Implementing financial coaching for parents of infants in a pediatric primary care setting reduced missed well-childcare visit rates by half and significantly improved receipt of vaccinations at a timely age, according to a new community-partnered pilot study led by UCLA researchers.
The study, published in Pediatrics, is the first to examine the effectiveness of delivering financial coaching and its impact on preventive care visits and vaccination in infants’ first six months of life, among families with low income who often face economic stress.
“Improving the continuity and quality of pediatric care has been a focus for pediatric care nationally, and the medical-financial partnership approach offers a novel strategy,” said the study’s lead author, Dr. Adam Schickedanz, an assistant professor of pediatrics at the David Geffen School of Medicine at UCLA. “Early childhood financial hardship has a significant impact on health. Infancy is full of new expenses and financial challenges that families grapple with. Having a new baby in the family can increase eligibility for a number of anti-poverty public benefits programs, and young children and their parents have relatively frequent visits to their physician, so the health care system has more contact with children and families in the preschool years than any other family-facing system. This makes health care a great setting for delivering financial guidance and supports to young families. What our study shows is that this in-clinic financial coaching leads to improvements in clinical care continuity and quality too.”
Poverty-related social needs and other measures of patient financial hardship are among the most consistent predictors of missed health care visits, yet interventions to increase patient visit attendance have tended not to focus on underlying financial needs of children and families. In this new study, conducted at the Harbor-UCLA pediatric primary care clinic, parents received financial coaching in exam rooms during their infants’ well-child visits while waiting for their pediatrician and other health care team members. The financial coaches, who have backgrounds in social work, were trained in the foundations of financial coaching by LIFT Inc., a national nonprofit that works to break intergenerational cycles of poverty. Through ongoing supervision and education from clinician supervisors, as well as LIFT’s financial coaching training, financial coaches were equipped to help parents identify their financial goals, plan action steps, and ultimately achieve greater financial stability. The coaches also connected parents to public benefits and cost-saving services such as low-cost childcare, nutrition assistance programs, free tax preparation, and other public resources. Coaches also followed up remotely with parents at least monthly to track progress toward goals.
This story was adapted from the UCLA press release.
Dr. Schickedanz started the CTSI KL2 program in July 2018 and subsequently obtained NICHD K23 funding in August 2019. He was mentored by Dr. Peter Szilagyi, co-leader of the CTSI Integrating Special Populations Program.