HIVTIDESNCT07862452

Tracking Income Dynamics and Everyday Health Study

A study testing Preventative health review invitation early in SNAP cycle, Financial counseling invitation early in the SNAP cycle and Aim 3 follow-up call early in the SNAP period in people with HIV and Hypertension, run by University of Pennsylvania at 1 site in United States.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts

Official record

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Trial summary

Who is it for?: Ages 50 years and older
Conditions the study is for: HIV, Hypertension, Hypercholerolemia
What is being tested?: Preventative health review invitation early in SNAP cycle, Financial counseling invitation early in the SNAP cycle and Aim 3 follow-up call early in the SNAP period
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 400 participants
Where: 1 siteUnited States
Study dates: 1 Mar 2027to 1 Jul 2029
Phase: Interventional
Are there results?: Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

Ages 50 years and older
All sexes
No healthy volunteers
Adult, Older adult

Who may be able to join

Age ≥50 years
SNAP beneficiary
Resident of Philadelphia, Bucks, Montgomery, Chester, or Delaware County (all with the same SNAP disbursement schedule) without plans to leave in the next 4 months
Diagnosis of hypertension, diabetes mellitus, hypercholesterolemia, or HIV (without advanced immunosuppression)
Prescribed a once-daily oral medication for the qualifying condition
Self-report missing ≥2 doses of this medication over the prior 30 days (i.e., <94% adherence)

Who cannot join

Does not meet all of the inclusion criteria
Unable to provide consent
Non-English speaker
Cognitive impairment, per PIs discretion
Receives cash assistance through the Temporary Assistance for Needy Families (TANF) program
Daily medication produces immediate symptomatic relief and thus provide a strong and immediate incentive to be adherent. Daily medication has common short-term side effects (e.g., sulfonylureas, which can cause hypoglycemia).

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site

Penn Medicine, 3535 Market St.
Philadelphia, Pennsylvania, 19104
Charlotte Babbin, 215-746-8556, Charlotte.babbin@pennmedicine.upenn.edu
Aaron Richterman

Other trials in United States

About this study

Official title: The Effects of Economic Scarcity on Health Behaviors in Older Adults With Chronic Disease

Among adults with chronic illnesses like hypertension, diabetes, or HIV, adherence to daily oral medications is essential but often below 50%. Why do medication adherence and preventive health service engagement remain stubbornly low? Scarcity theory offers a novel explanation in the context of poverty. It posits that economic hardship imposes a cognitive burden that shifts attention from long-term goals to immediate needs, reduces future orientation (the relative value placed on immediate vs. future outcomes), and limits mental bandwidth (the cognitive resources needed for decisions), thus undermining behaviors like daily medication adherence and service engagement. To address these gaps, the study's objective is to rigorously test whether and how economic scarcity affects medication adherence and preventive service uptake among older adults with chronic disease, leveraging the naturally occurring monthly fluctuation in scarcity created by the Supplemental Nutrition Assistance Program (SNAP) benefit cycle as a natural experiment.

There are three aims:

Daily medication adherence will be measured objectively for four months with wireless electronic pill bottle caps (CleverCaps). The investigators will test whether, when, and by how much adherence changes as scarcity fluctuates during the SNAP benefit cycle.
The investigators will conduct two easily implementable RCTs to test whether scarcity affects participants' engagement with beneficial services requiring navigation of administrative burdens. In one trial, participants will be randomized to receive an invitation during either a high- or low- scarcity period (i.e., before vs. after SNAP receipt) to a personalized preventive health review that identifies gaps in US Preventive Services Task Force Grade A/B recommendations. In the second, participants will be invited to free financial counseling provided by the City of Philadelphia during a high- or low-scarcity period. The investigators hypothesize invitation response rates will be >15% higher during low-scarcity periods.
Potential mechanisms that link scarcity with health behaviors will be examined by randomizing timing of validated measures of mental bandwidth and future orientation during a period of high- or low-scarcity (i.e., before vs. after SNAP receipt). The investigators hypothesize that there will be differences in several measures between participants who are randomly assessed during high- vs. low-scarcity periods (i.e. before vs. after SNAP receipt).

Impact: Demonstrating that scarcity helps to explain low medication adherence and beneficial health-related service uptake can inform patient-centered adherence interventions, clinical care-delivery approaches, health-system strategies, and public health approaches to improve these health behaviors and promote healthy aging.

