A Researcher–Practitioner Collaboration to Enable Replication of an Evidence-Based Financial Education and Coaching Program That Improves Health in Low-Income Single Mothers

2021 ◽  
pp. 152483992110654
Author(s):  
Danielle Galvin ◽  
Julie Kalkowski
Keyword(s):  
Low Income ◽  
Controlled Trial ◽  
Financial Education ◽  
Well Being ◽  
Social Determinant ◽  
Theory Of Change ◽  
Financial Strain ◽  
Structured Interviews ◽  
Health Related ◽  
Core Components

Financial strain is a social determinant of health (SDOH). Although public financial education helps individuals improve financial well-being, specifics are lacking on how and why effective programs work, potentially limiting their successful replication in other practice settings. In this study, researchers and practitioners cocreated the core components and theory of change of a novel financial education and coaching program, which a randomized controlled trial found was effective in significantly improving participants’ financial and health-related behaviors. A Cocreating Knowledge Translation Framework within a case study design was used at a university-affiliated nonprofit in Omaha, Nebraska, from August to December 2020. Twelve practitioner and alumni participants were purposefully sampled. An administrative records review, semi-structured interviews (n =3), survey (n = 10), and facilitated backward mapping session (n = 5) were conducted. Transcripts were coded to identify themes. Thirty-one core components were identified within program principles, design, tools, activities, and expectations of participants and coaches. Ten theory of change outcomes described participants’ pathway to change. Interventions occurred at individual, relationship, and community levels from initial engagement, through behavioral changes, to improved health-related quality of life. Activities and indicators were mapped to each outcome. The program’s intersecting and reinforcing design was key to enabling participants’ outcomes. Its theory of change described how and why the model improved financial and health behaviors. Findings suggest that other SDOH-focused organizations may benefit from researcher–practitioner collaboration to investigate their interventions’ core components and theories of change. This may enable replication, promoting downstream health benefits in new community settings.

scholarly journals “My coupons are like gold”: experiences and perceived outcomes of low-income adults participating in the British Columbia Farmers’ Market Nutrition Coupon Program

2021 ◽  
pp. 1-30
Author(s):  
Stéphanie Caron-Roy ◽  
Sayeeda Amber Sayed ◽  
Katrina Milaney ◽  
Bonnie Lashewicz ◽  
Sharlette Dunn ◽  
...  
Keyword(s):  
British Columbia ◽  
Rural Communities ◽  
Low Income ◽  
Well Being ◽  
Qualitative Description ◽  
Farmers Markets ◽  
Social Connections ◽  
Structured Interviews ◽  
Program Outcomes ◽  
Farmers Market

ABSTRACT Objective: The British Columbia Farmers’ Market Nutrition Coupon Program (FMNCP) provides low-income households with coupons valued at $21/week for 16 weeks to purchase healthy foods in farmers’ markets. Our objective was to explore FMNCP participants’ experiences of accessing nutritious foods, and perceived program outcomes. Design: This study used qualitative description methodology. Semi-structured interviews were conducted with FMNCP participants during the 2019 farmers’ market season. Directed content analysis was used to analyse the data whereby the five domains of Freedman et al’s framework of nutritious food access provided the basis for an initial coding scheme. Data that did not fit within the framework’s domains were coded inductively. Setting: One urban and two rural communities in British Columbia, Canada. Participants: 28 adults who were participating in the FMNCP. Results: Three themes emerged: Autonomy and Dignity; Social Connections and Community Building; and Environmental and Programmatic Constraints. Firstly, the program promoted a sense of autonomy and dignity through financial support, increased access to high-quality produce, food-related education and skill development, and mitigating stigma and shame. Secondly, shopping in farmers’ markets increased social connections and fostered a sense of community. Finally, participants experienced limited food variety in rural farmers’ markets, lack of transportation, and challenges with redeeming coupons. Conclusions: Participation in the FMNCP facilitated access to nutritious foods and enhanced participants’ diet quality, well-being and health. Strategies such as increasing the amount and duration of subsidies, and expanding programs may help improve participants’ experiences and outcomes of farmers’ market food subsidy programs.

scholarly journals The long term effect of pulmonary tuberculosis on income and employment in a low income, urban setting

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215338
Author(s):  
Jamilah Meghji ◽  
Stefanie Gregorius ◽  
Jason Madan ◽  
Fatima Chitimbe ◽  
Rachael Thomson ◽  
...  
Keyword(s):  
Low Income ◽  
Disease Onset ◽  
Treatment Completion ◽  
Well Being ◽  
Urban Setting ◽  
Financial Strain ◽  
First Episode ◽  
Health Seeking ◽  
Tb Treatment

