Recovery Finance: Financial Health and Mental Health After Incarceration

NCT06914856 | Recruiting DMC

• 2 other identifiers: 20000336581R01MD018255-01
• Study Type: interventional
• Target: 238
• Locations: 1 country
• Sites: 1

Brief Summary

This proposal will address financial wellbeing, an often overlooked but important factor impacting reentry for justice-involved people with mental health challenges, who are disproportionately Black and Latine. The project will change community level determinants by integrating financial capability support (one-on-one coaching and access to financial tools and services) into existing services and training bank and credit union staff to reduce discrimination. It will also support collaborative community efforts working towards upstream policy and legal reforms to reduce the incidence of those financial challenges.

Conditions

Financial Hardship; Mental Health Issue; Substance Use

Keywords

Financial Health; Incarceration; Mental Health; Substance Use

Outcome Measures

Primary Outcomes (7)

• Finances After Incarceration

  57 questions (plus sub-questions) measuring financial health after incarceration. Outcomes include: use of safe and affordable financial products (no/yes averaged across multiple products, range 0-1), Savings (ordinal scale for amount of savings, range 1-8), Credit score (ordinal scale for range of credit scores, range 0-6). Measuring change over time.

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

• Money And Mental Health Scale

  9-item survey used to measure money and mental health, including financial well-being. Total score range is 0-4, Higher scores indicate worse effect of money on mental health. Measuring mean change over time.

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

• Housing & Employment - QOL

  21-items selected from the Endicott Quality of Life measuring housing and employment. Subscales include satisfaction with living situation, satisfaction with safety, and satisfaction with work. Satisfaction rating scales range from 1-7 with higher scores indicating more satisfaction. An additional outcome is number of days worked in the last 90 days. For both satisfaction and number of days worked, measuring mean change over time.

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

• Social Needs Screening Tool (CMS-AHC HRSN)

  24-item screening tool assessing social determinants of health. Outcomes include financial strain (1-3), employment help needed (1-3), living situation (1-3). Higher scores indicate more social needs. Measuring change over time.

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

• Service Utilization

  31-item survey used to measure utilization of health and mental health services. Outcomes are indicated by subscales measuring number of visits to medical care outpatient, medical emergency services, mental health outpatient, mental health emergency services, psychiatric rehabilitation services, self-help programs, and alcohol/drug counseling. Other subscales indicate number of nights in a facility for a medical/surgical problem, psychiatric problem, substance use problem, or staffed residential facility. Answer formats are number of visits or days. Higher scores indicate more service use. Measuring mean change over time.

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

• Access To Health Services (from Phenx Toolkit)

  10 questions measuring access to healthcare services. Outcomes include wellness visit in the past year (yes/no), delaying/missing medical care because of the cost (yes/no), number of urgent care visits, having a usual place to go for medical care (no, yes, multiple). Measuring change over time.

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

• Intersectional Discrimination Index

  44-items (with branching logic) assessing discrimination, rating scales vary by question. Anticipated discrimination subscale ranges from 0-4, meaned across items. Lifetime day-to-day discrimination subscale ranges from 0-9, summed across items. Past year day-to-day discrimination subscale ranges from 0-18, summed across items. Lifetime major discrimination subscale ranges from 0-26, summed across items. Past year major discrimination subscale ranges from 0-13, summed across items. Higher scores indicate more discrimination. Measuring mean change over time.

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

Secondary Outcomes (7)

• Recidivism

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

• Wellness in 8 Dimensions Inventory

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

• SF-12v2 (Short Form Health Survey)

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

• Promis 1.0 - Anxiety for DSM-5

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

• Patient Health Questionnaire (PHQ-9)

  Baseline Assessment, 6-Month Assessment, and 12-Month Assessment

Study Arms (2)

Financial Capability Support

NO INTERVENTION

The participants in this arm will receive one-on-one financial coaching, which entails monthly or more frequent meetings with a financial coach. The initial meetings will be held in person and subsequent meetings may be held via zoom, phone, or in person depending on the comfort and convenience of the participant. Participants will also receive access to safe and affordable financial services, which includes support with managing any existing bank accounts, or supporting a person to open a new overdraft-free account. Coaches can also help people to access other financial products such as free tax preparation (VITA), credit builder loans, online bank accounts, or other products recommended by our Justice Tech partner.

Financial Capability Support with Peer Support

EXPERIMENTAL

The participants randomized into this arm will receive services offered in the Financial Capability Support arm with the additional services of one-on-one peer support provided by a trained Recovery Support Specialist. Recovery Support Specialist, also referred to as Wellness coaches, will provide weekly meetings (30-60 minutes in duration) to the participants.

Behavioral: Financial Capability Support with Peer Support Services

Interventions

Financial Capability Support with Peer Support Services BEHAVIORAL

The participants in this arm will receive one-on-one financial coaching, which entails monthly or more frequent meetings with a financial coach. Participants will also receive access to safe and affordable financial services, which includes support with managing any existing bank accounts, or supporting a person to open a new overdraft-free account. Coaches can also help people to access other financial products such as free tax preparation (VITA), credit builder loans, online bank accounts, or other products recommended by our Justice Tech partner. The participants will also receive will receive the additional services of one-on-one peer support provided by a trained Recovery Support Specialist. Recovery Support Specialist, also referred to as Wellness coaches, will provide weekly meetings (30-60 minutes in duration) to the participants.

Financial Capability Support with Peer Support

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Have been released from jail or prison 36 months ago or less
• Self-identify as having experiences with trauma, mental illness/mental distress, or substance use
• Living or using services in the greater New Haven area
• Interested in receiving financial guidance

You may not qualify if:

• Less than 18 years of age
• Not have been released from jail or prison 36 months ago or less
• Not self-identify as having experiences with trauma, mental illness/mental distress, or substance use
• Not living or using services in the greater New Haven area
• Not interested in receiving financial guidance

Sponsors & Collaborators

• Yale University: lead
• National Institute on Minority Health and Health Disparities (NIMHD): collaborator

Study Sites (1)

Yale University Program for Recovery and Community Health

New Haven, Connecticut, 06513, United States

RECRUITING

MeSH Terms

Conditions

Financial Stress; Substance-Related Disorders; Psychological Well-Being

Condition Hierarchy (Ancestors)

Stress, Psychological; Behavioral Symptoms; Behavior; Chemically-Induced Disorders; Mental Disorders; Personal Satisfaction

Study Officials

• Annie Harper, Ph.D.

  Yale University

  PRINCIPAL INVESTIGATOR

• Chyrell Bellamy, Ph.D.

  Yale University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Annie Harper, Ph.D.

CONTACT

203-764-8602; Annie.harper@yale.edu

Luz S Ocasio

CONTACT

2037648692; luz.ocasio@yale.edu

Study Design

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

Study Record Dates

• First Submitted: July 11, 2024
• First Posted: April 6, 2025
• Study Start: April 30, 2024
• Primary Completion: April 24, 2026
• Study Completion: April 24, 2026
• Last Updated: May 7, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

US (1)