Voucher Program Research Articles

Exploring the impact of a maternal support grant to improve mental health and food security amongst pregnant women in South Africa during the COVID‐19 pandemic

AbstractSocial protection during pregnancy may support pregnant women struggling to meet basic needs to ensure a healthy pregnancy and buffer negative impacts of multiple adversities. We assessed the effect of a bimonthly digital food voucher, delivered to pregnant women during the COVID‐19 pandemic in the Cape Town area, on their mental health, hunger, and dietary diversity. Pregnant women from antenatal clinics in specific high‐poverty areas were invited to join the voucher program; a subset was recruited for in‐depth telephone interviews. Interviews were conducted before, during, and after voucher distribution. Generalized estimating equations were fit to examine whether each outcome was associated with voucher exposure over time. Of the 205 participants, most were aged 25–34, not recently employed, with at least one child in their household. Approximately 1/3 were first‐time mothers and 32% reported mental health difficulties. Voucher exposure over 12 months was associated with significant reductions in mental health symptoms at midline and endline. Maternal hunger was reduced at midline and endline. High mental health scores were significantly associated with increased maternal hunger after adjusting for potential confounders. This study provides preliminary evidence for income support during pregnancy to shape positive health outcomes in South Africa.

“This Voicemail Box Is Full”: Landlord Perceptions of Communication Issues as a Key Challenge to Participating in the Housing Choice Voucher Program

The Housing Choice Voucher (HCV) program, which is the largest rental subsidy program in the United States, relies on the participation of landlords. Research shows, however, that not all landlords are willing to participate. The present study analyzes qualitative, semi-structured interviews conducted with landlords (N = 25) in an effort to deepen our understanding of their experiences with the HCV program, and specifically, to explore the challenges they face in communicating with the public housing authority (PHA). The sample comes from a city where the financial incentive to participate is not strong, and a lack of source of income protections makes landlord participation more voluntary. Landlords reported communication issues with the local PHA as one of the biggest challenges of working with the program—specifically, difficulty interacting with staff and accessing program information. Ultimately, these communication issues created negative experiences for landlords, characterized by frustration and feeling unsupported, which led some to reduce their participation. These findings suggest a need to improve communication between PHAs and currently participating landlords, especially in light of recent expansions in the HCV program.

The Potential for Race Discrimination in Voucher Programs in a Post-Carson World

ABSTRACT Between 2017 and 2022, the U.S. Supreme Court examined three cases that involved states that tried to limit the use of public money to support religious-affiliated schools. The Supreme Court found a violation of the Free Exercise Clause in all three cases. Although not the focus of the Court’s opinions, these cases may have created avenues for discriminatory practices in publicly funded state school voucher programs. In elevating free-exercise rights above Establishment Clause concerns, the Court’s decisions may have serious implications for students’ civil rights in schools. This article specifically examines whether the growth of school voucher programs in the context of these recent Supreme Court decisions creates a pathway for racial discrimination in participating voucher schools. We first explore the impact of the three Supreme Court decisions. Specifically, we argue that when the Court eliminated distinctions between policies denying funding because of religious status and policies denying funding for religious uses and when it elevated free-exercise arguments, it may have opened additional avenues for discrimination. Thus, we next address whether participating voucher schools can refuse admission to Black students. To set the context for this discussion, we provide a brief historical analysis of case law that has previously supported race-based discrimination on religious grounds. We show that although past court cases and federal tax policy have created a bulwark against such discrimination, the recent rulings favoring free exercise rights raise concerns. If free-exercise rights trump civil rights, some voucher statutes may create an alternative funding stream for modern-day “segregation academies.”

Preferences for Food Vouchers Among Adults with Low Incomes

ABSTRACT There is growing interest in understanding the optimal design of food voucher programs to impchange the word “All foods” in the Table to “SNAP-eligible” to be consistent with the language used in Table 2 and Figure 1rove diet quality and support chronic disease self-management. We examined preferences for voucher program design among adults with low incomes who participated in a randomized trial. Participants preferred vouchers eligible for all foods over those restricted to fruits and vegetables (p = .001) and a monthly over weekly redemption schedule (p = .003). Preferences differed significantly by voucher assignment (pinteraction < 0.0001 for both), with those assigned to the fruit and vegetable voucher more likely to prefer that voucher. Flexibility was identified as a key driver of preference.

