Clinical trial NCT04961177: Increasing Use of Earned Income Tax Credit (EITC) in New Mexico
Official title: Increasing Use of Earned Income Tax Credit (EITC) in New Mexico
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Adverse Childhood Experiences
Keywords: EITC
Poverty
ACEs
Frontline Health Workers
Community Health Workers (CHWs)
Lead sponsor: University of New Mexico
Sponsor class: OTHER
First posted: 2021-07-14
Enrollment: 91
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SEQUENTIAL
Intervention model description: The proposed intervention will have five components:

1. We will conduct trainings for our partner agencies and their frontline health workers to increase knowledge and understanding of: 1.) Risk/protective factors for ACEs and 2.) Eligibility criteria and filing requirements and procedures for EITC.
2. Working with our partners, we will also conduct EITC educational outreach and information sessions targeted to potential EITC filers.
3. We will track program level EITC data regarding screening and assistance provided to clients by CHWs in our network and the number of clients who submit EITC claims and the amounts received.
4. We will conduct a pre/post survey with clients who submit EITC claims to determine whether EITC reduces risk factors and increases protective factors for ACEs.
5. We will disseminate this model throughout the state.
Primary purpose: PREVENTION

Brief summary: Purpose of the Proposed Project. The literature makes clear that poverty and financial hardship and lack of social support are significant risk factors that create a household environment conducive to Adverse Childhood Experiences (ACEs). The purpose of the project is to reduce ACEs-related risk factors that threaten child wellbeing in the homes of low-income families by maximizing Earned Income Tax Credit (EITC) claims among populations of focus in Bernalillo County, and disseminating successful strategies for risk-reduction throughout the state. The project team will do this by integrating outreach and education regarding ACEs and EITC benefits across a group of community-based initiatives, training programs, networks, and collaborators that work with frontline health workers \[Community Health Workers (CHWs) and Medical Assistants (MAs)\].

Detailed description: Goal. The goal of this project is to reduce risk factors and increase protective factors for ACEs by measurably reducing household financial strain, financial insecurity, and economic instability, and increasing social support for low-income populations of focus in Bernalillo County (with an emphasis on designated Economic Opportunity Zones (EOZs) as required by the award) by increasing EITC utilization. The team will accomplish this using an innovative strategy to mobilize frontline health workers to conduct EITC outreach, education, referral, and support across our robust community-based initiatives, collaborations, networks, and training programs, and to disseminate this model for increasing EITC utilization.

Objectives. This project has three objectives.

1. Objective 1. By Y1, M12, increase capacity for EITC outreach and education among 28 core, established, multi-sectoral partner agencies by engaging them in the planning, design, and implementation to 56 trainings for frontline health workers and staff as measured by: A.) Improvement in scores on a pre/post test administered to 65 frontline health workers and 25 partner agency staff before and after the training regarding knowledge and understanding of ACEs-related risk and protective factors and EITC benefits, eligibility, logistics, and referral. B.) Documented increase in the number of times agency frontline health workers and staff use existing EITC materials from national EITC campaigns or the Internal Revenue Service website or start to use the tools following the training.
2. Objective 2. By Y3, M6, increase EITC utilization in Bernalillo County by a minimum of 5200 new EITC filed claims during the project implementation period by tax filers who have not previously filed for EITC in the past 12 months by mobilizing our partners and their 65 CHWs to conduct EITC education, outreach, screening and referral for free tax preparation assistance (65 CHWs x 10 clients per quarter x 2 years), and co-sponsorship of a minimum of 48 community outreach events reaching a minimum of 480 potential EITC filers (48 events x 10 filers).
3. Objective 3. By Y3, M12, using a rigorous evaluation of project activities and outcomes, demonstrate a statistically significant change in ACEs risk/protective factors between baseline and four months among a cohort of 200 EITC filers in order to demonstrate evidence that mobilizing community agencies and frontline health workers is a strong model for increasing EITC utilization: A.) Demonstrate a decrease in household financial strain, financial insecurity, and household economic instability as measured by a change in mean score of at least 0.77 on the In Charge Financial Distress/Financial Well-being Scale (IFDFW). B.) Demonstrate an increase in informational social support as measured by the informational support questions from the Medical Outcomes Study Social Support Survey (MOS-SSS).

Outcome and Impact. The outcome of this project will be to create a cadre of trained frontline health workers and community agencies with the knowledge and capacity to provide EITC outreach, information, screening, and referrals to low-income clients to increase utilization of EITC in New Mexico. The anticipated impact of this effort will be that more New Mexicans will file EITC claims and the funds they receive will help to ameliorate the stress of financial hardship and reduce poverty. Furthermore, the experience of working with the frontline health worker will increase social support and utilization of EITC, both of which will reduce negative social determinants of health and risk factors for ACEs and increase preventive factors for ACEs of children who live in some of the most at-risk homes, improving the wellbeing of these children today and creating a foundation for them to have healthier lives as adults.

Eligibility criteria: Inclusion Criteria

* Adult, 18 or over
* Speak English or Spanish
* Work as a frontline health worker or staff at one of our partner agencies who takes our training
* Be a client of one of the frontline health workers of our partner agencies who qualifies for EITC who has not submitted an EITC claim in the past 12 months and is interested in receiving assistance to submit an EITC claim through our project

Exclusion Criteria

* Children --individuals younger than 18
* Fetuses
* Individuals unable to provide consent
* Individuals who are incarcerated

Primary outcomes:
measure: A: Financial strain and insecurity.
timeFrame: 4 months
measure: B: Informational Social Support
timeFrame: 4 months
Secondary outcomes:
Other outcomes:
Locations:
city: Albuquerque
country: United States
facility: University of New Mexico
state: New Mexico
Study officials:
affiliation: University of New Mexico
name: Janet Page-Reeves, PhD
role: PRINCIPAL_INVESTIGATOR
References: