![]() Some 40 years after The Black Report indicated means of affecting social determinants through tax-benefit policy, welfare has failed to promote health. In terms of taking forward findings to the design of pilots and main trials, feasibility studies, including the Welsh Government pilot of basic income for care leavers, will be necessary to establish (a) establish formal power calculations based on the outcomes and demographic groups of interest, and (b) the final costs of the intervention and evaluation, which will determine the specific modules and measures included. However, we recognise that their use will not be feasible for all studies and therefore offer Open Access alternatives, which may be capable of providing comparable data based on establishing common, evidenced, cut-off points for clinical significance or through their adoption on a widespread basis. We have included wellbeing measures that require paid licences but facilitate comparison with existing data. We present measures that enable trials to use existing data as a control and to create data that is generalisable to whole populations and can be used to model medium and long-term outcomes. ![]() There has been uncertainty about the feasibility of establishing common measures that permit generalisability of findings in specific cash transfer trials-here focusing on Universal Basic Income (UBI) in a UK context-and in development of large, longitudinal datasets, due to the broad range of self-reported and physiological measures currently used. 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. ![]() 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. A process of development and implementation of the resource in pilot and feasibility studies will support assessment of whether or not our proposed health outcome measures are acceptable, feasible and can be used with validity and reliability in the target population. In addition, accurate self-reported objective income data remains a challenge and requires further development and testing. 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 find that, in general, self-reported measures alongside routinely collected linked respondent data may provide a feasible means of producing data capable of demonstrating comprehensive health impact. Through these measures, we seek to cover all areas of health impact identified in our theoretical model for use in pilot and feasibility studies. 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. We outline two types of prospective intervention based on pilots and trials currently under discussion. It has particular application for trials of Universal Basic Income but can be adapted to those covering other kinds of cash transfer and welfare system changes. The resource is capable of further adaptation for use in low- and middle-income countries (LMIC). ![]() The resource is designed for use in high-income countries (HIC) but draws on examples from a UK context to illustrate means of development and deployment. 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. 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 the context of the COVID-19 pandemic, upstream interventions that tackle social determinants of health inequalities have never been more important. ![]()
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