Banking Status as a Moderator of Outcomes in a Randomized Controlled Trial Targeting Financial Stress and Smoking

Area of Science:

• Social Determinants of Health
• Health Behavior Interventions
• Financial Literacy

Background:

• Financial capability is an understudied social determinant of health (SDoH).
• Bank account ownership, an indicator of financial capability, is linked to better health outcomes.
• Limited research exists on the relationship between bank account ownership and health behaviors like tobacco use.

Purpose of the Study:

• To examine participant characteristics, intervention use, and outcomes in subgroups of unbanked and banked individuals.
• To assess the impact of an integrated financial coaching and SDoH referral intervention within smoking cessation treatment.
• To compare outcomes between intervention and control groups across banking statuses.

Main Methods:

• Secondary analysis of a randomized controlled trial (RCT) involving 257 low-income individuals.
• Intervention group received smoking cessation coaching, nicotine replacement therapy, money management coaching, and SDoH referrals.
• Control group received usual care; analyses compared baseline characteristics and intervention outcomes by banking status.

Main Results:

• 36% of participants were unbanked, with lower income, education, and higher unemployment.
• Intervention use was similar between unbanked and banked groups.
• Unbanked participants showed high abstinence rates regardless of group; banked participants in the intervention group had higher abstinence and reduced financial stress.

Conclusions:

• Being unbanked did not impede smoking cessation in this RCT.
• The integrated intervention effectively reduced financial stress and improved smoking cessation among banked participants.
• Further research is needed to develop tailored interventions for unbanked individuals' health and financial well-being.