Cash Transfers and Peer Support for Family Health

Overseen By Marybeth Shinn, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Vanderbilt University

Disqualifiers: None

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 6

200 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if large, unconditional cash transfers and optional peer support can reduce the time families spend in homeless shelters and improve their overall well-being. Families with at least one child under two years old, residing in a designated shelter, are eligible to participate. One group will receive $1,500 a month with the option of peer support, while another group will receive $50 a month without peer support. The study will compare these groups to identify which approach better supports families in need. As an unphased trial, this study provides families with a unique opportunity to potentially enhance their living conditions and well-being through innovative support methods.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that giving families large amounts of money without conditions is generally safe. Studies have found that these programs can improve family life by reducing financial problems and making it easier to afford food. Families receiving these cash transfers are also more likely to maintain full-time employment.

Reports on these programs do not mention any major negative effects. Instead, they often highlight small improvements in emotional and behavioral health, suggesting that the approach is well-accepted.

The peer support component of the program is optional and provides extra help without direct safety concerns. Overall, evidence supports that this approach is safe and can benefit families in need. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the trial for cash transfers and peer support because it explores a novel approach to improving family health by addressing socioeconomic factors directly. Unlike traditional treatments that might focus solely on medical care or counseling, this trial provides large, unconditional cash transfers of $1,500 monthly, empowering families to meet their unique needs and reduce financial stress. Additionally, the option for voluntary peer support offers a community-based element that can enhance mental well-being and social connections, potentially leading to more sustainable health improvements. This holistic strategy could offer insights into the impact of financial stability and peer networks on health outcomes, which current standard care options do not typically address.

What evidence suggests that this trial's treatments could be effective for families with young children in homeless shelters?

Research shows that giving families cash without conditions can have many positive effects. In this trial, participants in the "Large unconditional cash transfers plus voluntary peer support" arm will receive monthly cash transfers of $1,500 and can choose to participate in peer support services. Studies have found that these cash gifts can help families become more financially stable, face fewer difficulties, and improve their overall well-being. For instance, families who receive cash in different programs often experience better financial outcomes and stronger family relationships. Combining cash transfers with peer support provides emotional and practical help, further boosting morale and resource management. While researchers are still studying the specific impact on reducing time spent in shelters, evidence strongly suggests that large cash gifts can improve family well-being overall. ^{1 3 4 6 7}

Who Is on the Research Team?

Marybeth Shinn, PhD

Principal Investigator

Vanderbilt University

Are You a Good Fit for This Trial?

The Growing Strong study is for families with at least one child under two years old living in a homeless shelter. It aims to see if giving these families cash without conditions, along with optional peer support, can help them get out of the shelter faster and improve their well-being.

Inclusion Criteria

My baby is under 2 years old.

I am an adult with custody of the child.

My family was deemed eligible for shelter within the last month.

Exclusion Criteria

None: any family configuration is permissible

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Families receive monthly cash transfers and may participate in peer support services

24 months

Monthly cash transfers

Follow-up

Participants are monitored for outcomes related to family and child well-being after intervention

6 months

Surveys at 6, 18, and 30 months

What Are the Treatments Tested in This Trial?

Interventions

• Large unconditional cash transfers plus voluntary peer support

Trial Overview This trial tests unconditional cash gifts ($1,500/month) plus voluntary peer support against smaller cash transfers ($50/month) or usual care in shelters. The goal is to determine if more money and support can reduce time spent in shelters and enhance family health.

How Is the Trial Designed?

Group I: Passive comparison Experimental Treatment 1 Intervention

These propensity-matched families will reside in other New York City shelters and will be followed anonymously in administrative records only. The will receive usual care from shelter staff.

Group II: Large unconditional cash transfers plus voluntary peer support Experimental Treatment 1 Intervention

These participants will receive monthly cash transfers of $1,500 via debit card for 24 months and can elect to participate in peer support services plus usual care from shelter staff.

Group III: Nominal cash transfers Active Control 1 Intervention

These participants will receive monthly cash transfers of $50 via debit card for 24 months plus usual care from shelter staff.

Large unconditional cash transfers plus voluntary peer support is already approved in United States, Canada for the following indications:

Approved in United States as Unconditional Cash Transfers for:

• Homelessness reduction
• Financial stability improvement

Approved in Canada as Direct Cash Transfers for:

• Homelessness reduction
• Financial stability improvement

Who Is Running the Clinical Trial?

Vanderbilt University

Lead Sponsor

Trials

714

Recruited

6,143,000+

New York City Center for Innovation through Data Intelligence (CIDI)

Collaborator

Trials

1

Recruited

200+

Women in Need (Win)

Collaborator

Trials

1

Recruited

200+

The Samuels Group

Collaborator

Trials

1

Recruited

200+

Published Research Related to This Trial

A scoping review of 68 studies across 25 countries found that conditional cash transfer (CCT) interventions significantly improved health outcomes, with 78% of studies reporting positive effects, particularly in areas like infectious diseases and maternal health.

The studies included a wide range of participants, from 47 to 5,788 individuals, indicating that CCTs can be effective across diverse populations and settings, although the amount of cash disbursed varied, with most payments being $20 or less.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Conditional cash transfers to improve health-focused outcomes: a global scoping review. Rezaei, SJ., de Walque, D., Mateen, FJ.[2023]

A systematic review of nine studies in sub-Saharan Africa found insufficient evidence that conditional cash transfers (CCTs) significantly improve health service utilization or child health outcomes, including nutrition and immunization rates.

