client will be able to take the test entirely on their own at the end of the program. With the client’s permission, the test should be re-administered after a year. The intent of this second evaluation is to track progress after the federally funded programs are finished. The questions should be answered as accurately as they can at the time the test is given.


This project is the first step in Ascentria’s Project ACE program aimed to provide better care to each of their clients. In order to offer improved, personalized care, Ascentria requested research on how refugee clients are progressing toward successful integration. Our project’s findings and the assessment tool can be utilized not only in the refugee resettlement programs but throughout the entire organization as the baseline for determining client success.