- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05930327
COIN: A Pilot Study of Cash Transfers to Improve Outcomes in Low-Income Preterm Neonates and Their Families
The investigators are conducting a pilot randomized controlled trial of unconditional cash transfers among Medicaid-eligible birthing parents of preterm infants in a single neonatal intensive care unit (NICU) in Pennsylvania.
The investigators will measure the feasibility and acceptability of the intervention, birthing parents' lived experiences of having a preterm infant and the impacts of cash transfers, and conduct a preliminary assessment of efficacy on birthing parent psychological stress and ability to invest in their infant's care.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Poverty is an important social determinant of health and contributes to child heath disparities. Among preterm infants, low-income is associated with worse long-term health outcomes. Given the connection between poverty and poor health outcomes, an urgent need exists to move beyond describing health disparities for low-income infants and towards interventions that interrupt these pathways in early childhood to improve outcomes.
A growing body of literature suggests that monthly unconditional cash transfers (UCTs) - no strings attached monthly cash payments - to low-income families may be an effective intervention to reduce poverty and financial stress, improve psychological health, and improve child health outcomes. However, current studies on UCTs focus primarily on term infants or heterogenous samples of children, with only a single pilot delivering direct financial assistance to low-income preterm infants. Thus, despite well-documented disparities in outcomes for low-income preterm infants, the impact of UCTs among low-income preterm infants and their families remains unknown.
Toward that end, the investigators are conducting a pilot randomized controlled trial of unconditional cash transfers among Medicaid-eligible birthing parents of preterm infants in a single NICU in Pennsylvania. The investigators have three specific aims:
Aim 1: To determine the feasibility and acceptability of randomizing high-value ($325/month) and low-value ($25/month) UCTs to low-income birthing parents of preterm infants beginning in the first month of life.
Aim 2: To examine birthing parents' lived experiences managing the financial impact of having a preterm infant and the perceived impact.
Exploratory Aim 3: To conduct a preliminary assessment of the efficacy of monthly UCTs on birthing parent psychological stress and ability to invest in their infant's care, recognizing the pilot is not designed to be powered for statistical significance.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Andrea Duncan, MD
- Phone Number: 267-425-1485
- Email: duncana2@chop.edu
Study Contact Backup
- Name: Timothy Nelin, MD
- Phone Number: 267-425-1485
- Email: nelint@chop.edu
Study Locations
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19104
- Children's Hospital of Philadelphia
-
Contact:
- Andrea Duncan, MD
-
Philadelphia, Pennsylvania, United States, 19104
- Hospital of the University of Pennsylvania
-
Contact:
- Andrea Duncan, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Medicaid-insured or uninsured by meets income requirements for Medicaid-eligibility, Over 18 years old, Speaks English or Spanish fluently, Lives in Philadelphia county, Has an infant born >=22 and <36 weeks gestational age
Exclusion Criteria:
- Reports being "highly likely" to move to a different state in the next 12 months, Reports planning to place the infant up for adoption at the time of enrollment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: High-Value Cash Transfer
Participants in the treatment group will receive four $325 payments.
The first payment will be disbursed at the time of enrollment (between birth and 4 weeks of age), and second payment on the infant's one-month birthday, third payment on the infant's two-month birthday, and the fourth payment on the infant's three-month birthdays.
|
Monthly, Unconditional Cash Transfer ($325) for 4-months
|
Active Comparator: Low-Value Cash Transfer
Participants in the control group will receive four $25 payments.
The first payment will be disbursed at the time of enrollment (between birth and 4 weeks of age), and second payment on the infant's one-month birthday, third payment on the infant's two-month birthday, and the fourth payment on the infant's three-month birthdays.
|
Monthly, Unconditional Cash Transfer ($25) for 4-months
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Acceptability of randomizing high-value and low-value unconditional cash transfers (UCT) to low income birthing parents of preterm infants.