While CCTs may show potential for enhancing access to health services, this does not necessarily lead to better health status for children, indicating a need for further research to understand the mechanisms behind these interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic Review on the Impact of Conditional Cash Transfers on Child Health Service Utilisation and Child Health in Sub-Saharan Africa. Onwuchekwa, C., Verdonck, K., Marchal, B.[2022]

Cash transfers, which are financial resources provided through social policies, have been shown to positively impact health outcomes, although the effects can vary based on different factors.

Ongoing research into innovative policies like universal basic income and Child Development Accounts may further enhance the effectiveness of cash transfers in improving health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cash Transfers and Health. Sun, S., Huang, J., Hudson, DL., et al.[2021]

The Janani Suraksha Yojana program has successfully increased the number of facility-based births in rural Uttar Pradesh, but it has not led to improved health outcomes due to poor quality of care provided by health service providers.

The financial incentives offered by the program are minimal when considering the costs of hospital births, and women also face emotional and psychological burdens, indicating a need for significant changes to the program to better focus on health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Costs and consequences of a cash transfer for hospital births in a rural district of Uttar Pradesh, India. Coffey, D.[2022]

Cash payments have been explored as a strategy for HIV prevention, with 16 studies identified, 10 of which are completed, primarily focusing on adolescents in developing countries.

Initial results indicate that cash transfer programs can lead to reductions in risky sexual behaviors and have shown a significant difference in HIV prevalence among young women receiving cash compared to those who do not.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can money prevent the spread of HIV? A review of cash payments for HIV prevention. Pettifor, A., MacPhail, C., Nguyen, N., et al.[2022]

The review included 127 studies from 24 countries, focusing on how recipients perceive cash transfer programs aimed at improving health outcomes, revealing that while recipients found cash transfers helpful for immediate needs, they often felt the amounts provided were insufficient for their total needs.

Recipients reported that cash transfers improved their empowerment and social cohesion but also faced challenges such as stigma, pressure on cash usage, and barriers to accessing the programs, indicating that broader social and cultural factors significantly influence the effectiveness of these interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Experiences of conditional and unconditional cash transfers intended for improving health outcomes and health service use: a qualitative evidence synthesis. Yoshino, CA., Sidney-Annerstedt, K., Wingfield, T., et al.[2023]

A doubling of cash transfers in the Oportunidades program led to significant improvements in child health, including increased height-for-age Z scores and reduced prevalence of stunting and being overweight, based on a study of 2,449 children.

The cash transfers were also linked to enhanced motor and cognitive development in children, indicating that financial support can positively impact various aspects of child growth and learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Role of cash in conditional cash transfer programmes for child health, growth, and development: an analysis of Mexico's Oportunidades. Fernald, LC., Gertler, PJ., Neufeld, LM.[2022]

Cash transfers (CTs) have been shown to effectively address social determinants of health (SDoH) such as financial poverty, education, and child labour in sub-Saharan Africa, based on a systematic review of 53 studies.

CTs also positively influence health outcomes and quality of life, with evidence suggesting they improve nutrition and reduce risky behaviours, highlighting their potential as a public health policy to reduce health inequalities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa: a systematic review. Owusu-Addo, E., Renzaho, AMN., Smith, BJ.[2022]

Brazil's Bolsa Família program, the largest conditional cash transfer program globally, led to a significant 9.3% reduction in overall infant mortality rates within its first five years, particularly benefiting areas with higher initial mortality rates.

The program's success highlights the importance of improving child health and addressing health inequalities, suggesting that policymakers should enhance basic health services to meet the increased demand from such initiatives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brazil's conditional cash transfer program associated with declines in infant mortality rates. Shei, A.[2022]

Citations

1. givedirectly.org givedirectly.org/gdresearch/

Our Research Direct cash to families in rural Kenyan​​ The study documented large, positive impacts of cash transfers averaging ~$500 across a wide range of outcomes ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12276889/

Unconditional Cash Transfers for Families with Children in the ... This research generally finds that cash transfers to families have minimal labor supply effects among parents (Banerjee et al., 2017) and favorable impacts on ...

3. povertyactionlab.org povertyactionlab.org/evaluation/impact-unconditional-cash-transfers-health-outcomes-united-states

The Impact of Unconditional Cash Transfers on Health ... Participants who received the large cash transfer experienced no change in their sleep quality, exercise frequency, self-reported access to health care, ...

4. nature.com nature.com/articles/s41467-025-62438-x

Effects of unconditional cash transfers on family processes ... This study examines causal impacts of unconditional cash transfers on economic hardship and key family processes that may affect children's ...

5. ph.ucla.edu ph.ucla.edu/news-events/news/report-landmark-guaranteed-income-program-city-los-angeles-produces-overwhelmingly

Report: Landmark guaranteed income program in City ... “BIG:LEAP participants experienced overwhelmingly positive outcomes with the infusion of unconditional cash,” write the authors of a new ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11920613/

Annual Research Review: Cash transfer programs and ... Most of these studies find that cash transfer programs are associated with reductions in emotional or behavioural health problems, effect sizes are small.

7. acf.gov acf.gov/sites/default/files/documents/ofa/selected-research-cash-transfers-508.pdf

Select Research on Cash Transfers Cash recipients were more likely to maintain full-time employment during and after the program and had reduced income volatility and increased food security ...