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Trial registered on ANZCTR
Registration number
ACTRN12620000154909
Ethics application status
Approved
Date submitted
16/12/2019
Date registered
13/02/2020
Date last updated
2/03/2021
Date data sharing statement initially provided
13/02/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
The Healthier Wealthier Families (HWF) pilot randomised trial: offering financial support through community health services.
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Scientific title
The Healthier Wealthier Families (HWF) pilot randomised trial: offering financial support through community health services.
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Secondary ID [1]
299493
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
HWF
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Childhood inequity
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Health service research
314729
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Poverty
314730
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Deprivation
316099
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Parent mental health
316100
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Condition category
Condition code
Public Health
313062
313062
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0
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Health service research
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Public Health
313063
313063
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0
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Health promotion/education
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is referral to financial counselling by Maternal and Child Health (MCH) nurses (also known as Child and Family Health (CFH) nurses). In Australia, financial counselling is free. It is administered by an independent and accredited financial counsellor in the non-government community sector. The intervention uses a client-centred approach to determine the frequency, duration, mode of delivery and activities delivered. An independent interpreter service may assist participants who prefer to use a language other than English.
Financial counselling activities are intended to improve a participant’s financial situation, and may include (but are not limited to) goal and priority-setting; explaining options and consequences of financial decisions; checking eligibility for government assistance; application for hardship variation; debt negotiation with creditors; assistance with planning finances and budgets; and referral to other health and social services. Participants have as many visits or contacts with the financial counsellor as needed.
At 3- and 6-months post-enrolment, financial counsellors will be asked to complete a questionnaire asking about goals initially set; frequency of participant contact and compliance; specific activities and advice delivered; and known changes in participant financial status.
At 3- and 6-months post-enrolment, participants will be asked to complete a questionnaire to assess the primary and secondary outcomes.
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Intervention code [1]
316289
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Treatment: Other
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Comparator / control treatment
The comparator is usual care, plus information from an independent and government-funded money advice website “MoneySmart”. MoneySmart is a free resource that provides objective, plain-language advice developed by financial counselling on a comprehensive range of debt, budgetary management and financial literacy topics; some resources are specific to Aboriginal and Torres Strait Islander people, and selected MoneySmart resources are available in multiple languages. MoneySmart outlines methods and contact details for further financial, legal and crisis support; this includes the National Debt Helpline, a free hotline which links callers to a local free financial counselling service. MoneySmart is commonly used by financial counsellors to advise clients.
At 3- and 6-months post-enrolment, participants will be asked to complete a questionnaire to assess the primary and secondary outcomes.
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Control group
Active
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Outcomes
Primary outcome [1]
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Feasibility:
• Number/proportion of clients who agree to complete screening survey with MCH/CFH nurse in relation to service usage statistics [MCH/CFH nurse report, MCH/CFH service records].
• Number/proportion of eligible clients who consent to participate [MCH/CFH nurse report].
• Number/proportion of intervention participants who access, attend and complete the financial counselling intervention [financial counsellor and participant report].
• Number/proportion of participants who complete 6-month follow-up assessment [research completion records].
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Assessment method [1]
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Timepoint [1]
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3- and 6-months post-enrolment.
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Secondary outcome [1]
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Intervention impact - Household income and sources of income
• Questions adapted from the Household, Income and Labour Dynamics in Australia (HILDA) Survey and Longitudinal Study of Australian Children (LSAC)
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Assessment method [1]
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Timepoint [1]
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3- and 6-months post-enrolment
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Secondary outcome [2]
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Intervention impact - Type of loans
• Questions adapted from the Household, Income and Labour Dynamics in Australia (HILDA) Survey and Longitudinal Study of Australian Children (LSAC)
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Assessment method [2]
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Timepoint [2]
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3- and 6-month post-enrolment
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Secondary outcome [3]
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Intervention impact - Meeting household costs
• Questions adapted from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, Australian Research Alliance for Children and Youth Nest Survey, and Community Understanding of Poverty and Social Exclusion (CUPSE) Survey
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Assessment method [3]
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Timepoint [3]
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3- and 6-months post-enrolment
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Secondary outcome [4]
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Intervention impact - Parent general health
• General Health Questionnaire 1 (GHQ1)
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Assessment method [4]
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Timepoint [4]
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3- and 6-months post-enrolment
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Secondary outcome [5]
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Intervention impact - Parent mental health
• Depression, Anxiety, Stress Scale short-form (DASS-21)
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Assessment method [5]
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Timepoint [5]
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3- and 6-months post-enrolment
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Secondary outcome [6]
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Intervention impact - Parenting efficacy
• From the Longitudinal Study of Australian Children (LSAC)
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Assessment method [6]
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Timepoint [6]
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3- and 6-months post-enrolment
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Secondary outcome [7]
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Intervention impact - Service use (including use of financial supports; study-designed questions)
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Assessment method [7]
380067
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Timepoint [7]
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3- and 6-months post-enrolment
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Secondary outcome [8]
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Intervention impact - Parent health utility
• EuroQol five-dimensional questionnaire (EQ-5D)
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Assessment method [8]
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Timepoint [8]
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3- and 6-months post-enrolment
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Eligibility
Key inclusion criteria
• The parent or carer of a young child (defined by the maternal and child health (MCH)/child and family health (CFH) nursing service as birth to age 5 years);
• A client of the participating MCH/CFH service.