BackgroundMitigating the socioeconomic impact of tuberculosis (TB) is key to the WHO End TB Strategy. However, little known about socioeconomic well-being beyond TB-treatment completion. In this mixed-methods study, we describe socioeconomic outcomes after TB-disease in urban Blantyre, Malawi, and explore pathways and barriers to financial recovery.MethodsAdults ≥15 years successfully completing treatment for a first episode of pulmonary TB under the National TB Control Programme were prospectively followed up for 12 months. Socioeconomic, income, occupation, health seeking and cost data were collected. Determinants and impacts of ongoing financial hardship were explored through illness narrative interviews with purposively selected participants.Results405 participants were recruited from February 2016 to April 2017. Median age was 35 years (IQR: 28–41), 67.9% (275/405) were male, and 60.6% (244/405) were HIV-positive. Employment and incomes were lowest at TB-treatment completion, with limited recovery in the following year: fewer people were in paid work (63.0% (232/368) vs 72.4% (293/405), p=0.006), median incomes were lower (US$44.13 (IQR: US$0–US$106.15) vs US$72.20 (IQR: US$26.71–US$173.29), p<0.001), and more patients were living in poverty (earning <US$1.90/day: 57.7% (211/366) vs 41.6% (166/399), p<0.001) 1 year after TB-treatment completion compared with before TB-disease onset. Half of the participants (50.5%, 184/368) reported ongoing dissaving (use of savings, selling assets, borrowing money) and 9.5% (35/368) reported school interruptions in the year after TB-treatment completion. Twenty-one participants completed in-depth interviews. Reported barriers to economic recovery included financial insecurity, challenges rebuilding business relationships, residual physical morbidity and stigma.ConclusionsTB-affected households remain economically vulnerable even after TB-treatment completion, with limited recovery in income and employment, persistent financial strain requiring dissaving, and ongoing school interruptions. Measures of the economic impact of TB disease should include the post-TB period. Interventions to protect the long-term health and livelihoods of TB survivors must be explored.

scholarly journals “You run out of hope:” An Exploration of Low-Income Parents’ Experiences with Food Insecurity using Photovoice

2021 ◽  
pp. 1-21
Author(s):  
Payge Lindow ◽  
Irene H. Yen ◽  
Mingyu Xiao ◽  
Cindy W. Leung
Keyword(s):  
Food Insecurity ◽  
San Francisco ◽  
Low Income ◽  
Eating Behaviors ◽  
Comparative Method ◽  
Well Being ◽  
Structured Interviews ◽  
Unhealthy Eating ◽  
Low Income Families ◽  
The Impact

ABSTRACT Objective: Using an adaption of the Photovoice method, this study explored how food insecurity affected parents’ ability to provide food for their family, their strategies for managing household food insecurity, and the impact of food insecurity on their well-being. Design: Parents submitted photos around their families’ experiences with food insecurity. Afterwards, they completed in-depth, semi-structured interviews about their photos. The interviews were transcribed and analyzed for thematic content using the constant comparative method. Setting: San Francisco Bay Area, California, USA. Subjects: 17 parents (14 mothers and 3 fathers) were recruited from a broader qualitative study on understanding the experiences of food insecurity in low-income families. Results: Four themes were identified from the parents’ photos and interviews. First, parents described multiple aspects of their food environment that promoted unhealthy eating behaviors. Second, parents shared strategies they employed to acquire food with limited resources. Third, parents expressed feelings of shame, guilt, and distress resulting from their experience of food insecurity. And finally, parents described treating their children to special foods to cultivate a sense of normalcy. Conclusions: Parents highlighted the external contributors and internal struggles of their experiences of food insecurity. Additional research to understand the experiences of the food-insecure families may help to improve nutrition interventions targeting this structurally vulnerable population.

scholarly journals Health-related quality of life among 13–14 year old adolescents with overweight - a mixed methods approach

2019 ◽  
Author(s):  
Turid Kristin Bigum Sundar ◽  
Kirsti Riiser ◽  
Milada Småstuen ◽  
Randi Opheim ◽  
Knut Løndal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mixed Methods ◽  
Well Being ◽  
Reference Population ◽  
Health Related Quality ◽  
Structured Interviews ◽  
Post Intervention ◽  
Related Quality ◽  
Health Related

