Unconditional cash transfers to improve health behaviors among primary care patients
A qualitative sub-study of a randomized clinical trial
Bibliographic Data
| ID | 19393003 |
|---|---|
| Authors | Laura Gibson (0000-0002-9651-4131, University of Pennsylvania), Aaron Richterman (0000-0001-7920-7191, University of Pennsylvania, corresponding author), Aaliyah Randall (University of Pennsylvania), Jonathan Muruako (University of Pennsylvania), Beth A Uzwiak (0000-0002-3461-9544, Philips (Finland)), Eva Fabian (University of Pennsylvania), Harsha Thirumurthy (0000-0002-3308-7603, University of Pennsylvania), Christina A Roberto (0000-0003-2333-9309, University of Pennsylvania) |
| Year | 2026 |
| Volume | 395 |
| Pages | 119068 |
| Publication date | 2026-04-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2026.119068 |
| PMID | 41691989 |
| OpenAlex | W7128514299 |
| Language | EN |
| References cited | 24 |
Unconditional cash transfers are a popular poverty reduction approach and may influence behavioral risk factors for chronic disease outcomes through economic and psychological pathways. Few studies have used qualitative interviews to identify the mechanisms through which cash transfers delivered in a health care context might influence the health of people living with chronic diseases in the United States. We conducted a pilot randomized controlled trial to identify pathways through which unconditional cash transfers may influence health and assess the acceptability and feasibility of such an intervention among low-income patients receiving treatment for hypertension or diabetes. Inclusion criteria were: ≥1 visit at the Penn Family Care clinic within the six months prior to study start, ≥18 years of age, Pennsylvania Medicaid beneficiary, diagnosis of pre-diabetes or diabetes, and/or hypertension, prescribed ≥1 oral medication for diabetes or hypertension, and no plans to leave the Philadelphia metro area. Participants were randomized to either the standard of care or an unconditional cash transfer intervention, and completed an assessment at enrollment and after 12 weeks of study participation. We enrolled 100 participants from 3/2023-8/2023 and 93 attended the follow-up visit. Thirty-four participants (selected randomly) completed qualitative interviews. The interviews and survey data revealed that cash transfers were primarily used to address basic needs. We identified potential pathways through which cash transfers may improve health, including temporary reductions in stress and anxiety, changes in diet and physical activity, improved medication adherence, and increased healthcare seeking behavior. The intervention itself was viewed as highly acceptable. Participants in the control group were disappointed not to receive the intervention, but felt the process was fair because all participants were economically vulnerable. These findings suggest unconditional cash transfers may improve health for patients with chronic diseases through a variety of pathways that should be measured in future trials
Cash transfers · Context (archaeology) · Health care · Health services research · Intervention (counseling) · Medicaid · Poverty · Public health · Randomized controlled trial · Food Security and Health in Diverse Populations · Health Systems, Economic Evaluations, Quality of Life · Poverty, Education, and Child Welfare
Fundamental Cause Theory
The State of Social Safety Nets 2018
The Psychological Lives of the Poor
The State of US Health, 1990-2016
We Can Do Better — Improving the Health of the American People
The Short-term Impact of Unconditional Cash Transfers to the Poor
Psychometric assessment of three newly developed implementation outcome measures
Two Brief Alcohol-Screening Tests From the Alcohol Use Disorders Identification Test (Audit)
Grounded theory research
Characterising and justifying sample size sufficiency in interview-based studies
The impact of antiretroviral treatment and child-focused unconditional cash transfers on child mortality
Acceptability and Feasibility of Cash Transfers for HIV Prevention Among Adolescent South African Women
The impact of cash transfers on social determinants of health and health inequalities in sub-Saharan Africa
Impact of Guaranteed Income on Health, Finances, and Agency
The effects of cash transfer programmes on HIV-related outcomes in 42 countries from 1996 to 2019
| Citation velocity | historical |
|---|---|
| Highly cited | No |