Study protocol for the Healthier Wealthier Families (HWF) cluster randomised controlled trial: testing the effectiveness and cost-benefits of offering financial counselling to families with young children who report financial hardship at well-child health home visits.
14 affiliations
- 1Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, 3052, Australia. [email protected].
- 2Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia. [email protected].
- 3Department of Paediatrics, The University of Melbourne, Parkville, VIC, 3052, Australia. [email protected].
- 4Prevention Strategy Branch, Population Health, Queensland Health, Brisbane, Qld, 4000, Australia.
- 5UnitingCare Queensland, Brisbane, Qld, 4000, Australia.
- 6Each, Gympie, Qld, 4570, Australia.
- 7Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.
- 8Department of Paediatrics, The University of Melbourne, Parkville, VIC, 3052, Australia.
- 9Deakin Health Economics, Deakin University, Geelong, VIC, 3220, Australia.
- 10Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, 3052, Australia.
- 11Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University, Penrith South, NSW, 2750, Australia.
- 12Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia.
- 13Financial Counselling Australia, Melbourne, Vic, 3000, Australia.
- 14Independent Advisor, Canberra, ACT, 2000, Australia.
Abstract
Background
Household income is a social determinant of children's health and development. In Australia, one in three families are unable to afford material basics, and the prevalence of poor mental health triples for these caregivers. Healthier Wealthier Families (HWF) connects well-child healthcare with community-based financial counselling to provide an early intervention for financial hardship. Adapted from a Scottish model and piloted in the Australian states of Victoria and New South Wales in 2020-22, this protocol describes an evaluation of the HWF model embedded in well-child home visits in the state of Queensland. Aims are to evaluate (1) HWF effectiveness in reducing financial hardship and improving caregiver mental health, (2) cost-benefits of HWF, and (3) implementation factors necessary for broader scale-up.Methods
This study is a pragmatic, cluster randomised controlled trial (RCT) involving 336 clients receiving well-child home visiting services across all active service regions in Queensland. 24 service areas (clusters) are allocated to either immediate ('now') or delayed ('next', after 12 months) screening for financial hardship by health home visitors. Caregivers who report financial hardship and consent to referral will be contacted by a financial counsellor. Aim 1 will compare the financial hardship and mental health outcomes between the randomised groups at 13-24 months. Using these outcome data and routine financial counselling data, Aim 2 will assess the costs of the program (measured through partner reports of time and materials used in provision of the intervention) against change in outcomes in the form of a cost-consequences analysis from a government perspective. For Aim 3, qualitative interviews with caregivers and service providers will explore experiences, barriers, and enablers of implementation.Discussion
Ethical approval has been granted by the Western Sydney University (#H13834) and UnitingCare Queensland (#202504) Human Research Ethics Committees. Results will be disseminated to partners and policymakers, through meetings, reports, and through peer-reviewed publications and conference presentations. Findings will inform if and how financial counselling can be embedded and scaled within universal well-child healthcare services state-wide and nationally.Trial registration
The trial is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12625001337460).
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BibTeX
@article{price2026study,
title = {{Study protocol for the Healthier Wealthier Families (HWF) cluster randomised controlled trial: testing the effectiveness and cost-benefits of offering financial counselling to families with young children who report financial hardship at well-child health home visits.}},
author = {Anna Price and Skye Frazer-Ryan and Jonathan Turk and Anneke C Grobler and Lisa Gold and Sharon Goldfeld and Emma Elcombe and Rachael Beswick and Joanne Trentin and Domenique Meyrick and Claerwen Little and Lynn Kemp},
journal = {BMC public health},
year = {2026},
month = jul,
doi = {10.1186/s12889-026-28551-2},
url = {https://europepmc.org/article/MED/42928184},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Study protocol for the Healthier Wealthier Families (HWF) cluster randomised controlled trial: testing the effectiveness and cost-benefits of offering financial counselling to families with young children who report financial hardship at well-child health home visits.
AU - Anna Price
AU - Skye Frazer-Ryan
AU - Jonathan Turk
AU - Anneke C Grobler
AU - Lisa Gold
AU - Sharon Goldfeld
AU - Emma Elcombe
AU - Rachael Beswick
AU - Joanne Trentin
AU - Domenique Meyrick
AU - Claerwen Little
AU - Lynn Kemp
PY - 2026
DA - 2026/07/29
JO - BMC public health
DO - 10.1186/s12889-026-28551-2
UR - https://europepmc.org/article/MED/42928184
AB - Background Household income is a social determinant of children's health and development. In Australia, one in three families are unable to afford material basics, and the prevalence of poor mental health triples for these caregivers. Healthier Wealthier Families (HWF) connects well-child healthcare with community-based financial counselling to provide an early intervention for financial hardship. Adapted from a Scottish model and piloted in the Australian states of Victoria and New South Wales in 2020-22, this protocol describes an evaluation of the HWF model embedded in well-child home visits in the state of Queensland. Aims are to evaluate (1) HWF effectiveness in reducing financial hardship and improving caregiver mental health, (2) cost-benefits of HWF, and (3) implementation factors necessary for broader scale-up.Methods This study is a pragmatic, cluster randomised controlled trial (RCT) involving 336 clients receiving well-child home visiting services across all active service regions in Queensland. 24 service areas (clusters) are allocated to either immediate ('now') or delayed ('next', after 12 months) screening for financial hardship by health home visitors. Caregivers who report financial hardship and consent to referral will be contacted by a financial counsellor. Aim 1 will compare the financial hardship and mental health outcomes between the randomised groups at 13-24 months. Using these outcome data and routine financial counselling data, Aim 2 will assess the costs of the program (measured through partner reports of time and materials used in provision of the intervention) against change in outcomes in the form of a cost-consequences analysis from a government perspective. For Aim 3, qualitative interviews with caregivers and service providers will explore experiences, barriers, and enablers of implementation.Discussion Ethical approval has been granted by the Western Sydney University (#H13834) and UnitingCare Queensland (#202504) Human Research Ethics Committees. Results will be disseminated to partners and policymakers, through meetings, reports, and through peer-reviewed publications and conference presentations. Findings will inform if and how financial counselling can be embedded and scaled within universal well-child healthcare services state-wide and nationally.Trial registration The trial is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12625001337460).
SN - 1471-2458
ER -