Abstract BackgroundOverweight and obesity are public concerns with risk of adverse health outcomes. Health-related quality of life (HRQoL) is lower in adolescents than children in general. An increase in body mass index (BMI) is associated with a decrease in HRQoL. The purpose of this study was to measure and explore the HRQoL among adolescents with overweight or obesity who had participated in an intervention study with the aim of increasing PA, reducing BMI and promoting HRQoL.Methods Mixed methods, with a convergent design, were used to investigate how different methodological approaches could expand our understanding of the adolescents’ HRQoL. Quantitative post-intervention data on HRQoL were collected among the 84 intervention participants, aged 13–14 years, using the KIDSCREEN 52 questionnaire. The data were compared with a Norwegian reference population of 244 individuals, and analysed using a non-parametric Mann-Whitney test. Qualitative semi-structured interviews were conducted with 21 adolescents from the intervention. A directed approach to content analysis was adopted, using the ten sub-scales from KIDSCREEN 52.ResultsHRQoL in the intervention sample was significantly reduced on the sub-scale of physical well-being compared to the reference population. The reference population scored significantly lower than the intervention sample on the sub-scale of parent relation and home life. No significant differences were found on the other sub-scales. The qualitative data supported the quantitative findings on the sub-scale of physical well-being, but showed that perceptions of fitness, energy level or health could vary. Regarding parent relations, the interviewees extended this to include relationships to other family members as equally important. Most of the interviewees expressed a negative view of their bodies, but not their clothing or accessories. This may explain why no statistically significant differences were found on these aspects in the results from the KIDSCREEN questionnaire. ConclusionThe use of the KIDSCREEN 52 instrument gave important indications about the adolescents’ HRQoL. Combining methods enabled a comprehensive approach to research on HRQoL, indicating better ways of providing help. More research using the benefits of mixed methods approaches is needed to further elucidate these findings.

scholarly journals Evaluating farm-level livestock interventions in low-income countries: a scoping review of what works, how, and why

2020 ◽  
pp. 1-14
Author(s):  
Johanna F. Lindahl ◽  
Florence Mutua ◽  
Delia Grace
Keyword(s):  
Developing Countries ◽  
Scoping Review ◽  
Low Income ◽  
Controlled Trial ◽  
Animal Health ◽  
Well Being ◽  
Good Evidence ◽  
Low Income Countries ◽  
Livestock Products ◽  
Development Outcomes

Abstract Livestock interventions can improve nutrition, health, and economic well-being of communities. The objectives of this review were to identify and characterize livestock interventions in developing countries and to assess their effectiveness in achieving development outcomes. A scoping review, guided by a search strategy, was conducted. Papers needed to be written in English, published in peer-reviewed journals, and describe interventions in animal health and production. Out of 2739 publications systematically screened at the title, abstract, and full publication levels, 70 met our inclusion criteria and were considered in the study. Eight relatively high-quality papers were identified and added, resulting in 78 reviewed publications. Only 15 studies used randomized controlled trial designs making it possible to confidently link interventions with the resulting outcomes. Eight studies had human nutrition or health as outcomes, 11 focused on disease control, and four were on livestock production. Eight interventions were considered successful, but only four were scalable. We found good evidence that livestock-transfer programs, leveraging livestock products for nutrition, and helping farmers manage priority diseases, can improve human well-being. Our report highlights challenges in garnering evidence for livestock interventions in developing countries and provides suggestions on how to improve the quantity and quality of future evaluations.

scholarly journals Low-income parents’ perceptions of the importance of a musical training programme for their children: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Laurie Long Kwan Ho ◽  
William Ho Cheung Li ◽  
Ankie Tan Cheung ◽  
Wei Xia ◽  
Ka Yan Ho ◽  
...  
Keyword(s):  
Data Analysis ◽  
Low Income ◽  
Financial Constraints ◽  
Musical Training ◽  
Well Being ◽  
Training Programme ◽  
Psychosocial Needs ◽  
Structured Interviews ◽  
Analysis Strategy ◽  
Parent Child Relationships

Abstract Background Despite clear evidence for the effectiveness of musical training in promoting psychological well-being among underprivileged children, parents’ perceptions of the importance of such training for their children remains unknown. Methods Of the parents of 171 underprivileged preschool children in Hong Kong who had participated in a free musical training programme, 25 were randomly selected and invited to participate in individual semi-structured interviews. Colaizzi’s descriptive phenomenological data analysis strategy was followed for analysing the data. Results The results showed that parents identified numerous benefits of the programme for their child, including increased happiness, improved confidence, positive behavioural changes, and enhanced parent-child relationships. At the beginning of the programme, parents tended to disregard the usefulness of musical training but gradually came to recognise its importance for their children’s psychological and social well-being. However, children were limited by their parents’ financial constraints from participating in musical training after the free programme ended. Conclusions These findings imply that existing policy may overlook the psychosocial needs of underprivileged children and suggest that more resources should be allocated to facilitate the continuity and sustainability of such a free programme for this vulnerable population. Trial registration ClinicalTrials.gov NCT02762786, registered on May 5, 2016.

scholarly journals Resources in vulnerable young adults: self-assessments during preventive consultation with their general practitioner in Denmark

