Feasibility of linking universal child and family healthcare and financial counselling: findings from the Australian Healthier Wealthier Families (HWF) mixed-methods study

作者：Anna Price, Natalie White, Jade Burley, Anna Zhu, Diana Contreras Suárez, Si Wang, Melissa M. Stone, Kellie Trotter, Mona Ben m’rad, Jane C. Caldwell, Rebecca Bishop, Sumayya Chota, Lien Bui, Debbie Sanger, Rob Roles, Amy Watts, Nora Samir, Rebekah Grace, Shanti Raman, Lynn Kemp, Raghu Lingam, Valsamma Eapen, Susan Woolfenden, Sharon Goldfeld · 发表于：BMJ Open · 年份：2023 · DOI：10.1136/bmjopen-2023-075651 · 被引用次数：6 · 研究领域：Food Security and Health in Diverse Populations、Financial Literacy, Pension, Retirement Analysis、Healthcare innovation and challenges

OBJECTIVES: 'Healthier Wealthier Families' (HWF) seeks to reduce financial hardship in the early years by embedding a referral pathway between Australia's universal child and family health (CFH) services and financial counselling. This pilot study investigated the feasibility and short-term impacts of HWF, adapted from a successful Scottish initiative. METHODS: Setting: CFH services in five sites across two states, coinciding with the COVID-19 pandemic. PARTICIPANTS: Caregivers of children aged 0-5 years experiencing financial hardship (study-designed screen). DESIGN: Mixed methods. With limited progress using a randomised trial (RCT) design in sites 1-3 (March 2020-November 2021), qualitative interviews with service providers identified implementation barriers including stigma, lack of knowledge of financial counselling, low financial literacy, research burden and pandemic disruption. This informed a simplified RCT protocol (site 4) and direct referral model (no randomisation, pre-post evaluation, site 5) (June 2021-May 2022). INTERVENTION: financial counselling; comparator: usual care (sites 1-4). Feasibility measures: proportions of caregivers screened, enrolled, followed up and who accessed financial counselling. Impact measures: finances (quantitative) and other (qualitative) to 6 months post-enrolment. RESULTS: 355/434 caregivers completed the screen (60%-100% across sites). In RCT sites (1-4), 79/365 (19%-41%) reported hardship but less than one-quarter enrolled. In si...