Conditions: HIV, Hypertension, Hypercholerolemia, Type 2 Diabetes
Being tested: Preventative health review invitation early in SNAP cycle, Financial counseling invitation early in the SNAP cycle, Aim 3 follow-up call early in the SNAP period, Preventative health review invitation late in SNAP cycle, Financial counseling invitation late in the SNAP cycle
Medical subject headings: Hypertension, Diabetes Mellitus, Type 2

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Preventative health review invitation early in SNAP cycleOther
Participant will receive preventative health review invitation early in the SNAP cycle (low scarcity period)
Financial counseling invitation early in the SNAP cycleOther
The participant will receive an invitation to a financial counseling servce early in the SNAP cycle (low scarcity period).
Aim 3 follow-up call early in the SNAP periodOther
Participant will complete aim 3 follow-up call early in the SNAP cycle (low scarcity period).
Preventative health review invitation late in SNAP cycleOther
Participant will receive preventative health review invitation late in the SNAP cycle (high scarcity period)
Financial counseling invitation late in the SNAP cycleOther
The participant will receive an invitation to a financial counseling servce late in the SNAP cycle (high scarcity period).
Aim 3 follow-up call late in the SNAP cycleOther
Participant will complete aim 3 follow-up call late in the SNAP cycle (high scarcity period).

Study groups in NCT07862452
Study group	Role	What they receive
Early preventative health review, early financial counseling invitation, early aim 3 follow-up call	Experimental	Not described Receives: Other: Preventative health review invitation early in SNAP cycle; Other: Financial counseling invitation early in the SNAP cycle; Other: Aim 3 follow-up call early in the SNAP period
Early preventative health review, early financial counseling invitation, late aim 3 follow-up call	Experimental	Not described Receives: Other: Preventative health review invitation early in SNAP cycle; Other: Financial counseling invitation early in the SNAP cycle; Other: Aim 3 follow-up call late in the SNAP cycle
Early preventative health review, late financial counseling invitation, late aim 3 follow-up call	Experimental	Not described Receives: Other: Preventative health review invitation early in SNAP cycle; Other: Preventative health review invitation late in SNAP cycle; Other: Aim 3 follow-up call late in the SNAP cycle
Early preventative health review, late financial counseling invitation, early aim 3 follow-up call	Experimental	Not described Receives: Other: Preventative health review invitation early in SNAP cycle; Other: Aim 3 follow-up call early in the SNAP period; Other: Financial counseling invitation late in the SNAP cycle
Late preventative health review, early financial counseling invitation, early aim 3 follow-up call	Experimental	Not described Receives: Other: Financial counseling invitation early in the SNAP cycle; Other: Aim 3 follow-up call early in the SNAP period; Other: Preventative health review invitation late in SNAP cycle
Late preventative health review, late financial counseling invitation, early aim 3 follow-up call	Experimental	Not described Receives: Other: Aim 3 follow-up call early in the SNAP period; Other: Preventative health review invitation late in SNAP cycle; Other: Financial counseling invitation late in the SNAP cycle
Late preventative health review, late financial counseling invitation, late aim 3 follow-up call	Experimental	Not described Receives: Other: Preventative health review invitation late in SNAP cycle; Other: Financial counseling invitation late in the SNAP cycle; Other: Aim 3 follow-up call late in the SNAP cycle
Late preventative health review, early financial counseling invitation, late aim 3 follow-up call	Experimental	Not described Receives: Other: Financial counseling invitation early in the SNAP cycle; Other: Preventative health review invitation late in SNAP cycle; Other: Aim 3 follow-up call late in the SNAP cycle

What is being measured

The primary outcome is the main question the study is designed to answer.

