COIN: A Pilot Study of Cash Transfers to Improve Outcomes in Low-Income Preterm Neonates and Their Families
COIN was a pilot randomized controlled trial run by PolicyLab, the research arm of Children's Hospital of Philadelphia (CHOP), in partnership with the University of Pennsylvania. It randomized 24 Medicaid-eligible birthing parents of preterm infants in a single Philadelphia-area NICU to either a high-value ($325/month) or low-value ($25/month) unconditional cash transfer for four months. The study was funded by a CHOP PolicyLab Pilot Grant and NIH NHLBI T32 training grants. It tested the feasibility and acceptability of randomizing UCTs in a NICU setting and explored impacts on caregiver psychological stress. Results were published in the Journal of Perinatology (2025) and a companion qualitative study in Academic Pediatrics (2026).
NICU, Preterm Infants, Guaranteed Income Research, Feasibility Study, Medicaid-Eligible Parents, Randomized Controlled Trial, Pennsylvania
Headquarters
- Organization Name
- PolicyLab, Children's Hospital of Philadelphia
- City
- Philadelphia
- State / Province
- Pennsylvania
- Country
- United States
Contact
- Website
- https://policylab.chop.edu/
Status & Funding
- Organization status
- Active
- Program status
- Inactive
- Application status
- Timed
- Number of recipients
- 24
- Funding type
- Research Pilot, Government, Nonprofit
Benefits
- Currency Type
- Fiat
- Currency
- USD
- Total Amount
- 1,300 USD
- Avg. Per Month
- 325 USD
- Payment frequency
- Monthly
- How long the program lasts
- 4 months
- Benefit details
Participants were randomized to one of two arms: a high-value arm receiving four monthly payments of $325 (total $1,300), or an active-control low-value arm receiving four monthly payments of $25 (total $100). Payments were disbursed unconditionally (no strings attached) at enrollment (birth to 4 weeks of age), and on the infant's one-, two-, and three-month birthdays. The seed data's $325 amount reflects only the high-value/intervention arm; not all 24 participants received that amount.
Eligibility
Overview
- Eligibility details
Eligible participants were birthing parents who were Medicaid-insured or uninsured but met Medicaid income-eligibility requirements, over 18 years old, fluent in English or Spanish, residents of Philadelphia County, with an infant born between 22 and less than 36 weeks gestational age and admitted to the CHOP or Hospital of the University of Pennsylvania NICU. Excluded were parents highly likely to move out of state within 12 months or planning to place the infant for adoption.
Demographics
- Minimum age
- 18
- Language
- English, Spanish
Family
- Family Status
- Parent
- Number of dependents (minimum)
- 1
Health
- Health conditions
- Infant born preterm (22 to <36 weeks gestational age), admitted to NICU
Financial
- Currently receiving government benefits
- Required
Geography
- US states covered
- Pennsylvania
- Countries covered
- United States
- Cities covered
- Philadelphia
- Counties covered
- Philadelphia
- Residency of Target Geography
- Yes
Participation
- Research / data sharing
- Required
- Research / participation requirements
Sponsored by Children's Hospital of Philadelphia with the University of Pennsylvania as collaborator; Principal Investigator Andrea Duncan, MD (CHOP/University of Pennsylvania). Registered on ClinicalTrials.gov as NCT05930327; enrolled 24 birthing parent-infant dyads (July-November 2023). Participants completed surveys and semi-structured interviews as part of the research protocol. Published findings (J Perinatol, 2025) found the high-value UCT arm feasible and universally acceptable, with participants reporting high financial strain, stress, and depressive symptoms; a companion qualitative study (Acad Pediatr, 2026) of 16 parents found most preferred cash delivered via debit card biweekly starting soon after birth.
Application Process
- How to apply
Study completed and no longer enrolling. Participants were recruited and enrolled directly through the CHOP and Hospital of the University of Pennsylvania NICUs by study staff; there was no public/open application process.
- Selection process
Eligible Medicaid-eligible birthing parents of preterm infants admitted to the CHOP or HUP NICU were identified, consented, and randomly assigned 1:1 to either the high-value ($325/month) or low-value ($25/month) unconditional cash transfer arm.