Exploring the association between household compositional change and mobility of subsidized householders in the United States: A life course perspective

ABSTRACT This study examines the relationship between household compositional change and residential mobility of subsidized householders. Data from the U.S. Department of Housing and Urban Development Annual Longitudinal Files 2005–2018 is used to measure household compositional change and mobility for subsidized householders in the Public Housing and Housing Choice Voucher programs. Householders are 67% more likely to move when a change in household composition occurs. Members entering the household induce larger estimated mobility effects than members exiting the household. Although the odds that a householder move are associated with a household compositional change is greatest in the Housing Choice Voucher program for tenant-based vouchers, there is still a strong association with household compositional changes and mobility in Public Housing and for project-based voucher units where options for mobility are limited. The results have implications for future research on program design factors such as occupancy standards in subsidized housing in the United States.

Impact of Priority Review Voucher Eligibility on Research and Development of Medical Countermeasures.

The priority review voucher was established to incentivize research and development of treatments for traditionally underfunded diseases and was extended to medical countermeasures from 2016 to 2023, despite limited evidence of an association between the voucher program and increased product development. To determine whether the voucher program has incentivized initiation of new medical countermeasures in clinical trials, we created three cohorts of material threats: (i) COVID-19, (ii) opioid pharmaceutical-based agents, and (iii) all others. Using the Citeline Trialtrove database, we determined the number of medical countermeasures initiated in clinical trials from 2009-2016 and 2017-2023. Eligibility of COVID-19 products for the voucher was confirmed with the issuance of a voucher for remdesivir in October 2020, so we compared January 2020-October 2020 to November 2020-July 2023. We fit two Poisson models-before and after voucher creation-within each cohort. Among COVID-19 medical countermeasures, there was a decrease in the proportion of drugs initiated before (4.5%; 95% CI, 1.0 to 8.3%) vs. after voucher eligibility (-5.1%; 95% CI, -6.1 to -4.0%) (P = 0.01). Among opioid pharmaceutical-based agents medical countermeasures, the rate of new drugs initiated did not change from 2009-2016 (8.1%, 95% CI, -4.4 to 22.6%) to 2017-2023 (5.6%; 95% CI, -3.2 to 15.2%) (P = 0.82). Among all other medical countermeasures, the rate of new drugs initiated also did not change from 2009-2016 (6.6%; 95% CI, -5.6 to 20.8%) to 2017-2023 (-14.8%; 95% CI, -29.2 to 2.0%) (P = 0.15). The priority review voucher program was not associated with stimulating new clinical testing of investigational medical countermeasures.

Status and Compliance of Senior High School Voucher Program among Private Schools in NCR: A Quality Assurance Review

The Enhanced Basic Education Act of 2013, often known as K to 12, was introduced by Republic Act10533. The SHS voucher program is a mechanism to provide financial assistance to qualified students while also decongesting public schools and promoting partnerships with private schools. In response to the mandate of RA 10533 to expand Government Assistance to Students and Teachers in Private Education (E-GASTPE), the Department of Education (DepEd) introduced the Senior High School Voucher Program. This demonstrates that condensing the 12 years of education taught around the world into 10 years of education in the Philippines has been a struggle for students and teachers seeking to meet global standards; thus, the goal of the study is to uncover implementation issues, show best practices, and recommend appropriate interventions that can improve the execution of the Senior High School Voucher Program among Metro Manila private schools. The study utilized a descriptive method of research and descriptive correlational design. The study was participated by the DepEd Officials/Employees, School Administrators, and Stakeholders. This demonstrates that condensing the 12 years of education taught around the world into 10 years of education in the Philippines has been a struggle for students and teachers seeking to meet global standards; thus, the goal of the study is to uncover implementation issues, show best practices, and recommend appropriate interventions that can improve the execution of the Senior High School Voucher Program among Metro Manila private schools.

