To determine the feasibility of a randomized controlled trial (RCT) evaluating the impact of community support worker (CSW) supported, structured review of financial supports and social system navigation.

A pilot RCT of parent-child dyads (1 parent and child aged 2–5 years old) endorsing the question “Do you ever have difficulty making ends meet at the end of the month?” was conducted in primary care in Kingston, Ontario, Canada. Interventions included CSW-supported social system navigation or control; both groups received a written summary of available resources. The primary outcome was feasibility, including recruitment, completion, and retention rates and intervention adherence and fidelity. Secondary outcomes were child social, emotional, and behavioral health (Strengths and Difficulties Scale [SDQ]) and parenting stress (Parenting Stress Index-IV [PSI]).

Of 74 eligible dyads, 37 (50%) were enrolled, mean (standard deviation [SD]) child age 35.4 (11.1) months and 57% were female. Outcomes were assessed on 29 participants (78%) at 6 months and 22 participants (60%) at 12 months. Participants randomized to the intervention arm met with the CSW a mean of 1.71 (SD 1.68) times, with a range of 0 to 5 meetings, including 35.7% who did not attend any meetings with the CSW. Using analysis of covariance, the mean between-group difference in the baseline adjusted SDQ Total Difficulties Score at 6 months was −1.21 (95% confidence interval [CI] −3.82, 1.40) and at 12 months was 1.10 (95% CI −3.13, 5.34), and in the baseline adjusted PSI Total Score at 6 months was −12.88 (95% CI −21.63, −4.12) and at 12 months was 7.79 (95% CI −4.42, 20.00).

Conducting a trial enrolling families of young children experiencing financial strain is feasible. A definitive trial with modifications is warranted and is underway.

clinicaltrials.gov NCT05667675.

health equity

poverty

primary care

social determinants of child health

© 2025 The Authors. Published by Elsevier, Inc. on behalf of Academic Pediatric Association.