Evaluating the implementation and impact of an online tool in primary care to improve access to financial benefits: a multi-site trial in Ontario and Manitoba

Pinto, A (NPI); Rucchetto, A; Singer, A; Halas, G; Bloch, G; Goel, R; Raza, D; Upshur, R; Bellaire, J; Katz, A

A

Background

Clinicians have been called on to address the social determinants of health, yet few evidence-based interventions exist. We co-developed an online tool with a financial literacy organization that identifies financial benefits that patients are entitled to receive. Our objective was to examine the acceptability and feasibility of such a tool and the short-term impact on income.

Methods

An advisory group made up of people with lived experience and agency representatives supported this study. We conducted a prospective trial with convenience sampling and one month follow-up at three clinics in Ontario and four in Manitoba. Providers were trained to screen for poverty and use the tool during a 3-month period. Based on answers to 13 demographic questions, a tailored list of benefits and community resources was generated.

Results

381 participants opened the website and 165 received a list of financial benefits. Fifty patients were reached after one month. 41 (82%) found it helpful, 43 (86%) would recommend it to family or friends, and 13 (26%) received a new financial benefit. Providers found the tool acceptable but each clinic should designate a specific person to administer it and ensure follow-up. Better links to community resources and assistance with forms that pre-populate would improve impact.

Conclusions

An online tool was acceptable and feasible in primary care and improved income security for about one in four patients. Future work should examine how tools can link with electronic health records and what is the most efficient support to provide patients.

Trial Registration: NCT02959866