• Lives inside the geographical boundaries serviced by the participating financial counselling service.
• Provides a signed and dated informed consent form.
• Reports at least one risk factor for financial hardship, as screened by MCH/CFH nurse.
Note, parents of any age are eligible, hence the young minimum age specified.
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Minimum age
10
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
• Does not comprehend the recruitment invitation.
• Already enrolled and assigned a research participant ID.
• Has no mechanism for contact (telephone or email).
• Already an active client in a financial counselling service.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation will be performed using a computer program. The randomisation schedule will be securely stored by the randomisation program and concealed by a statistician engaged by the research study for this purpose.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A statistician will prepare the randomisation schedule using block randomisation.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Sample size: In each site, we aim to enrol and randomise 60 participants (30 per arm). As this is a feasibility pilot, the sample size is not designed to provide sufficient power to detect between-groups differences in impact measures (i.e. efficacy). Therefore, we are not performing a sample size calculation, nor estimating a treatment effect.
Quantitative data analysis: Baseline characteristics of participating families will be described for each group. Impact measures will similarly be described by treatment arm and comparisons made using the t-test and non-parametric tests for continuous data and the chi-squared test for categorical data. If suitable (e.g. where the model allows), linear and logistic regression modelling will be conducted to test group differences adjusting for basic baseline characteristics identified a priori. A subgroup analysis will describe the participants identified as Priority 1 who are not included as RCT participants but do continue as research participants.
Qualitative data analysis: qualitative interviews with a subsample of participants, nurses and financial counsellors, will be audio-recorded and transcribed, and subsequently coded.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
17/02/2020
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Actual
18/03/2020
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Date of last participant enrolment
Anticipated
30/06/2021
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Actual
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Date of last data collection
Anticipated
31/03/2022
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Actual
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Sample size
Target
180
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Accrual to date
1
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment postcode(s) [1]
28786
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3757 - Whittlesea
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Recruitment postcode(s) [2]
28787
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3083 - Bundoora
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Recruitment postcode(s) [3]
28788
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3754 - Doreen
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Recruitment postcode(s) [4]
28789
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3076 - Epping
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Recruitment postcode(s) [5]
28790
0
3754 - Mernda
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Recruitment postcode(s) [6]
28791
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3082 - Mill Park
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Recruitment postcode(s) [7]
28792
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3752 - South Morang
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Recruitment postcode(s) [8]
28793
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3074 - Thomastown
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Recruitment postcode(s) [9]
28794
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3750 - Wollert
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Recruitment postcode(s) [10]
28868
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3757 - Eden Park
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Recruitment postcode(s) [11]
28870
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3757 - Kinglake West
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Recruitment postcode(s) [12]
28871
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3757 - Humevale
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Recruitment postcode(s) [13]
28872
0
3753 - Beveridge
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Recruitment postcode(s) [14]
28873
0
3755 - Yan Yean
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Recruitment postcode(s) [15]
28874
0
3064 - Donnybrook
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Recruitment postcode(s) [16]
28875
0
3075 - Lalor
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Recruitment postcode(s) [17]
28876
0
3751 - Woodstock
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Recruitment postcode(s) [18]
33290
0
2165 - Fairfield
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Recruitment postcode(s) [19]
33291
0
2176 - Abbotsbury
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Recruitment postcode(s) [20]
33292
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2177 - Bonnyrigg
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Recruitment postcode(s) [21]
33293
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2177 - Bonnyrigg Heights
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Recruitment postcode(s) [22]
33294
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2176 - Bossley Park
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Recruitment postcode(s) [23]
33295
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2166 - Cabramatta
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Recruitment postcode(s) [24]
33296
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2166 - Cabramatta West
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Recruitment postcode(s) [25]
33297
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2166 - Canley Heights
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Recruitment postcode(s) [26]
33298
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2166 - Canley Vale
