Integrating Systems and Basic Income: Improving Outcomes for Families of Young Children

Официальное название

Advancing Health Equity Via Basic Income + Early Childhood Systems Integration: An RCT of the Baby Bonus Program

Обзор

Early childhood is a critical period, laying the foundation for future growth and deveopment. This foundational period has an outsized effect, impacting health, well-being and achievement across one's lifespan. The U.S. lacks a cohesive early childhood system to support families with young children ages 0-5. The goal of this randomized controlled trial(RCT) is to test if community-based support via community health workers(CHWs) improves social and health services utilization, and child development. Furthermore, the trial will examine if income support enhances the impact of a CHW integrated system. Participants are English and Spanish speaking families with healthy newborns. This RCT was designed based on family priorities, community capacity and needs in a collective impact model. This trial is anchored at a university based children's hospital and involves many partners: families, county health, county leadership, a leading early childhood non-profit organization, the county's Medicaid managed care organization.

Вмешательства

• Поведенческое Community Health Worker
  A Community Health Worker will assist participants in navigating the medical system and connecting the participants to community services during the first three years of their child's life.
• Поведенческое Community Health Worker + Guaranteed Basic Income
  A Community Health Worker will assist participants in navigating the medical system and connecting the participants to community services during the first three years of their child's life. Participants will also receive a monthly unconditional cash gift for the first three years of their child's life.

Первичные конечные точки

• Change in attendance at well-child visits [Срок оценки: 12, 24 and 36 months]
• Change in attendance at maternal postpartum follow-up visits [Срок оценки: 12 months]
• Change in pediatric Emergency Department visits [Срок оценки: 12 months, 24 months and 36 months]
• Change in referrals to Child Protective Services [Срок оценки: 12 months, 24 months and 36 months]
• Change in utilization of the Women Infants and Children program (WIC) - survey parents [Срок оценки: Baseline, year 1, year 2, year 3]
• Change in utilization of the Women Infants and Children program (WIC) - administrative data [Срок оценки: Baseline, 12 months, 24 months and 36 months]
• Change in utilization of Supplemental Nutrition Assistance Program (SNAP) services - survey parents [Срок оценки: Baseline, year 1, year 2, year 3]
• Change in utilization of SNAP services - administrative data [Срок оценки: Baseline, 12 months, 24 months and 36 months]
• Change in food insecurity scale score as measured by U.S. Household Food Security Survey Module [Срок оценки: Baseline, year 1, year 2, year 3]
• Change in financial well-being scale score [Срок оценки: Baseline, year 1, year 2, year 3]

Вторичные конечные точки (11)

• Change in parent depression scale score as measured by Patient Health Questionnaire (PHQ-9) [Срок оценки: Baseline, year 1, year 2, year 3]
• Change in diagnoses for mental and behavioral health services for the parent - claims data [Срок оценки: Administrative data at baseline, 12, 24 and 36 months]
• Change in referrals for mental and behavioral health services for the parent - administrative data Family Health Services (FHS) [Срок оценки: Administrative data at baseline, 12, 24 and 36 months]
• Change in referrals for mental and behavioral health services for the parent - administrative data from Behavioral health and Recovery Services (BHRS) [Срок оценки: Administrative data at baseline, 12, 24 and 36 months]
• Change in parent stress level [Срок оценки: Year 1, year 2, year 3]
• Change in the breastfeeding duration [Срок оценки: Baseline, Year 1, year 2]
• Number of parents applying to childcare [Срок оценки: Year 1, year 2, year 3]
• Number of parents applying to preschool [Срок оценки: Year 3]
• Change in the purchase pattern for the child at home. [Срок оценки: Year 1, year 2, year 3]
• Change in parental involvement with child [Срок оценки: Year 1, year 2, year 3]
• Change in protective factors scale score as measured by Protective Factors Survey, 2nd Edition (PFS-2). [Срок оценки: Baseline, year 1, year 2, year 3]

Критерии участия

Критерии включения

Caregiver Eligibility Criteria

• 18 and Older
• Family plans to reside in San Mateo County
• Does not plan to move from the County in the next year
• Speaks English and/or Spanish
• Cared for in Postpartum Maternity unit

Child Eligibility Criteria

• Baby is being cared for in well newborn nursery
• Child is enrolled in Medicaid
• 36 weeks or older
• To be discharged home in the custody of the caregiver

Критерии исключения

Caregiver Exclusion Criteria

• Will not consent to share data via Epic/Study
• Caregiver has significant cognitive impairment
• Caregiver under contact isolation

Child Exclusion Criteria

• Sibling already enrolled in the Baby Bonus Study
• Child has significant genetic disorder issues at birth
• Child is a multiple (not a singleton)

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Двойное слепое

Основная цель

Организация здравоохранения

Центры проведения

США · 1 центр

• Lucile Packard Children's Hospital Stanford — Palo Alto

Публикации

• Egan-Dailey S, Gennetian LA, Magnuson K, Duncan GJ, Yoshikawa H, Fox NA, Noble KG. Child-directed speech in a large sample of U.S. mothers with low income. Child Dev. 2024 Nov-Dec;95(6):2045-2061. doi: 10.1111/cdev.14139. Epub 2024 Jul 29. PMID 39073390
• Rhodes, E. (2024, December 5). Insights from OpenResearch on the 2021 Expanded Child Tax Credit. Open Research. https://www.openresearchlab.org/findings/ctc
• Reyes-Velarde, A. (2024, January 30). They're getting $1,000 a month for 3 years. How guaranteed income is changing lives in L.A. County. CalMatters. http://calmatters.org/california-divide/2024/01/guaranteed-income-program/
• De Andrade, L. H. A., Ylikännö, M., & Kangas, O. (2021). Increased Trust in the Finnish UBI Experiment - Is the Secret Universalism or Less Bureaucracy? Basic Income Studies, 17(1), 95-115. https://doi.org/10.1515/bis-2021-0004
• Sauval M, Duncan GJ, Gennetian LA, Magnuson KA, Fox NA, Noble KG, Yoshikawa H. Unconditional Cash Transfers and Maternal Employment: Evidence from the Baby's First Years Study. J Public Econ. 2024 Aug;236:105159. doi: 10.1016/j.jpubeco.2024.105159. Epub 2024 Jul 5. PMID 40726482
• Rojas, N. M., Yoshikawa, H., Gennetian, L., Lemus Rangel, M., Melvin, S., Noble, K., Duncan, G., & Magunson, K. (2020). Exploring the experiences and dynamics of an unconditional cash transfer for low-income mothers: A mixed-methods study. Journal of Children and Poverty, 26(1), 64-84. https://doi.org/10.1080/10796126.2019.1704161
• Murray, M., Bridges, K., Solano, M., Greiner, K., & Woodward, J. (2023). Food RX + CHW: Investigating the Role of Community Health Workers to Close the Food Insecurity Gap. Annals of Family Medicine, 21(Suppl 1), 4231. https://doi.org/10.1370/afm.21.s1.4231
• Miller, S., Rhodes, E., Bartik, A., Broockman, D., Krause, P., & Vivalt, E. (2024). Does Income Affect Health? Evidence from a Randomized Controlled Trial of a Guaranteed Income (No. w32711; p. w32711). National Bureau of Economic Research. https://doi.org/10.3386/w32711

Идентификаторы

NCT: NCT07261254 · 78517

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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