Progress 10/01/19 to 09/30/20
Outputs
Target Audience:Consumers, Researcher, Practitioners and Policy Makers Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?A symposium "Integrating and Sustaining Financial Capability Services in Rural Healthcare Delivery: Consumers, Healthcare, Providers, and Systems Perspectives" was presented to consumer research scholars at a national conference. What do you plan to do during the next reporting period to accomplish the goals?Dr. Bartholomae will wrap up ongoing research projects and continue to focus on program development and evaluation research related to financial health and wellness.
Impacts
What was accomplished under these goals?
Overall impact statement: Addressing financial wellness is important because financially healthy families and households equates to strong communities. Dr. Bartholomae continues to provide leadership to several outreach and research projects to address financial wellness issues, including the intersection of financial and health behaviors and outcomes. Over 500 Iowans have been reached with financial literacy efforts that ultimately contribute to the improvement of their individual financial well-being. Objective 1... Understanding family resource management under uncertainties over life span. Dr. Bartholomae's primary work in FY 2020 has focused on outreach and program evaluation research, particularly to address pandemic related financial issues. Due to COVID-19, many Iowans find themselves suddenly out of work and struggling to pay their bills. To help Iowans navigate this crisis, starting in early April, Dr. Bartholomae co-led her team of family finance program specialists to offer one-on-one financial consultations. Between April and June, approximately 250 one-on-one consultations occurred, helping Iowans with information, resources and support about the denial of unemployment benefits, help obtaining their economic stimulus payment, concerns about credit repair and debt management, such as auto loans and mortgages, and struggles with unstable income, mortgage forbearance, or fraudulent credit card charges. Dr. Bartholomae leads program development and evaluation research related to retirement planning programs. First, COVID-19 has disrupted the retirement planning of many Americans. Due to constraints on businesses caused by COVID-19, some American have been offered early retirement packages, others may be considering early retirement due to job challenges, health concerns, or other reasons. Still others have been forced into involuntary retirement. At the same time, the CARES Act has created temporary changes to some common rules related to retirement accounts, making it easier for people to withdraw from their retirement accounts during 2020. In September, a new program, "Rethinking Your Retirement During COVID-19" was developed for Iowans. Since late September the program has reached over 50 Iowans, 67% of participants indicated they would take action and 82% would recommend the program to others. Second, Dr. Bartholomae works in a partnership collaboration with the Iowa Public Employee Retirement System (IPERS) to deliver Creating a Secure Retirement (CSR). To date, CSR has been delivered 29 times to over 700 IPERS members (2018: 2 programs; 2019 programs: 17; 2020: 10 programs. Based on statistical analyses, the program increased participant understanding of the retirement planning topics covered during the program. There was a significant increase in participants' knowledge and understanding on all six measures of the retirement topics covered by ISUEO and on all eight measures of the retirement topics covered by IPERS. Due to COVID-19, the program was converted to a virtual format. Since April, the six hour online program reached over 200 Iowans. Evaluation research indicated the program helped participants reduce stress and build confidence about retirement planning, 84% reported reduced stress concerning their ability to manage their finances during retirement. Participants impression of the online experience included "It gave me the opportunity to have my personal information at hand to calculate based on my information as the program progressed", and "I was very impressed with the format today as well as the enormous amount of information that was provided for consumption and planning"). Other examples of program feedback included "Great overview of different aspects of preparing for retirement", "I really liked the combination of IPERS, Social Security, and Investing. Helps to combine those areas and how to balance the importance of each. Thank you." Dr. Bartholomae and her family finance team continue to delivery timely and relevant programming to Iowans to help them address their needs and concerns related to retirement planning during the pandemic and beyond. Objective 2... Identifying personal characteristics and contextual factors contributing to household financial and health decisions. Dr. Bartholomae collaborated on a multi-state investigation that uses a text message intervention to assist student loan borrowers with repayment decisions. Six Midwestern universities delivered the text campaign that included message threads designed as a personalized dialogue with participants about their student loan and repayment options. In aggregate, 587 graduates completed the pre-survey