Daily medication adherence
Measured: Full 4-month participant enrollment period
Response to preventative health screening invitation
Measured: Month 3
Response to financial counseling invitation
Measured: Month 4
Mental bandwidth: Raven's Progressive Matrices
Raven's Progressive Matrices short form (number of correct answers)
Measured: Aim 3 follow-up survey (~1 month after baseline visit)
Mental bandwidth: BTACT Backward Digit Span
Longest span of digits correctly reversed
Measured: Aim 3 follow-up survey (~1 month after baseline visit)
Future orientation
Preference Survey Module - measures self-described temporal discounting with a 10-point probabilistic scale; Patience (Brownback) - measures number of weeks willing to wait for an increased payment (delayed economic gratification)
Measured: Aim 3 follow-up survey (~1 month after baseline visit)

Secondary outcomes (8)

Health-related quality of life (CDC HRQOL-4)
Measured: Aim 3 follow-up survey (~1 month after baseline visit)
Alcohol use (AUDIT-C)
Measured: Aim 3 follow-up survey (~1 month after baseline visit)
Tobacco use (days smoked in past 7 days; cigarettes per day)
Measured: Aim 3 follow-up survey (~1 month after baseline visit)
Stress (Perceived Stress Scale - short form)
Measured: Aim 3 follow-up survey (~1 month after baseline visit)
Psychological distress (Kessler Psychological Distress Scale [K6])
Measured: Aim 3 follow-up survey (~1 month after baseline visit)
Hope (State Hope Scale)
Measured: Aim 3 follow-up survey (~1 month after baseline visit)
Monitored medication side effects (FACIT GP5 single item, adapted)
Measured: Aim 3 follow-up survey (~1 month after baseline visit)
Subjective survival expectations
Measured: Aim 3 follow-up survey (~1 month after baseline visit)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

1 Mar 20271 Jul 2029

First posted7 Oct 2026
Study start1 Mar 2027 (estimated)
Primary completion1 Jul 2029 (estimated)
Study completion1 Jul 2029 (estimated)

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Other trials for HIVStudies of the same condition, open and under way.
More trials run by University of PennsylvaniaThe sponsor's other registered studies.
What the trial phases meanHow a treatment moves from first tests in people to approval.

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design

Study type: Interventional
Phase: Phase N/A
Primary purpose: Health services research
Allocation: Randomised
Intervention model: Factorial
Masking: None (open label)
Enrolment: 400 participants (estimated)

IDs, dates and publications

ClinicalTrials.gov ID: NCT07862452
Sponsor's protocol ID: 26-7966
Other IDs: 1R01AG103431-01
Acronym: TIDES
Status last verified: Oct 2026
First submitted: 1 Oct 2026
Last updated: 19 Oct 2026
Results posted: No
Data monitoring committee: No
FDA-regulated drug: No
FDA-regulated device: No
Individual data sharing: Yes: De-identified quantitative data providing sociodemographic characteristics, medication adherence, economic status, financial trends, food security, health, and psychological mechanisms linking SNAP receipt to health behaviors is likely to be useful for other researchers. These data will be preserved to enable sharing via the National Archive of Computerized Data on Aging (NACDA).

Interested in taking part?

Each site lists its own contact. Pick the site nearest to you.

Talk to your doctor first and take this page with you. Only the study team can confirm whether you can join.

Questions to ask the study team

What is the study trying to find out?
What would I need to do, and how often would I visit?
Could I receive a placebo instead of the treatment?
What are the possible risks and benefits for me?
Will it cost me anything? Are travel or time paid for?
Can I keep seeing my own doctor during the study?
What happens when the study ends?

See sites and contacts

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Study at a glance

From the registry record, last updated by the sponsor on 19 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: The Effects of Economic Scarcity on Health Behaviors in Older Adults With Chronic Disease
ClinicalTrials.gov ID: NCT07862452
Acronym / sponsor ID: TIDES / 26-7966
Conditions: HIV, Hypertension, Hypercholerolemia, Type 2 Diabetes
Study type: Interventional
Recruitment status: Not yet recruiting
Enrolment: 400 participants (estimated)
Lead sponsor: University of PennsylvaniaUniversity, hospital or other
Collaborators: National Institute on Aging (NIA)
Study start: 1 Mar 2027 (estimated)
Primary completion: 1 Jul 2029 (estimated)
Study completion: 1 Jul 2029 (estimated)
First posted: 7 Oct 2026 (actual)
Results: Not posted in the source record

Clinical summary

The research question as the sponsor registered it. This describes what the study plans to test, not what it found.

