Grant: Travel Awards - Institute Community Support

In response to the severe and unintended drug-related harms resulting from synchronized income assistance disbursement, we have initiated a randomized controlled trial of a structural intervention that examines whether changing the timing and frequency of disbursement can mitigate these harms. This study adopts a healthy equity theoretical framework that links institutional capacity and design to the production of inequities in health outcomes for disadvantaged populations. It partners with Pigeon Park Savings (PPS), a community branch of VanCity Savings and Credit Union operated by PHS Community Services Society, to deliver an intervention that varies when income assistance funds are released. Two hundred seventy-three volunteer study participants will be randomly allocated for six social assistance cycles to a control or one of two intervention arms. Intervention arm participants will have their income assistance deposited directly into a personalized account at PPS and released: (1) monthly; or (2) semi-monthly, in each case on days that do not fall during the week of cheque issue. Bi-weekly follow up interviews will collect participant information on key outcomes of interest, including drug use, drug related harm (e.g. non-fatal overdose), health and social service utilization, interactions with police, and financial management practices. Self-reported data will be supplemented with participant information from health, financial, police and government databases. Outcomes will be compared between control and intervention arms to identify potential impacts of alternative disbursement schedules on severe and unintended escalations in drug-related harm resulting from synchronized income assistance. The study holds significant potential to provide evidence that leveraging social policy levers can improve population health outcomes and service provision for disadvantaged populations.