Parent/carer experiences and challenges in redeeming the First Lap swimming lesson voucher in New South Wales, Australia

ABSTRACT Rationale Swimming is a popular, enjoyable, and important form of physical activity. Swimming skills play a vital role in water safety and drowning prevention, particularly among young children. The First Lap program is a New South Wales government swimming lesson subsidy voucher program for preschool-aged children. This study examined parent/carer program views and experiences in 2021–2022, specifically reasons for voucher non-redemption. Approach A thematic analysis examined 1031 parent/carer qualitative responses concerning reasons for voucher non-redemption and overall views and experiences of the program in an online parent/carer survey.Findings: Voucher non-redemption was evident through: seasonal, weather and health; program parameter; parent/carer (user); and swim school (provider) themes. Despite non-redemption, parent/carer program views were additionally evident through: positive feedback about the program and its objectives; evidence of knowledge and awareness of the importance of water safety and learning to swim; lesson affordability concerns. Practical implications Swim school and lesson availability, accessibility, and affordability can be addressed through clear engagement and communication with both the user and provider sides. Research contribution Reasons for First Lap voucher non-redemption represent barriers to swimming lesson participation for preschool-aged children. Originality Voucher programs must consider the impacts of the broader socio-ecological context and ecosystem.

Veterinary and pet owner perspectives on addressing access to veterinary care and workforce challenges.

(1) Assess and compare the perceptions of pet owners and veterinary professionals pertaining to the extent of veterinary workforce and access to care challenges in 2023 in Colorado, and (2) Assess what programs, policies, and resources veterinary professionals and pet owners believe would be most effective at addressing access to care and workforce challenges in Colorado. 736 veterinarians, veterinary technicians, or practice/owner manager ("veterinary professionals") in Colorado. A total of 1,209 pet owners (919 from an online survey and 290 from in-person surveying). Distribution of an online anonymous survey to veterinary professionals in Colorado. Pet owners were surveyed both online and in-person at pet pantry or shelter events. Veterinary professionals reported significant workforce challenges, including having to frequently divert clients, clients forced to decline medical care or having to euthanize their pets due to cost. Veterinary professionals were especially supportive of policy efforts to enhance recruitment and retention of technicians, including through mechanisms such as clarifying their scope of practice, loan repayment programs, and enhancing career pathways. Colorado pet owners' responses pertaining to the scope of access to care challenges were similar to prior national research. Pet owners reported particularly needing low-cost emergency clinics in their community as well as resources to reduce the cost of care. Pet owners were generally supportive of expanding veterinary care access through telemedicine; indicating they would feel comfortable seeing a veterinarian via telemedicine, even for the first time, and that expanded use of telemedicine would increase their ability to obtain care. Colorado pet owners and veterinary professionals both identified numerous access to care challenges as well as indicated support for the development of several potential initiatives to address the problem. Low-cost clinics that provide sick and emergency care was the resource rated as being most helpful among pet owners. Further exploration of grants, voucher programs, expansion of telemedicine, increased utilization and title protection for CVTs, and the creation of the veterinary professional associate position are all initiatives that were noted to be worthy of further exploration.

Pennsylvania

Amid partisan disagreement over the creation of a $100 million private school voucher program, Pennsylvania lawmakers did not pass a Commonwealth Budget by the start of the 2023–24 fiscal year. A $45.5 billion state budget was eventually signed by Governor Josh Shapiro in early August. However, lawmakers remain divided over the accompanying legislation needed to distribute some of the funds included in the enacted budget.

Food Purchasing Behavior of Predominantly Minority Families in an Urban Supermarket Voucher Pilot Program.

The objective of this exploratory community-based trial was to examine the usage and behavior of underserved urban residents participating in a 2-month food voucher program. $70 supermarket vouchers were provided each month for 2 months to participants enrolled in selected child daycare centers in East Harlem, New York, and receipts were collected to examine purchases. Participants were from low-income households with at least 1 child 5 years and younger (n = 113). Participants spent the most on meat, fish, poultry, and eggs (29.7%); fruits and vegetables (15.9%); and cereal and bakery products (15.1%). Fruit and vegetable purchases and dairy purchases were higher in foreign-born participants than in US-born participants. Furthermore, future models should consider the potential benefit of unrestricted vouchers in supporting differences in dietary needs and preferences.

Evaluation of Financial Interventions in Breast Cancer Care Worldwide: A Systematic Review.