baseline data and signed up to receive text messages. One hundred and forty-five (25%) engaged in the first batch of text messages, 118 (20%) in batch two, and 95 (16%) engaged in batches three and four. A total of 58 of participants took the post-survey, 15 of them by participating in the full Qualtrics survey and 43 responding to the message text survey. Using the SMS post-survey preliminary results (n=43), over half of the respondents (n=25) found that the text messaging campaign was useful, with roughly one-quarter unsure of the usefulness of the intervention (n=9). Dr. Bartholomae co-published a manuscript about the text campaign and shared several important practices that can assist professionals who are interested in conducting their own text campaign regardless of the topic or behavior. Dr. Bartholomae is investigating whether financial distress predicts forgone healthcare services-- unfilled prescriptions, skipped medical tests, treatments, or follow-ups, and absence of attention to medical problems-- due to the cost, all of which have long-term health consequences. Using data from the National Financial Capability Study, NC-2172 scholars examine the financial trade-off households make when facing financial distress. This research will help inform consumer practices related to health care consumption and household resource management. Objective 3... Understanding how financial capability affects household health decisions and outcomes. Dr. Bartholomae led the development of a manuscript and symposia presentation "Rural Healthcare Providers' Perceptions about Integrating Financial Capability Services into Delivery'. The symposium first addressed the question 'Would consumers benefit from an integration of financial capability supports into rural healthcare?. The question examined healthcare costs from the consumer and health care provider's perspectives. The second half of the symposium examined the question 'What capacity requirements and system features can help develop and sustain a partnership between rural health systems and financial capability support services?'. Dr. Bartholomae presented focus group findings that explore healthcare providers' perspectives about integration. The symposium engaged approximately 50 consumer research scholars interested in healthcare decisions on the topic. Dr. Bartholomae initiated a collaboration to develop a systematic review of medical debt. A review of literature will describe the prevalence of medical debt, the association of medical debt with individual and household outcomes, and demonstrate its relevant consumer well-being. A systematic review will identify current practices, as well as relevant policies and consumer rights related to medical debt. No other review on medical debt exists, this work will help inform consumer programs and practice related to medical debt. Objective 4... Understanding how health conditions affect household financial decisions. This objective has not been addressed yet.
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2020
Citation:
Johnson, C., Bartholomae, S., Serido, J., Katras, M.J., & Tobie, E. (2020) Launching a text message intervention to assist student loan borrowers with repayment decisions, Family & Consumer Sciences Research Journal. DOI: 10.1111/fcsr.12349
- Type:
Journal Articles
Status:
Published
Year Published:
2019
Citation:
Kiss, D.E., Bartholomae, S., Johnson, C., ONeill, B., Xu, Y., & Gutter, M.S. (2019). Conceptualizing health and financial wellness: Using facilitated discussion to collect input from professionals. The Forum for Family and Consumer Issues, 22, 1. https://www.theforumjournal.org/2019/09/30/conceptualizing-health-and-financial-wellness-using-facilitated-discussion-to-collect-input-from-professionals/
- Type:
Journal Articles
Status:
Published
Year Published:
2019
Citation:
Bartholomae, S., (2019). Introduction to the Special Issues on Student Loan Debt. Journal of Family and Economic Issues, 40(1), 1-2. https://doi.org/10.1007/s10834-019-09608-4
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2020
Citation:
Bartholomae, S., Collins, J.M., C. Janney, C. Johnson, D.E. Kiss (2020). Integrating and Sustaining Financial Capability Services in Rural Healthcare Delivery: Consumers, Healthcare Providers, and Systems Perspectives. Consumer Interests Annual, 66, N. Porto (Ed.). Proceedings American Council on Consumer Interest, Moved from Washington, DC to Online. https://www.consumerinterests.org/cia2020
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Progress 10/01/18 to 09/30/19
Outputs
Target Audience:Nurses located in mostly rural areas of Iowa were reached through focus group discussions. IowaState University Extension and Outreach Family Finance program specialists are an important audience for dissemination of Dr. Bartholomae's work. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?
Nothing Reported
How have the results been disseminated to communities of interest?A webinar that included a discussion about the focus groups with Iowa nurses was delivered in November 2019, facilitated by the Michigan State North Central Regional Center for Rural Development. What do you plan to do during the next reporting period to accomplish the goals?Dr. Bartholomae will finish the ongoing research projects.
Impacts
What was accomplished under these goals?
