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We will evaluate the acceptability, feasibility and impact of an online tool that helps patients identify financial benefits that they are entitled to at six clinic sites over a three month period. We will answer the following questions: Is an online tool that addresses income security feasible and acceptable to clinicians? Can such a tool be integrated into regular clinic workflow? What is the patient perspective on the tool and what is the short-term impact?
Addressing the social determinants of health of patients has been identified as a key way to achieve health system goals. However, few evidence-based interventions exist. This study emerges from an ongoing collaboration between family physicians, researchers and a charitable financial literacy organization. This study aims to answer the following questions: Is an online tool that addresses income security feasible and acceptable to clinicians? Can such a tool be integrated into regular clinic workflow? What is the patient perspective on the tool and what is the short-term impact? We will recruit six primary care sites in Toronto and Winnipeg that serve low-income communities. We will introduce clinicians to screening for poverty and increasing access to additional income sources via government benefits. Following an initial orientation session, health providers will be encouraged to use the tool with any patient seen. The health provider and patient will complete the online tool together, generating a tailored list of financial benefits, along with local community resources to assist with obtaining these benefits. A brief survey on this experience will be administered to patients after they complete the tool, as well as a request to contact them in one month. Those who agree to be contacted will be interviewed on whether the intervention impacted their knowledge and ability to access benefits. We will administer an online survey to providers and conduct provider focus groups at each site at the end of study. An advisory group made up of patients living on low incomes and representatives from community agencies will support this study. An online tool could help health providers in improving the income security of their patients. Strengths of this study include that it involves a diverse set of clinics and that the tool has been implemented pragmatically, in the real world of busy primary care clinics. Limitations include the convenience sampling method, that the selected clinics may not be representative of all primary care providers and the relatively short follow-up period. Our findings will provide insight into the potential of electronic tools that assist providers address the social determinants of health.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Online income tool | Experimental | Patients who complete the online income tool with their health provider during the study period. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| online income tool | Other | An online tool that uses information about the patient to develop a tailored list of financial benefits that they are eligible to apply for. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Awareness of Financial Benefits | Self-reported awareness of at least one financial benefit | 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Increase in Income | Self-reported increase in income through accessing a financial benefit | 4 weeks |
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Inclusion Criteria:
Exclusion Criteria:
- None
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| Name | Affiliation | Role |
|---|---|---|
| Andrew D Pinto, MD MSc | Unity Health Toronto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Family Medicine, Faculty of Medicine, University of Manitoba | Winnipeg | Manitoba | R3E 3P5 | Canada | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29061603 | Background | Aery A, Rucchetto A, Singer A, Halas G, Bloch G, Goel R, Raza D, Upshur REG, Bellaire J, Katz A, Pinto AD. Implementation and impact of an online tool used in primary care to improve access to financial benefits for patients: a study protocol. BMJ Open. 2017 Oct 22;7(10):e015947. doi: 10.1136/bmjopen-2017-015947. |
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Clinicians will be encouraged to screen patients for poverty and use the online tool with every eligible patient during 3-months. It is difficult to estimate how many patients will be seen during the 3-month time period, the number who will be living in poverty, the number who agree to the intervention and be consented to the study for follow-up.
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| ID | Title | Description |
|---|---|---|
| FG000 | Online Income Tool | Patients who complete the online income tool with their health provider during the study period and were enrolled in the study through participation in the evaluation. Online income tool: An online tool that uses information about the patient to develop a tailored list of financial benefits that they are eligible to apply for. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
This is the sample of people who were enrolled in this research by participating in one-month follow-up interviews after using the tool with their healthcare provider.
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| ID | Title | Description |
|---|---|---|
| BG000 | Online Income Tool | Patients who were reached for follow-up at one month, after using the Online income tool with their healthcare provider: 59 online income tool: An online tool that uses information about the patient to develop a tailored list of financial benefits that they are eligible to apply for. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | We did not collect information about age during our follow-up interviews with participants. |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Awareness of Financial Benefits | Self-reported awareness of at least one financial benefit | This the the number of people who used the tool to completion with their healthcare provider | Posted | Count of Participants | Participants | 4 weeks |
|
|
6 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Online Income Tool | Patients who complete the online income tool with their health provider during the study period. online income tool: An online tool that uses information about the patient to develop a tailored list of financial benefits that they are eligible to apply for. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Anne Rucchetto, Research Coordinator | St. Michael's Hospital | 416-864-6060 | 76155 | rucchettoa@smh.ca |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 14, 2016 | Aug 19, 2019 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D012934 | Social Isolation |
| D062487 | Social Marginalization |
| ID | Term |
|---|---|
| D012919 | Social Behavior |
| D001519 | Behavior |
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|
| St. Michael's Hospital |
| Toronto |
| Ontario |
| M5B1W8 |
| Canada |
| Count of Participants |
| Participants |
|
| Sex: Female, Male | We did not collect data on sex. | We did not collect information on gender from those reached for follow-up interviews. | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Whether participants have trouble making ends meet at the end of the month | Count of Participants | Participants |
|
| Participants |
|
|
| Secondary | Increase in Income | Self-reported increase in income through accessing a financial benefit | Posted | Count of Participants | Participants | 4 weeks |
|
|
|
| 0 |
| 59 |
| 0 |
| 59 |
| 0 |
| 59 |
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