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Recruitment postcode(s) [27]
33299
0
2163 - Carramar
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Recruitment postcode(s) [28]
33300
0
2178 - Cecil Park
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Recruitment postcode(s) [29]
33301
0
2176 - Edensor Park
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Recruitment postcode(s) [30]
33302
0
2165 - Fairfield East
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Recruitment postcode(s) [31]
33303
0
2165 - Fairfield Heights
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Recruitment postcode(s) [32]
33304
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2165 - Fairfield West
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Recruitment postcode(s) [33]
33305
0
2176 - Greenfield Park
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Recruitment postcode(s) [34]
33306
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2175 - Horsley Park
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Recruitment postcode(s) [35]
33307
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2166 - Lansvale
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Recruitment postcode(s) [36]
33308
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2170 - Mount Pritchard
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Recruitment postcode(s) [37]
33309
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2161 - Old Guildford
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Recruitment postcode(s) [38]
33310
0
2176 - Prairiewood
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Recruitment postcode(s) [39]
33311
0
2163 - Villawood
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Recruitment postcode(s) [40]
33312
0
2176 - St Johns Park
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Recruitment postcode(s) [41]
33313
0
2164 - Smithfield
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Recruitment postcode(s) [42]
33314
0
2164 - Smithfield West
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Recruitment postcode(s) [43]
33315
0
2176 - Wakeley
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Recruitment postcode(s) [44]
33316
0
2164 - Wetherill Park
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Recruitment postcode(s) [45]
33317
0
2161 - Yennora
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Recruitment postcode(s) [46]
33318
0
3694 - Bandiana Milpo
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Recruitment postcode(s) [47]
33319
0
3691 - Baranduda
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Recruitment postcode(s) [48]
33320
0
3688 - Barnawartha
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Recruitment postcode(s) [49]
33321
0
3691 - Bonegilla
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Recruitment postcode(s) [50]
33322
0
3691 - Castle Creek
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Recruitment postcode(s) [51]
33323
0
3691 - Ebden
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Recruitment postcode(s) [52]
33324
0
3691 - Gateway Island
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Recruitment postcode(s) [53]
33325
0
3691 - Huon Creek
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Recruitment postcode(s) [54]
33326
0
3691 - Killara
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Recruitment postcode(s) [55]
33327
0
3691 - Leneva
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Recruitment postcode(s) [56]
33328
0
3691 - Staghorn Flat
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Recruitment postcode(s) [57]
33329
0
3690 - Wodonga
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Recruitment postcode(s) [58]
33330
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3690 - West Wodonga
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Helen Macpherson Smith Trust
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Address [1]
303989
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27 Windsor Place,
Melbourne, Victoria 3000.
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Country [1]
303989
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Australia
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Funding source category [2]
304502
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Charities/Societies/Foundations
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Name [2]
304502
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Murdoch Children's Research Institute
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Address [2]
304502
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48-50 Flemington Road,
Parkville Victoria 3052.
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Country [2]
304502
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Australia
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Funding source category [3]
307991
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University
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Name [3]
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University of NSW, School of Women Children and Health, Medicine.
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Address [3]
307991
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High Street, Randwick, NSW, 2031
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Country [3]
307991
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Australia
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Funding source category [4]
307992
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Charities/Societies/Foundations
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Name [4]
307992
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The Corella Fund
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Address [4]
307992
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Mutual Trust,
Castlereagh Street,
Sydney NSW 2000
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Country [4]
307992
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Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
Murdoch Children's Research Institute
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Address
48-50 Flemington Road,
Parkville Victoria 3052.
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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University of NSW, School of Women Children and Health, Medicine.
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Address [1]
304770
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High Street, Randwick, NSW, 2031.
