Giving Resources to lOw-income Children to Enhance RecoverY (GROCERY): Protocol for a randomized control trial

BACKGROUND: Social and structural factors drive health disparities in children. Hospitalization of a child is stressful for families, especially for low-income families who may experience exacerbation of food insecurity and other financial hardships. There is a need to evaluate interventions to support low-income families after hospitalization to improve child health and family well-being and ultimately to reduce health disparities. OBJECTIVES: In this randomized control trial (RCT), we will compare the effectiveness of a post-discharge financial support intervention with standard resources on the primary outcomes of food insecurity and urgent healthcare reutilization over 12 months among low-income families of hospitalized children. METHODS: Families are eligible to participate if their child is hospitalized on our main Hospital Medicine unit between September 2024 and July 2025, <18 years old, and enrolled in our institution's Medicaid accountable care organization. Our planned sample size is 400, with a 3:1 control to intervention randomization. The intervention is monthly $100 gift cards to a grocery store chain, provided for 12 months after hospital discharge. Intervention and control participants are offered standard resources (i.e., social work referral) as needed. We will assess food insecurity through longitudinal surveys and urgent healthcare reutilization with claims data. Our secondary outcomes include family-centered measures, primary care utilization, and cost. RESULTS: We expect to complete primary analyses in the spring of 2027. CONCLUSIONS: In this RCT, we will evaluate the effectiveness of a post-discharge financial support intervention among low-income families. Findings may inform future high-value interventions, programs, and policies to support low-income families and children.