There are three aims:

Daily medication adherence will be measured objectively for four months with wireless electronic pill bottle caps (CleverCaps). The investigators will test whether, when, and by how much adherence changes as scarcity fluctuates during the SNAP benefit cycle.
The investigators will conduct two easily implementable RCTs to test whether scarcity affects participants' engagement with beneficial services requiring navigation of administrative burdens. In one trial, participants will be randomized to receive an invitation during either a high- or low- scarcity period (i.e., before vs. after SNAP receipt) to a personalized preventive health review that identifies gaps in US Preventive Services Task Force Grade A/B recommendations. In the second, participants will be invited to free financial counseling provided by the City of Philadelphia during a high- or low-scarcity period. The investigators hypothesize invitation response rates will be >15% higher during low-scarcity periods.
Potential mechanisms that link scarcity with health behaviors will be examined by randomizing timing of validated measures of mental bandwidth and future orientation during a period of high- or low-scarcity (i.e., before vs. after SNAP receipt). The investigators hypothesize that there will be differences in several measures between participants who are randomly assessed during high- vs. low-scarcity periods (i.e. before vs. after SNAP receipt).

Study design

Primary purpose: Health services research
Allocation: Randomised
Intervention model: Factorial
Masking: None (open label)
Number of arms: 8

Arm	Type	Receives
Early preventative health review, early financial counseling invitation, early aim 3 follow-up call	Experimental	Other: Preventative health review invitation early in SNAP cycle, Other: Financial counseling invitation early in the SNAP cycle, Other: Aim 3 follow-up call early in the SNAP period
Early preventative health review, early financial counseling invitation, late aim 3 follow-up call	Experimental	Other: Preventative health review invitation early in SNAP cycle, Other: Financial counseling invitation early in the SNAP cycle, Other: Aim 3 follow-up call late in the SNAP cycle
Early preventative health review, late financial counseling invitation, late aim 3 follow-up call	Experimental	Other: Preventative health review invitation early in SNAP cycle, Other: Preventative health review invitation late in SNAP cycle, Other: Aim 3 follow-up call late in the SNAP cycle
Early preventative health review, late financial counseling invitation, early aim 3 follow-up call	Experimental	Other: Preventative health review invitation early in SNAP cycle, Other: Aim 3 follow-up call early in the SNAP period, Other: Financial counseling invitation late in the SNAP cycle
Late preventative health review, early financial counseling invitation, early aim 3 follow-up call	Experimental	Other: Financial counseling invitation early in the SNAP cycle, Other: Aim 3 follow-up call early in the SNAP period, Other: Preventative health review invitation late in SNAP cycle
Late preventative health review, late financial counseling invitation, early aim 3 follow-up call	Experimental	Other: Aim 3 follow-up call early in the SNAP period, Other: Preventative health review invitation late in SNAP cycle, Other: Financial counseling invitation late in the SNAP cycle
Late preventative health review, late financial counseling invitation, late aim 3 follow-up call	Experimental	Other: Preventative health review invitation late in SNAP cycle, Other: Financial counseling invitation late in the SNAP cycle, Other: Aim 3 follow-up call late in the SNAP cycle
Late preventative health review, early financial counseling invitation, late aim 3 follow-up call	Experimental	Other: Financial counseling invitation early in the SNAP cycle, Other: Preventative health review invitation late in SNAP cycle, Other: Aim 3 follow-up call late in the SNAP cycle

Who may qualify

Ages: 50 years and older
Sex: All
Healthy volunteers: Not accepted
Age groups: Adult, Older adult

Key inclusion criteria (6 listed)

Age ≥50 years
SNAP beneficiary
Resident of Philadelphia, Bucks, Montgomery, Chester, or Delaware County (all with the same SNAP disbursement schedule) without plans to leave in the next 4 months
Diagnosis of hypertension, diabetes mellitus, hypercholesterolemia, or HIV (without advanced immunosuppression)
Prescribed a once-daily oral medication for the qualifying condition

Key exclusion criteria (6 listed)

Does not meet all of the inclusion criteria
Unable to provide consent
Non-English speaker
Cognitive impairment, per PIs discretion
Receives cash assistance through the Temporary Assistance for Needy Families (TANF) program

Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.

