The EARN-Health Trial of Financial Savings and Health (EARN-Health)
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|ClinicalTrials.gov Identifier: NCT02185612|
Recruitment Status : Completed
First Posted : July 9, 2014
Last Update Posted : September 28, 2021
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The current literature in social epidemiology and public health suggests that low financial savings has an unsurprising negative relationship with subjective well-being, and increases the odds of making visits to a healthcare provider, receiving a chronic disease diagnosis, and experiencing medical disability. Earn.org is a community-based non-profit based in San Francisco with a mission to help low-income workers build lifelong savings habits and financial capability. The organization is one of the largest providers of "goal-based savings accounts" or "matched savings accounts" in the US. The investigators propose to conduct a randomized controlled trial to determine the health effects of Earn's savings program. Through this trial, the investigators will test three principal hypotheses: (1) Participants in the Earn account, as compared to a control group, are hypothesized to demonstrate improved scores on mental health scales assessing depression and anxiety.
(2) Participants in the Earn account, as compared to a control group, are hypothesized to experience lower odds of harmful behaviors associated with stress, specifically tobacco and alcohol abuse. The investigators hypothesize that the effect on behaviors will be of smaller effect size, and more delayed, than the effect on mental health outcomes, judging from similar effects observed in the micro-credit literature.
(3) The mediating variables between Earn account participation and beneficial health outcomes will include increased optimism and internal locus of control.
|Condition or disease||Intervention/treatment||Phase|
|Depression Anxiety Alcohol Abuse Tobacco Abuse||Behavioral: Savings program||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||678 participants|
|Intervention Model:||Parallel Assignment|
|Official Title:||EARN-Health: A Randomized Controlled Trial of the Effects of an Incentivized Savings Program on Depression, Anxiety, Substance Abuse, and Locus of Control|
|Study Start Date :||October 2016|
|Actual Primary Completion Date :||April 13, 2018|
|Actual Study Completion Date :||April 13, 2018|
No Intervention: Control
Participants will be randomized to a 1 year wait list. Participants take 0 month, 6 month, and 12 month surveys on depression, anxiety, alcohol and tobacco use, locus of control, and overall self-rated health.
Experimental: Savings program
Participants will be randomized to the EARN.org online savings program for 6 months. Participants take 0 month, 6 month, and 12 month surveys on depression, anxiety, alcohol and tobacco use, locus of control, and overall self-rated health.
Behavioral: Savings program
The intervention is a web-based centralized savings account, which is a secure online account without fees. The account offers eligible savers nominal financial rewards for each deposit they make, as a financial incentive for savings.
- Self-rated health scales [ Time Frame: 12 months ]
The following survey measures of self-rated health are taken from the validated CDC Behavioral Risk Factor Surveillance Study and will be recorded and reported from our study:
H0) Would you say that in general your health, as compared to other people your age, is…?
[ Excellent Very good Good Fair OR Poor ]
H1) Please think about your physical health. This includes physical illness and injury. How many days during the past 30 days was your physical health not good?
[Number from 0 to 30]
H2) Now please think about your emotional health. This includes stress, depression, and anxiety. How many days during the past 30 days was your emotional health not good?
[Number from 0 to 30]
H3) During the past 30 days, for about how many days did poor physical or emotional health keep you from doing your usual activities, such as self-care, work, or recreation?
[Number from 0 to 30]
- Depression and anxiety symptoms: yes/no questions [ Time Frame: 12 months ]
The following survey measures are taken from the validated Patient Health Questionnaire 8 and will be recorded and reported from our study:
M1) Little interest or pleasure in doing things M2) Feeling down, depressed, or hopeless M3) Trouble falling asleep or staying asleep, or sleeping too much M4) Feeling tired or having little energy M5) Poor appetite or overeating M6) Feeling bad about yourself, or that you are a failure, or have let yourself or your family down M7) Trouble concentrating on things, such as reading the newspaper or watching television M8) Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual.
- Alcohol abuse screening questions [ Time Frame: 12 months ]
The following survey measures of alcohol use are taken from the validated CDC Behavioral Risk Factor Surveillance Study and will be recorded and reported from our study:
A1) During the past 30 days, how many days did you have at least one drink of any alcoholic beverage? This includes beer, wine, malt beverages, and liquor.
Days in past 30 days
A2) A drink of alcohol is 1 can or bottle of beer, 1 glass of wine, 1 can or bottle of wine cooler, 1 cocktail, or 1 shot of liquor. During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage?
A3) Considering all types of alcoholic beverages, how many times during the past 30 days did you have X [Script: X = 5 for men, X = 4 for women] or more drinks on an occasion?
- Tobacco abuse screening questions [ Time Frame: 12 months ]
The following survey measures of tobacco use are taken from the validated CDC's Behavioral Risk Factor Surveillance Study and will be recorded and reported from our study:
T0) Have you smoked at least 100 cigarettes in your entire life? yes no Script: If NO go to Part 5, else go to "T1"
T1) Do you now smoke cigarettes every day, some days, or not at all? every day some days not at all
T2) During the past 6 months, have you stopped smoking for one day or longer because you were trying to quit smoking?
- Locus of control Likert scales [ Time Frame: 12 months ]
The following survey measures are taken from the validated Health and Retirement study to assess locus of control, and will be recorded and reported from our study::
Please read the statements below and indicate the extent to which you agree with each statement. Select one of the following: Strongly Agree, Agree, Neutral, Disagree, or Strongly Disagree O1) In uncertain times, I expect the best O2) If something can go wrong for me, it will O3) I'm always optimistic about the future O4) I hardly ever expect things to go my way O5) I rarely count on good things happening to me O6) Overall, I expect more good things to happen to me than bad
- Optimism Likert scales [ Time Frame: 12 months ]
The following survey measures are taken from the validated Health and Retirement study to assess optimism, and will be recorded and reported from our study::
L1) I have little control over the things that happen to me L2) There is really no way I can solve some of the problems I have L3) There is little I can do to change many of the important things in my life L4) I often feel helpless in dealing with the problems of life L5) Sometimes I feel that I'm being pushed around in life L6) What happens to me in the future mostly depends on me L7) I can do just about anything I really set my mind to do
- Spending behaviors [ Time Frame: 12 months ]
The following survey measures of spending behaviors will be recorded and reported from our study:
S1) Over the past six months, would you say your household has been... Spending less money than you have had coming in. Spending more money than you have had coming in. Spending about the same amount of money that you have had coming in. S2) Over the past six months, which most accurately describes your household? We put aside money as savings every paycheck or every month. We put aside money as savings when we can, but not regularly. We didn't really put aside money as savings. S3) How much money did your household put aside as savings in an average month? We did not put aside savings in an average month. S4) Does your household have a monthly spending plan? Yes, and we mostly stick to it. Yes, but we don't really stick to it. No, we do not have a plan.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:||18 Years and older (Adult, Older Adult)|
|Sexes Eligible for Study:||All|
|Accepts Healthy Volunteers:||Yes|
- English-speaking US residents
- ages 18 and older
- below 50% of the area median income
- have a regular Internet connection
- non-English speakers
- non-US residents
- history of or current enrollment in other incentivized savings programs
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02185612
|United States, California|
|Stanford, California, United States, 94305|
|Principal Investigator:||Sanjay Basu, MD. PhD||Stanford University|
|Responsible Party:||Stanford University|
|Other Study ID Numbers:||
|First Posted:||July 9, 2014 Key Record Dates|
|Last Update Posted:||September 28, 2021|
|Last Verified:||September 2021|
|Individual Participant Data (IPD) Sharing Statement:|
|Plan to Share IPD:||No|
Tobacco Use Disorder