Article Text
Abstract
Background Since the introduction of the Child Poverty Act (2017) in Scotland, all health visitors, midwives and family nurses in Scotland are expected to screen and offer a financial advice referral to at-risk pregnant women and parents/carers of families with children under five in Scotland. The so-called ‘Financial Inclusion Pathway’ (FIP) emerged in 2019 as one of a number of strategies intended to tackle child poverty. At this early implementation stage, little is known about parents’ perspectives about the acceptability or impact of this initiative in relation to its aim.
Methods In 2020, low income parents with young children living in Aberdeen City were invited to take part in a qualitative study that aimed to determine any challenges they might face engaging with the FIP policy in practice, and their perspectives about financial discussions with professionals that could help to increase household incomes through this approach.One-to-one semi-structured telephone interviews lasting between 30–40 minutes took place during July and August 2020. Interviews were fully transcribed and thematically analysed.
Results Ten women, ranging from ages 20–41 years. Each participant had between one and five child(ren), ranging in age from 2 to 18 years and all had one child under school-age. All lived in multiply deprived postcode areas within Aberdeen City. Three main themes emerged: i. difficulties associated with discussing financial concerns; ii. how to talk about the issue; iii. intervention utility. Within each of these three main themes, nine-sub themes were apparent, ranging from those indicating potential unintended negative consequences, as well as intervention benefits.
Discussion Most participants considered health visitors to be a potentially good source of help about financial challenges; they were less clear about midwives’ role here. However, parents’ perceptions of the problems they may face associated with disclosing financial difficulties to health professionals, is a distinct barrier to conversations that could lead to a financial advice referral. Given the levels of unclaimed benefit in the UK, this is important to note. Establishing trust and rapport, careful and sensitive enquiry, and positive framing of financial maximisation were recommended to aid discussion of financial challenges. These findings are important given the current and predicted economic impact of the COVID-19. The study is limited by its sample size and recruitment site, but provides valuable insights to inform a larger scale investigation. The study also indicates the importance of understanding health professionals’ associated views and experiences.