Designing a generic, adaptive protocol resource for the measurement of health impact in cash transfer trials

Elliott Aidan Johnson, Matthew Thomas Johnson, Christodoulos Kypridemos, Aase Villadsen, Kate E. Pickett

Research output: Contribution to journalArticle



In the context of the COVID-19 pandemic, upstream interventions that tackle social determinants of health inequalities have never been more important. Evaluations of upstream cash transfer trials have failed to capture comprehensively the impacts that such systems might have on population health through inadequate design of the interventions themselves and failure to implement consistent, thorough research measures that can be used in microsimulations to model long-term impact. In this article, we describe the process of developing a generic, adaptive protocol resource to address this issue and the challenges involved in that process.


We outline two types of prospective intervention based on trials currently under discussion. In developing the remainder of the resource, we establish six key principles, implement a modular approach based on types of measure and their prospective resource intensity, and source (validated where possible) measures and baseline data primarily from routine collection and large, longitudinal cohort studies. Through these measures, we seek to cover all areas of health impact identified in our theoretical model.


We find that, in general, self-reported measures alongside routinely collected linked respondent data may provide data capable of demonstrating comprehensive health impact. However, we also suggest that, where possible, physiological measures should be included to elucidate underlying biological effects that may not be accurately captured through self-reporting alone and can enable modelling of long-term health outcomes.


We suggest that while Open Access evaluation instruments are available and usable to measure most constructs of interest, there remain some areas for which further development is necessary. This includes self-reported wellbeing measures that require paid licences but are used in a range of nationally important longitudinal studies instead of Open Access alternatives.
Original languageEnglish
JournalPilot and Feasibility Studies
Publication statusSubmitted - 15 Apr 2022
Externally publishedYes


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