Keywords: Anti-poverty programs, financial coaching, pediatric healthcare

Background: Poverty is a social determinant of health that profoundly impacts children’s healthcare with disproportionate impact on communities that experience racial economic marginalization. While current literature reveals the positive impacts of clinic-based financial coaching on financial well-being, evidence on child healthcare outcomes is limited. 

Objective: The aim of this study is to assess the impact of clinic-based financial coaching on recommended well child check (WCC) adherence from infancy to third year of life.  

Methods: Low-income parent-infant dyads receiving care from a safety-net hospital-based pediatrics clinic were enrolled from 2018 to 2023 and received either usual care (control) or clinic-based financial resilience coaching. Total number of WCC visits attended were analyzed at three intervals post-enrollment: to 12 months (through 9-month WCC), 24 months (through 18-month WCC), and 36 months (through 30-month WCC). Patients less than 12, 24, and 36 months of age were excluded from the respective analyses. Demographics were obtained from parent-reported surveys and primary care visit data were collected via electronic medical record. Descriptive statistics and two sample t-tests were calculated in Stata.

Results: 455 parent-infant dyads were included in our analysis - 179 controls and 276 in the intervention, with similar demographics between the groups. Adherence to recommended preventive care pediatric visits was higher in the intervention group compared to controls by 12 months (3.58 vs 3.89 total periodicity schedule visits attended, p=0.042), 24 months (5.14 vs 5.65 visits attended, p=0.064), and 36 months (5.68 vs 6.52 visits attended, p=0.035) post-enrollment.     

Conclusion: In our randomized trial, families who received clinic-based financial resilience coaching beginning while their children were infants attended more well child visits through the first three years of child age. This suggests financial resilience coaching increases adherence to recommended preventive visits, improving quality of care.