Interventions

Intervention	Type	Arms
Preventative health review invitation early in SNAP cycleParticipant will receive preventative health review invitation early in the SNAP cycle (low scarcity period)	Other	Early preventative health review, early financial counseling invitation, early aim 3 follow-up call, Early preventative health review, early financial counseling invitation, late aim 3 follow-up call, Early preventative health review, late financial counseling invitation, early aim 3 follow-up call, Early preventative health review, late financial counseling invitation, late aim 3 follow-up call
Financial counseling invitation early in the SNAP cycleThe participant will receive an invitation to a financial counseling servce early in the SNAP cycle (low scarcity period).	Other	Early preventative health review, early financial counseling invitation, early aim 3 follow-up call, Early preventative health review, early financial counseling invitation, late aim 3 follow-up call, Late preventative health review, early financial counseling invitation, early aim 3 follow-up call, Late preventative health review, early financial counseling invitation, late aim 3 follow-up call
Aim 3 follow-up call early in the SNAP periodParticipant will complete aim 3 follow-up call early in the SNAP cycle (low scarcity period).	Other	Early preventative health review, early financial counseling invitation, early aim 3 follow-up call, Early preventative health review, late financial counseling invitation, early aim 3 follow-up call, Late preventative health review, early financial counseling invitation, early aim 3 follow-up call, Late preventative health review, late financial counseling invitation, early aim 3 follow-up call
Preventative health review invitation late in SNAP cycleParticipant will receive preventative health review invitation late in the SNAP cycle (high scarcity period)	Other	Early preventative health review, late financial counseling invitation, late aim 3 follow-up call, Late preventative health review, early financial counseling invitation, early aim 3 follow-up call, Late preventative health review, early financial counseling invitation, late aim 3 follow-up call, Late preventative health review, late financial counseling invitation, early aim 3 follow-up call, Late preventative health review, late financial counseling invitation, late aim 3 follow-up call
Financial counseling invitation late in the SNAP cycleThe participant will receive an invitation to a financial counseling servce late in the SNAP cycle (high scarcity period).	Other	Early preventative health review, late financial counseling invitation, early aim 3 follow-up call, Late preventative health review, late financial counseling invitation, early aim 3 follow-up call, Late preventative health review, late financial counseling invitation, late aim 3 follow-up call
Aim 3 follow-up call late in the SNAP cycleParticipant will complete aim 3 follow-up call late in the SNAP cycle (high scarcity period).	Other	Early preventative health review, early financial counseling invitation, late aim 3 follow-up call, Early preventative health review, late financial counseling invitation, late aim 3 follow-up call, Late preventative health review, early financial counseling invitation, late aim 3 follow-up call, Late preventative health review, late financial counseling invitation, late aim 3 follow-up call

Primary outcome

Daily medication adherence
Time frame: Full 4-month participant enrollment period
Response to preventative health screening invitation
Time frame: Month 3
Response to financial counseling invitation
Time frame: Month 4
Mental bandwidth: Raven's Progressive Matrices
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)
Raven's Progressive Matrices short form (number of correct answers)
Mental bandwidth: BTACT Backward Digit Span
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)
Longest span of digits correctly reversed
Future orientation
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)
Preference Survey Module - measures self-described temporal discounting with a 10-point probabilistic scale; Patience (Brownback) - measures number of weeks willing to wait for an increased payment (delayed economic gratification)

8 secondary outcomes

Health-related quality of life (CDC HRQOL-4)
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)
Alcohol use (AUDIT-C)
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)
Tobacco use (days smoked in past 7 days; cigarettes per day)
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)
Stress (Perceived Stress Scale - short form)
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)
Psychological distress (Kessler Psychological Distress Scale [K6])
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)
Hope (State Hope Scale)
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)
Monitored medication side effects (FACIT GP5 single item, adapted)
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)
Subjective survival expectations
Time frame: Aim 3 follow-up survey (~1 month after baseline visit)

Results and safety

This study is still under way. Results are not available in the source record yet.

Research links

Official record on ClinicalTrials.govLast updated by the sponsor 19 Oct 2026.
Individual participant dataSharing planned: Yes. De-identified quantitative data providing sociodemographic characteristics, medication adherence, economic status, financial trends, food security, health, and psychological mechanisms linking SNAP receipt to health behaviors is likely to be useful for other researchers. These data will be preserved to enable sharing via the National Archive of Computerized Data on Aging (NACDA).

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Referral and contact

AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.

Penn Medicine, 3535 Market St.

Philadelphia, United States

215-746-8556

Charlotte.babbin@pennmedicine.upenn.edu

1 site in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 19 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Daily medication adherence (time frame: Full 4-month participant enrollment period). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07862452.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Oct 2026; AzTrials last refreshed its copy on 26 Oct 2026.