Increasing financial and health equity among low income black youth and young adults

提高低收入黑人青年和年轻人的财务和健康公平

• 批准号: 10414694
• 负责人: Margaret Libby
• 金额: $ 336.91万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-23 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10414694
• 关键词: Accidental Injury; Acute; Address; Adult; Affect; Age; Anxiety; Behavior; Behavioral Research; California; Cause of Death; Cellular Phone; Chlamydia; Cities; Communities; Coupled; Cross-Over Trials; Crossover Design; Data; Development; Discrimination; Economics; Education; Effectiveness; Emotional; Employment; Enrollment; Ensure; Evaluation; Exposure to; Family; Family Planning; Female; Future; Gonorrhea; HIV Infections; HIV/STD; Health; Health Services Needs; Health behavior; Human Papilloma Virus Vaccination; Income; Individual; Intervention; Investments; Lead; Life; Low income; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Monitor; Mood Disorders; Municipalities; Outcome; Participant; Personal Satisfaction; Phase; Policies; Policy Maker; Politics; Population; Poverty; Psyche structure; Randomized; Reproductive Health Services; Research; Risk; Risk-Taking; Savings; Science; Security; Service provision; Services; Sexual Health; Statutes and Laws; Structure; Suicide; System; Testing; Time; Training; Training and Education; United States; Work; Youth; aged; arm; base; black women; community based participatory research; critical period; depressive symptoms; design; economic disparity; education pathway; emerging adult; emerging adulthood; experience; follow-up; health disparity; health equity; health inequalities; help-seeking behavior; improved; innovation; insight; multidisciplinary; payment; peer learning; peer support; physical conditioning; programs; real time monitoring; referral services; response; service gap; service utilization; social determinants; social health determinants; social structure; working group; young adult

PROJECT SUMMARY Black Emerging Adults (BEA), ages 18-24, in the U.S. experience higher levels of poverty, illness, and discrimination than White youth. These exposures to harm, coupled with the lack of supportive services to address and mitigate poverty and structural inequities, result in health inequities. BEA experience high mental health service needs, but much less service utilization than White youth, have higher rates of STI and less access to family planning. Disrupting the social determinants of poverty that systematically affects BEA, can have a transformative impact on a healthy transition into adulthood during a critical time in their development. Guaranteed basic income (GBI) is an economic strategy that could redress financial inequities and transform the mental and physical health outcomes of BEA, which has shown tremendous promise in adults populations and youth in families receiving income, but little is known about how GBI program would work when cash is transferred unconditionally and directly to Black emerging adults and what critical supports would be needed to ensure GBI is most effective. We propose a randomized controlled crossover trial in which 300 low-income BEA are allocated to receive a $500/month GBI either during the first twelve months of follow-up (phase I) or to receive GBI in the second 12 months of a total of 24 months follow-up (phase II). All participants, regardless of randomization arm, will be offered enrollment in financial capability programs -- peer learning circles and financial coaching -- to bolster GBI effectiveness. Participants will also receive a cell phone-based real-time monitoring and response intervention (RTMR), which will ensure that BEA with unmet health service needs receive referrals. The RTMR system will simultaneously provide critical, time-sensitive information for community agencies and policy makers to address documented service gaps. All components will be co- designed and monitored by our Community Working Group, comprised of representatives from an extensive network of partnering community agencies, city officials, and youth who have been active in the financial capability space. Together these intervention components support BEA on the individual-level (GBI, coaching, RTMR), interpersonal-level (peer learning circles), community-level (GBI & RTMR), and at the societal level (policy impacts of GBI, RTMR). We will determine the impacts of GBI and GBI+multi-level supports on BEA’s investment in their future (education, employment training), mental health (depressive symptoms and anxiety), and unmet mental health and sexual/reproductive health service needs. We will also include a nested qualitative component to explore mechanisms of impact on financial, mental and physical health. This study leverages a strong multi-disciplinary community and research partnership; multilevel intervention components that address the most urgent inequities that impact the trajectory of BEA during their transition to adulthood and independence; and provides urgent experimental data with findings that could inform service provision and policy to advance health equity.

项目摘要 在美国，新兴成年人（BEA）18-24岁，贫困，疾病和 歧视比白人青年。这些伤害的暴露，加上缺乏支持服务 解决并减轻贫困和结构性不平等，导致健康不平等。 BEA经历高心态 卫生服务需求，但服务利用率比白人青年少得多，STI的速度更高，更少 访问计划生育。破坏系统影响BEA的贫困社会决定者，可以 在其发展的关键时期内，对健康过渡到成年后的健康过渡产生了变革性的影响。 保证基本收入（GBI）是一种经济战略，可以纠正财务不平等并改变 BEA的身心健康成果，在成年人人群中表现出巨大的希望 和家庭中的年轻人获得收入，但对于现金时GBI计划的工作方式知之甚少 无条件和直接转移到黑人新兴成年人，需要什么关键的支持 确保GBI最有效。我们提出了一项随机控制的跨界试验，其中300个低收入 BEA在随访的前十二个月（I阶段）或到 在总共24个月随访的第二个12个月中接收GBI（第二阶段）。所有参与者，不管 随机化部门，将提供财务能力计划的入学率 - 同行学习循环和 财务指导 - 增强GBI的有效性。参与者还将获得基于手机的实时 监视和响应干预（RTMR），这将确保具有未满足健康服务需求的BEA 接收推荐。 RTMR系统将简单地提供关键的时间敏感信息 社区机构和政策制定者解决有记录的服务差距。所有组件将是共同的 由我们的社区工作组设计和监视，包括代表广泛的代表 活跃于财务的社区机构，城市官员和青年的网络 容量空间。这些干预组件共同支持个人级别的BEA（GBI，教练， RTMR），人际关系级别（同伴学习电路），社区级别（GBI＆RTMR），在社会层面上 （GBI，RTMR的政策影响）。我们将确定GBI和GBI+多层支持对BEA的影响 投资未来（教育，就业培训），心理健康（抑郁症状和动画）， 以及未满足的心理健康和性/生殖健康服务需求。我们还将包括一个嵌套 定性组成部分，以探索对财务，身心健康影响的机制。这项研究 利用强大的多学科社区和研究伙伴关系；多层干预组件 这解决了影响BEA在过渡到成年期间影响轨迹的最紧急不平等 和独立；并提供紧急的实验数据，这些发现可以为服务提供提供信息和 促进健康公平的政策。

项目成果

A guaranteed income intervention to improve the health and financial well-being of low-income black emerging adults: study protocol for the Black Economic Equity Movement randomized controlled crossover trial.

• DOI: 10.3389/fpubh.2023.1271194
• 发表时间: 2023
• 期刊: FRONTIERS IN PUBLIC HEALTH
• 影响因子: 5.2
• 作者: Lippman, Sheri A.;Libby, Margaret K.;Nakphong, Michelle K.;Arons, Abigail;Balanoff, Monica;Mocello, Adrienne Rain;Arnold, Emily A.;Shade, Starley B.;Qurashi, Fahad;Downing, Alexandria;Moore, Alexis;Dow, William H.;Lightfoot, Marguerita A.
• 通讯作者: Lightfoot, Marguerita A.