Out-of-pocket costs are burdensome for breast cancer patients. Cost-reducing interventions, though implemented, have unclear comparative efficacy. This study aimed to critically evaluate characteristics of successful versus unsuccessful interventions designed to decrease out-of-pocket costs for breast cancer patients. A systematic review was conducted in accordance with the PRISMA checklist. Embase, PubMed, Global Index Medicus, and Global Health were queried from inception to February 2021. Articles describing a financial intervention targeting costs for breast cancer screening, diagnosis, or treatment and addressing clinical or patient-level financial outcomes were included. Methodological quality was evaluated using the QualSyst tool. Interventions were organized in accordance with timing of implementation, with narrative description of intervention type, success, and outcomes. Of the 11,086 articles retrieved, 21 were included in this review. Of these, 14 consisted of interventions during screening, and seven during diagnosis or treatment. Free/subsidized screening mammography was the most common screening intervention; 91% of these programs documented successful outcomes. Patient navigation and gift voucher programs demonstrated mixed success. The most successful intervention implemented during diagnosis/treatment was reducing medication costs. Low-cost programs and direct patient financial assistance were also successful. Limitations included lack of standardization in outcome metrics across studies. Financial interventions reducing prices through free screening mammography and decreasing medication costs were most successful. Less successful interventions were not contextually tailored, including gift card incentivization and low-cost treatment modalities. These findings can facilitate implementation of broader, more generalizable programs to reduce costs and improve outcomes during evaluation and management of breast cancer.

Fix‐it voucher program aims to improve road safety, ease student stress

Improving campus safety can have wide‐ranging benefits for the community at large. That was the ethos behind the new Fix‐a‐Falcon Bulb Replacement Program at the Solano Community College Department of Public Safety, which allows students to use vouchers to deal with vehicle bulb replacement‐related safety violations.

Analysis of the first ten years of FDA’s rare pediatric disease priority review voucher program: designations, diseases, and drug development

BackgroundThe Rare Pediatric Disease (RPD) Priority Review Voucher (PRV) Program was enacted in 2012 to support the development of new products for children. Prior to requesting a voucher, applicants can request RPD designation, which confirms their product treats or prevents a rare disease in which the serious manifestations primarily affect children. This study describes the trends and characteristics of these designations. Details of RPD designations are not publicly disclosable; this research represents the first analysis of the RPD designation component of the program.ResultsWe used an internal US Food and Drug Administration database to analyze all RPD designations between 2013 and 2022. Multiple characteristics were analyzed, including the diseases targeted by RPD designation, whether the product targeted a neonatal disease, product type (drug/biologic), and the level of evidence (preclinical/clinical) to support designation. There were 569 RPD designations during the study period. The top therapeutic areas were neurology (26%, n = 149), metabolism (23%, n = 131), oncology (18%, n = 105). The top diseases targeted by RPD designation were Duchenne muscular dystrophy, neuroblastoma, and sickle cell disease. Neonatology products represented 6% (n = 33), over half were for drug products and 38% were supported by clinical data.ConclusionsThe RPD PRV program was created to encourage development of new products for children. The results of this study establish that a wide range of diseases have seen development—from rare pediatric cancers to rare genetic disorders. Continued support of product development for children with rare diseases is needed to find treatments for all children with unmet needs.

Exposing Pittsburgh Landlords To Asset-Framing Narratives: An Experiment To Increase Housing Voucher Participation.

Landlords are essential actors within the rental housing market, and there is much to be learned about their willingness to participate in rental assistance programs that improve access to stable housing. Because the success of these programs, such as the Mobility (Location-Based) Voucher program in Pittsburgh, Pennsylvania, can be derailed by landlord opposition, it is important to test strategies that increase landlords' participation. Using data from a unique survey of Pittsburgh landlords, we found that exposing landlords to an asset-framing narrative that highlighted the social, economic, and health benefits of receiving a mobility voucher increased landlords' reported willingness to rent to a mobility voucher recipient by 21percentage points. Reported willingness was also higher among landlords who believed that housing affordability was connected to health. Our findings offer insight into how to increase landlords' participation in affordable housing programs that require their engagement to succeed.

Leveraging accessibility modeling to improve housing equity for low-income assisted renters: A case study in Bridgeport, Connecticut

The Housing Choice Voucher Program (HCVP) in the United States assists low-income households with a rent voucher to be redeemed in the private rental market. However, public housing authorities in certain states, such as Connecticut, may impose geographic restrictions that we coin as the “same-jurisdiction rule,” when implementing the HCVP. In practice, this constraint is translated to the requirement that assisted households must lease up within the same jurisdiction, which may eventually restrict access to high-quality housing or prevent relocation to higher-opportunity neighborhoods. To identify ways for policy improvement, we adopt the two-step floating catchment area method to evaluate the accessibility to HCVP-eligible housing in Bridgeport, Connecticut with and without the same-jurisdiction rule. The results indicate that when the geographic restrictions are lifted, there is a 9.23 % increase in median accessibility, and the increase is more significant in low-accessibility areas, which are often lower-opportunity neighborhoods. The results suggest that removing the same-jurisdiction rule can result in more housing options and thus improve housing equity for assisted renters. Since the HCVP and other rental assistance programs are spatial-driven, we call for establishing an operational workflow to corroborate the rigor of these programs to improve housing equity for low-income households.

