Unconditional Cash Transfers for Medicaid Eligible Parents of Preterm Infants: A Qualitative Study within a Pilot...

Emerging evidence has demonstrated mixed results regarding the ability of unconditional cash transfers to intervene on the pathway between poverty and adverse term infant outcomes. Parents of preterm infants with lower incomes endure significant financial and psychological stress, yet only a single study has examined the impact of unconditional cash transfers in preterm infants. This study aimed to investigate parents' 1) experiences of the financial impact of having an infant in the neonatal intensive care unit (NICU), 2) perceptions of the impact of monthly unconditional cash transfers distributed as part of a pilot randomized controlled trial, and 3) perceptions of a NICU-based unconditional cash transfer program.

This qualitative study contains 16 parents from a pilot randomized controlled trial of unconditional cash transfers to parent-infant dyads with Medicaid-eligible income. Parents participated in semi-structured interviews analyzed using a hybrid deductive-inductive approach.

Parents described significant financial and mental stress during and after the NICU admission. Many perceived that an unconditional cash transfer program mitigated this stress. Unconditional cash transfers were used mostly on baby and family items. Unconditional cash transfers also were associated with a sense of relief and, in some cases, increased trust. Most parents prefer that the unconditional cash transfers be delivered by debit card biweekly starting soon after birth.

Parents of preterm infants that are Medicaid-eligible felt that a NICU-based unconditional cash transfer program provided relief from the financial and mental stress of the NICU. Future, larger studies should examine the impacts of unconditional cash transfers on neonatal and birthing parent outcomes, and trust in the NICU.