Financial Coaching for Enhancing Household Finances and Health/Well-Being: A Systematic Review

Background. Financial stress is a widespread and significant problem in the U.S., affecting a variety of populations. The long-term health/well-being effects of poverty and financial stress are well-documented. Financial coaching has grown in recent years as a strengths-based, future-oriented, collaborative approach that uses client goals setting and behavioral practice to assist low-income families in achieving their potential for financial well-being. Financial coaching is a structured process to help participants bridge the gap between intention and knowledge, and create lasting behavior change. Despite its growing popularity, to date, no systematic review of the intervention of financial coaching has been conducted to provide evidence of their effectiveness.

Method. Systematic review methodology was used for the search, selection, and coding of studies and meta-analysis was employed to quantitatively synthesize effects. Campbell Collaboration procedures and guidelines for systematic review and meta-analytic methods were used. We searched for and retrieved both published and unpublished studies through a comprehensive search that included multiple electronic databases, conference proceedings, grey literature sources, Google, and Google Scholar using key terms. Reference lists from included studies were harvested for potential studies, and forward citation searching using Google Scholar was conducted. The first authors of the included studies were contacted to request information about studies we may have missed. Two independent reviewers screened studies for eligibility, extracted data from each study and assessed risk of bias using Cochrane’s Risk of Bias tools for randomized and non-randomized studies. Any discrepancies were discussed and resolved through consensus.

Results. Our comprehensive search resulted in 4,085 reports for title and abstract screening and 12 full texts moving forward for full text screening. Three additional studies were located via Google Scholar, and one additional study was located through an author suggestions. A total of 11 studies reported in 20 reports met eligibility criteria. Eight studies were randomized experiments and three were quasi-experimental. The predominant intervention setting was a community setting, and in addition to financial coaching, financial education and budgeting assistance were the most common secondary intervention, often delivered as part of financial coaching. The majority of studies provided in-person and individual, rather than group, financial coaching. A range of financial outcomes were measured, including savings, credit scores, financial confidence, financial stress/strain/distress, income, and financial self-efficacy. Health measures included smoking cessation, physical and mental health, and adherence to care. Preliminary results indicate that there were not a sufficient number of studies reporting the same outcomes in the same time periods to quantitatively synthesize effects across studies. All of the RCT studies had “some concerns” about their risk of bias.

Discussion. Overall, while research on the effects of financial coaching interventions appears to be growing and promising, the evidence of the effects on financial and health outcomes is relatively weak and based on a limited amount of lower quality studies. Moreover, there is little consistency across studies on the outcomes measured. To advance financial coaching interventions, social work practitioners and policy advocates should prioritize efforts to strengthen the evidence base.