Economic Mobility Pilot

NCT05963763 | Withdrawn

• 1 other identifier: H-43633
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

Research on economic mobility barriers consistently demonstrates that lack of access to jobs that pay living wages and to asset building opportunities coupled with cliff effects across public assistance programs (families losing multiple benefits at the same time when their incomes increase) traps families in a cycle of poverty and food insecurity, and as a result, negatively impacts their financial well-being and physical and mental health. The investigators will explore the extent to which an Economic Mobility Pilot improves the financial well-being, physical and mental health, and reduces the social risks of study participants. Study participants will be eligible consented Boston Medical Center (BMC) employees. The intervention developed for this study consists of six months of coaching session offered by the Career Navigator. Participant will receive support on career and financial through services, such as career pathway navigation, employee benefit maximization, financial literacy, wealth building, resources, and referrals. A step wedge design will be implemented with participants randomized in two groups, Group 1, and Group 2 - intervention on different timeframe, analysis of the difference and similarities between groups pre- and post-survey. The qualitative component will include focus group of participants to provide information on the employee's perception of the intervention received, barriers to adherence and facilitators, and semi- structured interviews of the employer leadership to help assess the barriers and facilitators of the pilot. A primary aim of this research is to monitor changes in economic mobility and financial well-being. Additional aims are to investigate changes in household hardships and employee, employee depressive symptoms, and their child's health. The investigators will examine whether the participants in the intervention group compared to those before receiving the intervention, are more likely to:

• Increase employee retention and self-reported financial well-being.
• Improve self-reported food security.
• Improve housing stability, energy security, childcare access, and/or health care access.
• Improve employee self-reported physical health status, and/or reduce self-reported anxiety and depressive symptoms.
• Improve employee-reported physical health status of the employee's child.
• Cost of delivery of the intervention
• Increased family income as result of this intervention

Conditions

Financial Hardship; Food Insecurity; Health Status

Keywords

Financial insecurity; Food insecurity; Health Status; Mental Health Assessment; Mental Health

Outcome Measures

Primary Outcomes (2)

• Financial well-being

  Financial well-being will be assessed using the Consumer Financial Protection Bureau's abbreviated 5-item scale, covering aspects such as income, employment, savings, safety net, past financial experiences, and financial behaviors, skills, and attitudes. Ratings will be given on a scale from 0 to 4, indicating the level of description or frequency, with higher values representing stronger agreement or more frequent occurrences. The collected scores will be aggregated and categorized by age and administration type (self or external). The Item Response Theory (IRT) model will be employed to ensure the validity and significance of the items, while a higher score on the scale will reflect greater financial security.

  18 months

• Food insecurity

  Food security status over the past year will be assessed using the validated Abbreviated Child and Adult Food Security Scale (ACAFSS), which includes 6 household-specific and 2 child-specific questions. Household are classified into 3 categories: (1) household food secure (HFS) if one or none questions were endorsed as sometimes or often true, (2) household FI (HFI) if three or more, or the 4th question on household were endorsed, and (3) child FI if 2 or more child-specific questions were endorsed.

  18 months

Secondary Outcomes (6)

• Housing instability

  18 months

• Child Health Outcomes

  18 months

• Lifetime Child Hospitalizations

  18 months

• Participant Health Outcomes

  18 months

• Parental depressive symptoms

  18 months

Study Arms (2)

Career Navigator Coaching

OTHER

Participants randomized into this group will be invited to participate in the quantitative and qualitative surveys. At baseline, participants in Group1 will receive the intervention- tailored coaching sessions with the Career Navigator which will continue until the end of the 6th month. The intervention will be tailored for each participant according to their need. The Career Navigator will be in charge to plan and develop tools to help the participant achieve their own goals.

Behavioral: Career Navigator Coaching

Delayed Career Navigator Coaching

OTHER

Participants randomized into this group will be invited to participate in the quantitative and qualitative surveys For the first six months, participants in Groups 2 will not receive the intervention and will function as a control group. When the study reaches the sixth-month Group 2 participants will receive the intervention - tailored coaching sessions with the Career Navigator. The intervention will be tailored for each participant according to their need. The Career Navigator will be in charge to plan and develop tools to help the participant achieve their own goals.

Behavioral: Career Navigator Coaching

Interventions

Career Navigator Coaching BEHAVIORAL

The Career Navigator will support participants with a tailored approach to reach career and financial goals through one or more of the following services, in addition to referrals to other external services (community-based organizations) as needed for 6 months: 1. Career pathway navigation 2. Employee benefit maximization 3. Financial literacy and wealth building 4. Services funds for resources that mitigate specific barriers or needs.

Career Navigator Coaching; Delayed Career Navigator Coaching

Eligibility Criteria

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

You may qualify if:

• Recently hired Boston Medical Center employees, since June 2021
• Employees financially responsible for a child 18 years of age or younger
• Employees who live in one of the following zip codes: 02119, 02121, 02122, 02124, 02125, 02126, 02130
• Employees who have Income threshold hourly wage of $35 Dollars

You may not qualify if:

• Employees who have been previously contacted by the Career Navigator
• Employees not financially responsible for a child of 18 years old of age or younger
• Employees not interested in receiving support from Career Navigator
• Employees who do not accept consent
• Employees who Do not reside in one of the seven zip codes

Sponsors & Collaborators

• Boston Medical Center: lead
• Wagner Foundation: collaborator
• Someone Elses Child: collaborator
• Boston University: collaborator

Study Sites (1)

Boston Medical Center

Boston, Massachusetts, 02119, United States

Location

Related Publications (10)

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  BACKGROUND

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  PMID: 26154451 BACKGROUND

• Bailey MJ, DiNardo J, Stuart BA. THE ECONOMIC IMPACT OF A HIGH NATIONAL MINIMUM WAGE: EVIDENCE FROM THE 1966 FAIR LABOR STANDARDS ACT. J Labor Econ. 2021 Apr;39(Suppl 2):S329-S367. doi: 10.1086/712554.

  PMID: 35414741 BACKGROUND

MeSH Terms

Conditions

Financial Stress; Psychological Well-Being

Condition Hierarchy (Ancestors)

Stress, Psychological; Behavioral Symptoms; Behavior; Personal Satisfaction

Study Officials

• Megan Sandel, MD MPH

  Boston Medical Center and Boston University Chobanian

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Step wedge design: participants randomized in two groups, Group 1, and Group 2 - intervention on different timeframe, analysis of the difference and similarities between groups pre- and post-survey.

Study Record Dates

• First Submitted: July 19, 2023
• First Posted: July 27, 2023
• Study Start: March 1, 2024
• Primary Completion: September 1, 2025
• Study Completion: September 1, 2025
• Last Updated: March 29, 2024

Record last verified: 2024-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)