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Country [1]
304770
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
304486
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Royal Children's Hospital
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Ethics committee address [1]
304486
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48-50 Flemington Road, Parkville 3052, Victoria.
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Ethics committee country [1]
304486
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Australia
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Date submitted for ethics approval [1]
304486
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10/09/2019
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Approval date [1]
304486
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06/12/2019
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Ethics approval number [1]
304486
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HREC/57372/RCHM-2019
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Ethics committee name [2]
307985
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South West Sydney Local Health District
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Ethics committee address [2]
307985
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Locked Bag 7103 Liverpool BC, NSW, 1871
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Ethics committee country [2]
307985
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Australia
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Date submitted for ethics approval [2]
307985
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20/11/2019
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Approval date [2]
307985
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11/02/2020
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Ethics approval number [2]
307985
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2019/ETH13455
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Summary
Brief summary
Financial hardship can have a major deleterious impact on the health and wellbeing of children and their families. In Australia, 1 in 6 children live in poverty, and one quarter experience deprivation (such as missing out on proper nutrition, housing and supportive personal relationships) due to financial hardship. Government aims to provide social care and support services to protect families from financial hardship; however, many families miss out. This pilot study aims to test the feasibility and short-term impact of financial counselling offered to families experiencing or at-risk of financial hardship, by systematising referral pathways between the free, universal Maternal and Child Health Service/Child and Family Health Nursing Service and a free, community-based financial counselling service.
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Trial website
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Trial related presentations / publications
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Public notes
1. The Primary outcome (Feasibility) will not be assessed using a between-groups comparison of the RCT. 2. Participants identified as being high-risk for high impact consequences (e.g. bankruptcy, loss of housing or essential service utilities, termed 'Priority 1') will not be randomised. This group will be referred directly with indicated priority to the financial counselling service. For those who consent, we will continue to collect research data to inform the feasibility of the study (primary outcome), but their data will not be part of the RCT (between-groups) analyses. 3. We will use an ongoing process review following quality improvement principles to monitor feasibility from the start of the study. This means the study procedures may be modified (following approval from the governing HREC/s) to optimise feasibility. 4. The pilot may be extended to additional sites.
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Contacts
Principal investigator
Name
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Dr Anna Price
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Address
97114
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Centre for Community Child Health,
Royal Children's Hospital,
48-50 Flemington Road,
Parkville, Victoria 3052.
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Country
97114
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Australia
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Phone
97114
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+61 3 9936 6613
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Fax
97114
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Email
97114
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[email protected]
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Contact person for public queries
Name
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Natalie Schreurs
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Address
97115
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Centre for Community Child Health,
Royal Children's Hospital,
48-50 Flemington Road,
Parkville, Victoria 3052.
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Country
97115
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Australia
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Phone
97115
0
+61 3 9936 6286
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Fax
97115
0
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Email
97115
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[email protected]
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Contact person for scientific queries
Name
97116
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Natalie Schreurs
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Address
97116
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Centre for Community Child Health,
Royal Children's Hospital,
48-50 Flemington Road,
Parkville, Victoria 3052.
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Country
97116
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Australia
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Phone
97116
0
+61 3 9936 6286
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Fax
97116
0
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Email
97116
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Decided on a case-by-case basis at the discretion of the Investigator team and consistent with Ethics approval.
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When will data be available (start and end dates)?
After publication and available for at least 15 years after data collection, or indefinitely for participants who consent to having their research information stored for future use.
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Available to whom?
Decided on a case-by-case basis at the discretion of the Investigator team and consistent with Ethics approval.
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Available for what types of analyses?
Decided on a case-by-case basis at the discretion of the Investigator team and consistent with Ethics approval.
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How or where can data be obtained?
Subject to approval by the Investigator team and Ethical and Legal departments. By emailing the study team at
[email protected]
.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Current Study Results
No documents have been uploaded by study researchers.
Update to Study Results
Doc. No.
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
4779
Study results article
Yes
Price A., White N, Burley J, Zhu A, Contreras-Suar...
[
More Details
]
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Feasibility of linking universal child and family healthcare and financial counselling: findings from the Australian Healthier Wealthier Families (HWF) mixed-methods study.
2023
https://dx.doi.org/10.1136/bmjopen-2023-075651
N.B. These documents automatically identified may not have been verified by the study sponsor.
Download to PDF