Overall impact statement: Dr. Bartholomae is leading several projects to examine the intersection of financial and health behaviors and outcomes. Focus group work with Iowa nurses brought awareness to this issue and provided insight into future collaborations between Extension and the healthcare system. Research with secondary datasets provides insights into the importance of consumer's health and financial literacy as well as consumer decision making, providing implications to support existing and future extension programming. Objective 1... Understanding family resource management under uncertainties over life span. Dr. Bartholomae is leading a study that formally investigates whether financial distress predicts forgone healthcare services-- unfilled prescriptions, skipped medical tests, treatments, or follow-ups, and absence of attention to medical problems-- due to the cost, all of which have long-term health consequences. We use data from the 2015 and 2018 National Financial Capability Study, an online survey of 54,655 American adults weighted to be nationally representative. Due to missing cases, the sample was reduced to 45,296. Dr. Bartholomae is analyzing the financial trade-off households make when facing financial distress. Using a mediation model, we will examine factors that could mitigate the impact of financial distress on forgone health care. In addition, the National Financial Capability Study is made up of state-by-state survey data that allow Dr. Bartholomae to examine the issue of foregone healthcare among Iowans. Iowa data will be broken out to and shared with ISUEO family finance educators, allowing this research to inform programming that addresses the financial security of Iowans. Objective 2... Identifying personal characteristics and contextual factors contributing to household financial and health decisions. Dr. Bartholomae led an investigation into contextual factors by conducting three online focus groups with rural Iowa nurses (N=13). The research documented nurses' 1) observations of the influence of financial capability on patients' healthcare access, 2) knowledge of current resources (or lack thereof) to support patients' financial capability, and 3) attitudes and suggestions for integrating financial capability services into healthcare systems. There were several major focus group findings. Nurses had consensus around the need for resources to support patients' financial capability. Nurses do not feel well positioned to address patients' financial needs, but would offer materials and resources if they had any. Nurses expressed a strong interest in financial education supports for patients and see an opportunity in referring patients to services outside the healthcare setting. The findings present an opportunity for future collaboration between ISUEO and healthcare partners. Objective 3... Understanding how financial capability affects household health decisions and outcomes. Dr. Bartholomae is advancing a paper that examines the intersection of financial literacy and health literacy. Health and financial resources are closely intertwined in later life and health literacy and financial literacy are linked to better health and financial outcomes, respectively. Limited studies have examined the extent to which individuals have both health literacy and financial literacy. We use data from the Wisconsin Longitudinal Study (WLS), a one-third random sample of 1957 Wisconsin high school graduates (most born in 1939). The WLS' rich array of covariates from across the life course enables us to examine a variety of potential predictors of financial literacy and health literacy, reflecting knowledge and skills that individuals acquire across their lives. Surveys were conducted in 1957 (age 18), 1964 (age 25), 1975 (age 35), 1992 (age 53), 2004 (age 65), and 2011 (age 71). We use multinomial logistic regression models to explore factors associated with financial literacy-health literacy profiles (both high health literacy and financial literacy, high health literacy only, high financial literacy only, and neither high health literacy nor financial literacy) at age 71. Forty-three percent of respondents had high levels of both health literacy and financial literacy while the remainder was about equally distributed among the other profiles. Female gender; low education; low IQ test scores in adolescence; low high school class rank; low net worth; not owning investments; and lower cognitive performance in adulthood were independent risk factors for having both low health literacy and financial literacy (versus having high levels of both). As decision-making responsibilities in both the health care and financial services sectors increasingly fall on individuals, having adequate levels of both health literacy and financial literacy becomes increasingly important. This works helps inform Dr. Bartholomae's outreach program supporting health insurance literacy among Iowans. Objective 4... Understanding how health conditions affect household financial decisions. This objective has not been addressed yet, we are only in year 1.
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2018
Citation:
Kiss, D.E., Bartholomae, S., Johnson, C., ONeill, B., Xu, Y., & Gutter, M.S. (2018). Conceptualizing health and financial wellness: Using facilitated discussion to collect input from professionals. The Forum for Family and Consumer Issues, 22, 1. https://www.theforumjournal.org/2019/09/30/conceptualizing-health-and-financial-wellness-using-facilitated-discussion-to-collect-input-from-professionals/
- Type:
Journal Articles
Status:
Published
Year Published:
2019
Citation:
Bartholomae, S., Kiss, D.E., Jurgenson, J., ONeill, B., Worthy, S., & Kim, J. (2019). Examining gender bias in judging student loan borrowing: An experimental survey on the effect of framing. Submitted to Journal of Family and Economic Issue Special Issue on Student Loans.
- Type:
Conference Papers and Presentations
Status:
Other
Year Published:
2018
Citation:
Bartholomae, S., Xu, Y., Kiss, D.E., ONeill, B., Gutter, M.S. & Evans, D. (2018). Financial distress and foregone healthcare. Symposium at the annual meeting of the American Council on Consumer Interest, Clearwater, FL.
- Type:
Conference Papers and Presentations
Status:
Other
Year Published:
2018
Citation:
Kiss, D.E., Xu, Y., Bartholomae, S., ONeill, B., & Gutter, M.S. (2018). Exploring the Intersections of Health and Financial Wellness. National Health Outreach Conference. Minneapolis, MN.
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