addressInG iNcome securITy in Primary carE

NCT02459184 | Unknown

• 1 other identifier: SMH2015
• Study Type: interventional
• Target: 284
• Locations: 1 country
• Sites: 1

Brief Summary

Social processes that impact the health of individuals have been labeled the social determinants of health (SDOH). These are "the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels". Perhaps the most important SDOH is income security, a person's actual, perceived and expected income. Our objective is to carry out a pragmatic randomized controlled trial that evaluates the impact of an income-focused health promoter.

Conditions

Poverty; Income; Social Determinants of Health

Keywords

preventive medicine; social determinants of health; primary health care; poverty; income; health promotion

Outcome Measures

Primary Outcomes (1)

• Change in monthly income from baseline to 6 months after intervention

  Change in monthly income from baseline to 6 months after intervention

  6 months

Secondary Outcomes (7)

• quality of life: Change in scores on the WHO QoL-BREF and EQ-5D-5L

  12 months

• quality of life (overall health, mental health, physical health): change in units on a measured scale of EQ VAS

  12 months

• community integration: Change in scores on the Community Integration Scale

  12 months

• financial literacy: Change in scores on the Canadian Centre for Financial Literacy Personal Financial Literacy Quiz

  12 months

• co-morbidities and medication access

  12 months

Study Arms (2)

Early intervention

EXPERIMENTAL

Participants will meet with the Income Security Health Promoter immediately.

Other: Income Security Health Promotion

Late intervention

ACTIVE COMPARATOR

Participants will meet with the Income Security Health Promoter at 6 months.

Other: Income Security Health Promotion

Interventions

Income Security Health Promotion OTHER

The ISHP will work to improve the income security of participants within this study. To that end, her activities include: * Providing one-to-one case management support and ongoing follow-up to diverse low-income patients and families regarding their income security. * Developing and implementing targeted information self-help sessions, such as; banking basics, income tax submissions, and social service forms, for the target population * Developing and maintaining up-to-date detailed knowledge of financial issues and financial services affecting low-income people, and applying this knowledge in his/her work. * Assisting individual low-income patients with income security-focused interventions, including access to tax benefits, applications for income security programs such as social assistance and seniors and child benefits, and navigation of disability support programs.

Early intervention; Late intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥18
• Lives within the Metropolitan catchment areas
• Lives in a postal code that is in the lowest income quintile, or has had a billing code specific to social assistance forms billed ever billed, or has been identified as low income based on reported family income and number of people supported by income on the "Health Equity Data"
• Patient of the Family Health team including those that are: rostered, non-rostered, refugee claimants (IFH) or uninsured seen in the FHT.
• Verified by the patient's family physician as living in poverty, a good candidate for the intervention, and the patient's family physician agrees to have a letter submitted with his/her name attached.

You may not qualify if:

• Patients who have previously worked with the Income Security Health Promoter, or are part of households of people who have previously worked with the Income Security Health Promoter.
• Patients who have no available contact information for mailing.
• Patients of any member of the investigative team.

Sponsors & Collaborators

• Unity Health Toronto: lead

Study Sites (1)

St. Michael's Hospital

Toronto, Ontario, M5B1W8, Canada

Location

Study Officials

• Andrew D Pinto, MD MSc

  Unity Health Toronto

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 28, 2015
• First Posted: June 1, 2015
• Study Start: September 1, 2017
• Primary Completion: July 9, 2021
• Study Completion: January 31, 2022
• Last Updated: September 28, 2021

Record last verified: 2021-09

Locations

CA (1)