Cargando…

Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep: A Randomized Clinical Trial

IMPORTANCE: Children experiencing poverty are more likely to experience worse health outcomes, including injury, chronic illness, worse nutrition, and poorer sleep. The extent to which poverty reduction improves these outcomes is unknown. OBJECTIVE: To evaluate the effect of a 3-year, monthly uncond...

Descripción completa

Detalles Bibliográficos
Autores principales: Sperber, Jessica F., Gennetian, Lisa A., Hart, Emma R., Kunin-Batson, Alicia, Magnuson, Katherine, Duncan, Greg J., Yoshikawa, Hirokazu, Fox, Nathan A., Halpern-Meekin, Sarah, Noble, Kimberly G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543132/
https://www.ncbi.nlm.nih.gov/pubmed/37773497
http://dx.doi.org/10.1001/jamanetworkopen.2023.35237
_version_ 1785114233108692992
author Sperber, Jessica F.
Gennetian, Lisa A.
Hart, Emma R.
Kunin-Batson, Alicia
Magnuson, Katherine
Duncan, Greg J.
Yoshikawa, Hirokazu
Fox, Nathan A.
Halpern-Meekin, Sarah
Noble, Kimberly G.
author_facet Sperber, Jessica F.
Gennetian, Lisa A.
Hart, Emma R.
Kunin-Batson, Alicia
Magnuson, Katherine
Duncan, Greg J.
Yoshikawa, Hirokazu
Fox, Nathan A.
Halpern-Meekin, Sarah
Noble, Kimberly G.
author_sort Sperber, Jessica F.
collection PubMed
description IMPORTANCE: Children experiencing poverty are more likely to experience worse health outcomes, including injury, chronic illness, worse nutrition, and poorer sleep. The extent to which poverty reduction improves these outcomes is unknown. OBJECTIVE: To evaluate the effect of a 3-year, monthly unconditional cash transfer on health, nutrition, sleep, and health care utilization among children experiencing poverty who were healthy at birth. DESIGN, SETTING, AND PARTICIPANTS: This longitudinal randomized clinical trial recruited 1000 mother-infant dyads between May 2018 and June 2019. Dyads were recruited from postpartum wards in 12 hospitals in 4 US cities: New York, New York; Omaha, Nebraska; New Orleans, Louisiana; and Minneapolis/St Paul, Minnesota. Eligibility criteria included an annual income less than the federal poverty line, legal age for consent, English or Spanish speaking, residing in the state of recruitment, and an infant admitted to the well-baby nursery who will be discharged to the mother’s custody. Data analysis was conducted from July 2022 to August 2023. INTERVENTION: Mothers were randomly assigned to receive either a high-cash gift ($333/mo, or $3996/y) or a low-cash gift ($20/mo, or $240/y) for the first several years of their child’s life. MAIN OUTCOMES AND MEASURES: Primary preregistered outcomes reported here include an index of child health and medical care and child sleep disturbances. Secondary preregistered outcomes reported include children’s consumption of healthy and unhealthy foods. RESULTS: A total of 1000 mother-infant dyads were enrolled, with 400 randomized to the high-cash gift group and 600 to the low-cash gift group. Participants were majority Black (42%) and Hispanic (41%); 857 mothers participated in all 3 waves of data collection. We found no statistically detectable differences between the high-cash and low-cash gift groups in maternal assessments of children’s health (effect size [ES] range, 0.01-0.08; SE range, 0.02-0.07), sleep (ES range, 0.01-0.10; SE, 0.07), or health care utilization (ES range, 0.01-0.11; SE range, 0.03-0.07). However, mothers in the high-cash gift group reported higher child consumption of fresh produce at child age 2 years, the only time point it was measured (ES, 0.17; SE, 0.07; P = .03). CONCLUSIONS AND RELEVANCE: In this study, unconditional cash transfers to mothers experiencing poverty did not improve reports of their child’s health, sleep, or health care utilization. However, stable income support of this magnitude improved toddlers’ consumption of fresh produce. Healthy newborns tend to grow into healthy toddlers, and the impacts of poverty reduction on children’s health and sleep may not be fully borne out until later in life. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03593356
format Online
Article
Text
id pubmed-10543132
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher American Medical Association
record_format MEDLINE/PubMed