Implementation of Joint Delivery Voucher Program Through Blended Reinforcement Activity for Competency Enhancement (Project BRACE)

The world was severely affected by the Covid-19 pandemic which brings chaos and uncertainty to everyone in society including the Education Sector. With the ongoing lockdowns and restrictions in different parts of the country, the education sector never stops pursuing to deliver the best kind of training and enhancement activities to the learners especially the Senior High School of the Technical Vocational Livelihood Track of Mataas na Paaralang Neptali A. Gonzales through Project BRACE (Blended Reinforcement Activity for Competency Enhancement). The researchers anchor this study on the selected Joint Delivery Voucher Program (JDVP) scholars as to the basis for the development of knowledge, skills, and attitudes in enhancing their competencies in Cookery. The purpose of this study is to use blended reinforcement activities through Online Distance Learning and Modular Distance Learning Approaches to assist those students who were not able to catch up on lessons due to some work, poor internet connection, and struggling students. This is in support of our School Division Mantra: “Batang Mandunong Walang Maiiwan, Lahat Kabahagi ng Bilang”. The effectiveness of the program is being measured by getting the level of performance of the respondents as revealed by their mean grades before and after the implementation of Project BRACE. The researchers collected the TVL final grades of the 32 beneficiaries of Cookery from their respective advisers and the grade given by their Work Immersion TechVoc Institution during the JDVP Program. Consolidated grades of each competency were recorded and computed to get the Mean grades in both sources to determine the level of performance of the learners before and after Project BRACE. Based on the overall interpretation of the Mean having the mean average of 4.67, the respondents’ level of acceptability of JDVP through Project BRACE is “Strongly Agree”. Therefore, the objective of the program was met. As a result of the Focused Group Discussion, most of the learner-beneficiaries mastered those given competencies set by the work immersion partner institution which are closely related to the TESDA Training Rules and Regulations.

European priority review vouchers for neglected disease product development

IntroductionNeglected diseases are a significant global health challenge. Encouraging the development of therapeutics and vaccines for these diseases would address an important unmet medical need. We propose a priority review...

Financing for equity for women's, children's and adolescents' health in low- and middle-income countries: A scoping review.

Over the past few decades, the world has witnessed considerable progress in women's, children's and adolescents' health (WCAH) and the Sustainable Development Goals (SDGs). Yet deep inequities remain between and within countries. This scoping review aims to map financing interventions and measures to improve equity in WCAH in low- and middle-income countries (LMICs). This scoping review was conducted following Joanna Briggs Institute (JBI) guidance for conducting such reviews as well as the PRISMA Extension for Scoping Reviews (PRISMA-ScR) for reporting scoping reviews. We searched Medline, PubMed, EMBASE and the World Health Organization's (WHO) Global Index Medicus, and relevant websites. The selection process was conducted in duplicate and independently. Out of 26 355 citations identified from electronic databases, relevant website searches and stakeholders' consultations, 413 studies were included in the final review. Conditional cash transfers (CCTs) (22.3%), health insurance (21.4%), user fee exemptions (18.1%) and vouchers (16.9%) were the most reported financial interventions and measures. The majority were targeted at women (57%) and children (21%) with others targeting adolescents (2.7%) and newborns (0.7%). The findings highlighted that CCTs, voucher programs and various insurance schemes can improve the utilization of maternal and child health services for the poor and the disadvantaged, and improve mortality and morbidity rates. However, multiple implementation challenges impact the effectiveness of these programmes. Some studies suggested that financial interventions alone would not be sufficient to achieve equity in health coverage among those of a lower income and those residing in remote regions. This review provides evidence on financing interventions to address the health needs of the most vulnerable communities. It can be used to inform the design of equitable health financing policies and health system reform efforts that are essential to moving towards universal health coverage (UHC). By also unveiling the knowledge gaps, it can be used to inform future research on financing interventions and measures to improve equity when addressing WCAH in LMICs.

The Potential for Race Discrimination in Voucher Programs in a Post-Carson World

The Potential for Race Discrimination in Voucher Programs in a Post-Carson World