title: The EARN-Health Trial: protocol for a randomised controlled trial to identify health effects of a financial savings programme among low-income US adults.
abstract: BACKGROUND
  A theory within the social epidemiology field is that financial stress related to having inadequate financial savings may contribute to psychological stress, poor mental health and poor health-related behaviours among low-income US adults. Our objective is to test whether an intervention that encourages financial savings among low-income US adults improves health behaviours and mental health.
  
  
  METHODS
  A parallel group two-arm controlled superiority trial will be performed in which 700 participants will be randomised to the intervention or a wait list. The intervention arm will be provided an online Individual Development Account (IDA) for 6 months, during which participants receive a $5 incentive (£3.2, €4.5) for every month they save $20 in their account (£12.8, €18), and an additional $5 if they save $20 for two consecutive months. Both groups will be provided links to standard online financial counselling materials. Online surveys in months 0 (prior to randomisation), 6 and 12 (6 months postintervention) will assess self-reported health behaviours and mental health among participants in both arms. The surveys items were tested previously in the US Centers for Disease Control and Prevention national health interviews and related health studies, including self-reported overall health, health-related quality of life, alcohol and tobacco use, depression symptoms, financial stress, optimism and locus of control, and spending and savings behaviours. Trial data will be analysed on an intent-to-treat basis.
  
  
  BACKGROUND
  This protocol was approved by the Institutional Review Board of Stanford University (Protocol ID: 30641). The findings of the trial will be disseminated through peer-reviewed publication.
  
  
  BACKGROUND
  Identifier NCT02185612; Pre-results.
authors.affiliation: Department of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Basu
authors.affiliation: Department of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Hamad
authors.affiliation: Department of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Justin S
authors.initials: JS
authors.lastname: White
authors.affiliation: Department of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Modrek
authors.affiliation: Department of Medicine, Stanford University, Stanford, California, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Rehkopf
authors.affiliation: Department of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cullen
mesh_terms: D000328:Adult; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D008603:Mental Health / Q000191:economics*; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011203:Poverty / Q000706:statistics & numerical data*; D015397:Program Evaluation; D011788:Quality of Life; D014481:United States / Q000453:epidemiology
keywords: HEALTH ECONOMICS; MENTAL HEALTH; PUBLIC HEALTH; SOCIAL MEDICINE