spelling pubmed-105431322023-10-03 Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep: A Randomized Clinical Trial Sperber, Jessica F. Gennetian, Lisa A. Hart, Emma R. Kunin-Batson, Alicia Magnuson, Katherine Duncan, Greg J. Yoshikawa, Hirokazu Fox, Nathan A. Halpern-Meekin, Sarah Noble, Kimberly G. JAMA Netw Open Original Investigation IMPORTANCE: Children experiencing poverty are more likely to experience worse health outcomes, including injury, chronic illness, worse nutrition, and poorer sleep. The extent to which poverty reduction improves these outcomes is unknown. OBJECTIVE: To evaluate the effect of a 3-year, monthly unconditional cash transfer on health, nutrition, sleep, and health care utilization among children experiencing poverty who were healthy at birth. DESIGN, SETTING, AND PARTICIPANTS: This longitudinal randomized clinical trial recruited 1000 mother-infant dyads between May 2018 and June 2019. Dyads were recruited from postpartum wards in 12 hospitals in 4 US cities: New York, New York; Omaha, Nebraska; New Orleans, Louisiana; and Minneapolis/St Paul, Minnesota. Eligibility criteria included an annual income less than the federal poverty line, legal age for consent, English or Spanish speaking, residing in the state of recruitment, and an infant admitted to the well-baby nursery who will be discharged to the mother’s custody. Data analysis was conducted from July 2022 to August 2023. INTERVENTION: Mothers were randomly assigned to receive either a high-cash gift ($333/mo, or $3996/y) or a low-cash gift ($20/mo, or $240/y) for the first several years of their child’s life. MAIN OUTCOMES AND MEASURES: Primary preregistered outcomes reported here include an index of child health and medical care and child sleep disturbances. Secondary preregistered outcomes reported include children’s consumption of healthy and unhealthy foods. RESULTS: A total of 1000 mother-infant dyads were enrolled, with 400 randomized to the high-cash gift group and 600 to the low-cash gift group. Participants were majority Black (42%) and Hispanic (41%); 857 mothers participated in all 3 waves of data collection. We found no statistically detectable differences between the high-cash and low-cash gift groups in maternal assessments of children’s health (effect size [ES] range, 0.01-0.08; SE range, 0.02-0.07), sleep (ES range, 0.01-0.10; SE, 0.07), or health care utilization (ES range, 0.01-0.11; SE range, 0.03-0.07). However, mothers in the high-cash gift group reported higher child consumption of fresh produce at child age 2 years, the only time point it was measured (ES, 0.17; SE, 0.07; P = .03). CONCLUSIONS AND RELEVANCE: In this study, unconditional cash transfers to mothers experiencing poverty did not improve reports of their child’s health, sleep, or health care utilization. However, stable income support of this magnitude improved toddlers’ consumption of fresh produce. Healthy newborns tend to grow into healthy toddlers, and the impacts of poverty reduction on children’s health and sleep may not be fully borne out until later in life. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03593356 American Medical Association 2023-09-29 /pmc/articles/PMC10543132/ /pubmed/37773497 http://dx.doi.org/10.1001/jamanetworkopen.2023.35237 Text en Copyright 2023 Sperber JF et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Sperber, Jessica F.
Gennetian, Lisa A.
Hart, Emma R.
Kunin-Batson, Alicia
Magnuson, Katherine
Duncan, Greg J.
Yoshikawa, Hirokazu
Fox, Nathan A.
Halpern-Meekin, Sarah
Noble, Kimberly G.
Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep: A Randomized Clinical Trial
title Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep: A Randomized Clinical Trial
title_full Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep: A Randomized Clinical Trial
title_fullStr Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep: A Randomized Clinical Trial
title_full_unstemmed Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep: A Randomized Clinical Trial
title_short Unconditional Cash Transfers and Maternal Assessments of Children's Health, Nutrition, and Sleep: A Randomized Clinical Trial
title_sort unconditional cash transfers and maternal assessments of children's health, nutrition, and sleep: a randomized clinical trial
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543132/
https://www.ncbi.nlm.nih.gov/pubmed/37773497
http://dx.doi.org/10.1001/jamanetworkopen.2023.35237
work_keys_str_mv AT sperberjessicaf unconditionalcashtransfersandmaternalassessmentsofchildrenshealthnutritionandsleeparandomizedclinicaltrial
AT gennetianlisaa unconditionalcashtransfersandmaternalassessmentsofchildrenshealthnutritionandsleeparandomizedclinicaltrial
AT hartemmar unconditionalcashtransfersandmaternalassessmentsofchildrenshealthnutritionandsleeparandomizedclinicaltrial
AT kuninbatsonalicia unconditionalcashtransfersandmaternalassessmentsofchildrenshealthnutritionandsleeparandomizedclinicaltrial
AT magnusonkatherine unconditionalcashtransfersandmaternalassessmentsofchildrenshealthnutritionandsleeparandomizedclinicaltrial
AT duncangregj unconditionalcashtransfersandmaternalassessmentsofchildrenshealthnutritionandsleeparandomizedclinicaltrial
AT yoshikawahirokazu unconditionalcashtransfersandmaternalassessmentsofchildrenshealthnutritionandsleeparandomizedclinicaltrial
AT foxnathana unconditionalcashtransfersandmaternalassessmentsofchildrenshealthnutritionandsleeparandomizedclinicaltrial
AT halpernmeekinsarah unconditionalcashtransfersandmaternalassessmentsofchildrenshealthnutritionandsleeparandomizedclinicaltrial
AT noblekimberlyg unconditionalcashtransfersandmaternalassessmentsofchildrenshealthnutritionandsleeparandomizedclinicaltrial