Time Frame: 1 year
|
The investigators define acceptability as greater than or equal to 90% of respondents reporting "agree" to "strongly agree" to each of the 4 measures of acceptability on the follow-up surveys at 2-months.
|
1 year
|
Feasibility of enrolling caregivers of preterm infants in the study procedures and receipt of UCTs.
Time Frame: 1 year
|
The investigators will measure the percentage of eligible subjects enrolled in study procedures, percentage of participants eligible for cash transfers who consented to receive the cash transfers, percentage of participants receiving monthly payments delivered within 1-2 days of the the child's monthly birthday.
The investigators define feasibility as greater than 60% of those eligible enrolling in the study procedures, greater than or equal to 90% of those eligible for cash transfers to consent to cash transfers, and greater than or equal to 95% of monthly payments delivered within 1-2 days on either side of the child's monthly birthday.
The investigators will additionally measure the attrition rate of survey and follow-up interview completion, aiming for an attrition rate less than or equal to 20%.
|
1 year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Lived experiences of caring for a preterm infant admitted to the neonatal intensive care unit.
Time Frame: 1 year
|
Birthing parents' perspectives and measures of birthing parent psychological stress as measured through semi-structured interviews.
|
1 year
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Andrea Duncan, MD, Children's Hospital of Philadelphia/University of Pennsylvania
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 23-021011
- 852454 (Other Identifier: University of Pennsylvania)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Preterm Birth
-
e-Bio CorpRecruitingPreterm Labor | PreTerm Birth | Preterm Labor With Delivery NosUnited States
-
Thomas Jefferson UniversityCompleted
-
Federico II UniversityRecruiting
-
University of OxfordShoklo Malaria Research UnitCompleted
-
Chelsea and Westminster NHS Foundation TrustSPD Development Company Limited; Borne CharityRecruitingPreterm Birth | Preterm Labor | Preterm Birth Complication | Preterm Premature Rupture of Membrane | Preterm PregnancyUnited Kingdom
-
PreTeL, IncDuke University; University of RochesterRecruitingPreterm Birth | Threatened Preterm Labor | PreTerm LaborUnited States
-
Cairo UniversityCompleted
-
University of OklahomaCompletedPreTerm Birth | PreTerm NeonateUnited States
-
Eunice Kennedy Shriver National Institute of Child...CompletedPregnancy | Preterm Birth | Preterm LaborUnited States
-
University Hospital Inselspital, BerneAmniSure International LLCCompletedPreterm Birth | Preterm LabourSwitzerland
Clinical Trials on Unconditional Cash Transfer (High-Value)
-
University of PennsylvaniaChildren's Hospital of Philadelphia; Rutgers University; Redlich Horwitz FoundationRecruiting
-
Stockholm UniversityYale University; University of Chile; EDI Global; Elizabeth Glaser Pediatric AIDS... and other collaboratorsRecruitingParenting | Early Child DevelopmentTanzania
-
George Washington UniversityBerk Ozler, The World BankCompletedMental DepressionUganda
-
New Mexico Cancer Care AllianceNational Cancer Institute (NCI); Wake Forest University Health Sciences; University...Completed
-
Imperial College LondonWellcome Trust; World Bank; Biomedical Research and Training Institute; UNICEF; Catholic...CompletedEducation | Vaccination | Birth Registration | Financial SupportZimbabwe
-
University of California, San FranciscoDestination: Home SV; Sí Se Puede Collective; Sacred Heart Community Service; County...RecruitingFamilies Experiencing Homelessness and/or Housing InstabilityUnited States
-
Action Contre la FaimCenters for Disease Control and Prevention; University Ghent; AgroParisTechCompletedAcute MalnutritionBurkina Faso
-
University of California, San FranciscoKenya Medical Research InstituteCompletedHiv | Mental Health Issue | Breastfeeding, ExclusiveKenya
-
Vanderbilt UniversityWomen in Need (Win); The Samuels Group; New York City Center for Innovation through...Not yet recruitingTime to Shelter Exit | Family Well-being | Child Well-beingUnited States
-
National Institute for Medical Research, TanzaniaUnknownHIV/AIDS | HSV-2 InfectionTanzania