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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Forgone Health Care.

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Strategy. Financial Coaching

Approach. Address non-medical influences on health, such as poverty, food insecurity, and housing instability, that can impact a child's ability to access healthcare

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Overview. Clinically embedded antipoverty programs that address financial stressors may prevent missed visits and improve show rates. Clinic-based financial coaching delivered by trained coaches addresses parent-identified, strengths-based financial goals. (employment, savings, public benefits enrollment, etc) and can also include social needs screening and resource referral. Findings show that adherence to recommended preventive care pediatric visits and vaccinations are improved as a result of financial coaching.[1]

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health Outcomes. This strategy helps contribute to reducing avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality.
  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Consultation (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of families screened for non-medical influences on health (SDOH) needs during healthcare encounters. (Measures identification of social needs) Number of healthcare staff trained on SDOH screening, referral process, and trauma-informed care practices. (Assesses workforce capacity building)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of healthcare encounters that include comprehensive SDOH screening and assessment. (Measures systematic integration of SDOH into care process) Percent of referrals to SDOH support services that are successfully completed and utilized by families. (Shows referral effectiveness and closed-loop process)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of cross-sector partnerships led by Title V established to create coordinated systems of care that address SDOH and healthcare access. (Measures collaborative infrastructure) Number of families who report improved ability to access healthcare for their children after receiving SDOH support. (Measures family-reported impact on access) Number of communities that demonstrate sustained reductions in child health differences through comprehensive SDOH strategies. (Measures long-term population health impact) Number of healthcare organizations that report improved performance on cost and quality measures as a result of addressing SDOH. (Shows healthcare value impact)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of cross-sector partnerships led by Title V established to create coordinated systems of care that address SDOH and healthcare access. (Measures collaborative infrastructure) Percent of families who report improved ability to access healthcare for their children after receiving SDOH support. (Measures family-reported impact on access) Percent of communities that demonstrate sustained reductions in child health differences through comprehensive SDOH strategies. (Measures long-term population health impact) Percent of healthcare organizations that report improved performance on cost and quality measures as a result of addressing SDOH. (Shows healthcare value impact)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Schickedanz, A., Perales, L., Holguin, M., Rhone-Collins, M., Robinson, H., Tehrani, N., Smith, L., Chung, P. J., & Szilagyi, P. G. (2023). Clinic-Based Financial Coaching and Missed Pediatric Preventive Care: A Randomized Trial. Pediatrics, 151(3), e2021054970.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.