2019 ◽  
Vol 35 (5) ◽  
pp. 1180-1189
Author(s):  
Kirsten Schierup Freund ◽  
Ann Dorrit Guassora ◽  
Trine Hegelund ◽  
Lotte Hvas ◽  
Jørgen Lous
Keyword(s):  
General Practitioner ◽  
Extrinsic Motivation ◽  
Controlled Trial ◽  
Well Being ◽  
Self Determination Theory ◽  
Old Patients ◽  
Vulnerable Patients ◽  
Inequality In Health ◽  
Health Related ◽  
Self Assessments

Abstract Inequality in health is increasing. People with many problems often lack energy to improve well-being and reduce their problems. This study analyses how psycho-socially challenged younger (20- to 44-year-old) patients described their own resources to reach lifestyle goals or alter life circumstances. Within the context of a randomized controlled trial, Danish participants had two structured preventive person-centred consultations with their general practitioner. Consultations focused on well-being, salutogenesis, resources, barriers and support of autonomy. Using the qualitative method: Systematic Text Condensation, we made thematic cross-analysis of patients’ goal-specific resource statements described at the first consultation. Of the 209 patients, 191 (91%) chose one or two goals for a better life next year; nearly all (179) could recall and describe which resources they would use to reach their goal. We categorized resource statements into (i) personal constitution as ‘willpower’ and ‘tenacity’; (ii) network, e.g. family; (iii) personal experience with identical or similar problems. Some patients needed to free up resources by handling psychological problems before being able to focus on lifestyle goals. The study demonstrates that patients with particular psycho-social problems could describe essential resources in a structured, salutogenic, preventive consultation with their general practitioner. Reflecting intrinsic and extrinsic motivation, these resources reflected dimensions of essential health theories like sense of coherence, self-efficacy and self-determination theory. Increased awareness of these resources seems essential for vulnerable patients by improving psychological well-being and optimism, thereby facilitating health-related changes. This may be an important step to reducing inequality in health.

Effects of Exercise on Health-Related Quality of Life and Fear of Falling in Home-Dwelling Older Women

2012 ◽  
Vol 20 (2) ◽  
pp. 198-214 ◽  
Author(s):  
Saija Karinkanta ◽  
Ritva Nupponen ◽  
Ari Heinonen ◽  
Matti Pasanen ◽  
Harri Sievänen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Women ◽  
Exercise Intervention ◽  
Fear Of Falling ◽  
Controlled Trial ◽  
Well Being ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

This randomized, controlled trial evaluated the effects of exercise on health-related quality of life (HRQoL) and fear of falling (FoF) among 149 home-dwelling older women. The 12-mo exercise program was intended to reduce the risk of falls and fractures. HRQoL was assessed by the RAND-36 Survey, and FoF, with a visual analog scale, at baseline, 12 mo, and 24 mo. On all RAND-36 scales, the scores indicated better health and well-being. The exercise had hardly any effect on HRQoL; only the general health score improved slightly compared with controls at 12 mo (p = .019), but this gain was lost at 24 mo. FoF decreased in both groups during the intervention with no between-groups difference at 12 or 24 mo. In conclusion, despite beneficial physiological changes, the exercise intervention showed rather limited effects on HRQoL and FoF among relatively high-functioning older women. This modest result may be partly because of insufficient responsiveness of the assessment instruments used.

A comparison on financial literacy between welfare recipients and non-welfare recipients in Brunei

2015 ◽  
Vol 42 (7) ◽  
pp. 598-613 ◽  
Author(s):  
Ak Md Hasnol Alwee Pg Md Salleh
Keyword(s):  
Low Income ◽  
Financial Literacy ◽  
Well Being ◽  
Literacy Programs ◽  
Welfare Recipients ◽  
Structured Interviews ◽  
Welfare Programs ◽  
Content Type ◽  
Logistic Regressions ◽  
Random Sampling Approach

Purpose – The purpose of this paper is to provide insights onto the level of financial literacy in Brunei, notably focussing on the findings of welfare recipient’s vis-à-vis non-welfare recipients. Design/methodology/approach – Findings are based on structured interviews with 431 heads of households (215 welfare recipients and 216 non-welfare recipients), within the realm of money management, emergency planning and investing for goals. To analyze the data, Pearson’s χ2 test and logistic regressions are undertaken. Findings – The findings underline the importance of enhancing the level of financial literacy, notably for low-income households and those in poverty, as the analysis highlighted their level of financial literacy was significantly lower than non-welfare recipients. Research limitations/implications – Future researches may want to consider a random sampling approach and/or using other districts in the country, to ascertain a representative set of findings. Practical implications – The implication of the findzings highlights the need for welfare programs to consider incorporating financial literacy programs, designed specifically for welfare recipients, distinct from non-welfare recipients. Originality/value – There is currently no known research on financial literacy related to Brunei. Further, the paper also focusses on financial literacy, as a means to assist those in welfare or poverty, in order to enhance their financial well-being.

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