Evaluating the impact of the Bolsa Familia conditional cash transfer program on premature cardiovascular and all-cause mortality using the 100 million Brazilian cohort: a natural experiment study protocol

Introduction Brazil’s Bolsa Familia Program (BFP) is the world’s largest conditional cash transfer scheme. We shall use a large cohort of applicants for different social programmes to evaluate the effect of BFP receipt on premature all-cause and cardiovascular mortality.Methods and analysis We will...

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Main Authors: Mauricio L Barreto, Alastair H Leyland, Liam Smeeth, Srinivasa Vittal Katikireddi, Peter Craig, Mirjam Allik, Estela M L Aquino, Sanni Ali, Julia M Pescarini, Leila Amorim
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e039658.full
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author Mauricio L Barreto
Alastair H Leyland
Liam Smeeth
Srinivasa Vittal Katikireddi
Peter Craig
Mirjam Allik
Estela M L Aquino
Sanni Ali
Julia M Pescarini
Leila Amorim
author_facet Mauricio L Barreto
Alastair H Leyland
Liam Smeeth
Srinivasa Vittal Katikireddi
Peter Craig
Mirjam Allik
Estela M L Aquino
Sanni Ali
Julia M Pescarini
Leila Amorim
author_sort Mauricio L Barreto
collection DOAJ
description Introduction Brazil’s Bolsa Familia Program (BFP) is the world’s largest conditional cash transfer scheme. We shall use a large cohort of applicants for different social programmes to evaluate the effect of BFP receipt on premature all-cause and cardiovascular mortality.Methods and analysis We will identify BFP recipients and non-recipients among new applicants from 2004 to 2015 in the 100 Million Brazilian Cohort, a database of 114 million individuals containing sociodemographic and mortality information of applicants to any Brazilian social programme. For individuals applying from 2011, when we have better recorded income data, we shall compare premature (age 30–69) cardiovascular and all-cause mortality among BFP recipients and non-recipients using regression discontinuity design (RDD) with household monthly per capita income as the forcing variable. Effects will be estimated using survival models accounting for individuals follow-up. To test the sensitivity of our findings, we will estimate models with different bandwidths, include potential confounders as covariates in the survival models, and restrict our data to locations with the most reliable data. In addition, we will estimate the effect of BFP on studied outcomes using propensity score risk-set matching, separately for individuals that applied ≤2010 and >2011, allowing comparability with RDD. Analyses will be stratified by geographical region, gender, race/ethnicity and socioeconomic position. We will investigate differential impacts of BFP and the presence of effect modification for a combination of characteristics, including gender and race/ethnicity.Ethics and dissemination The study was approved by the ethics committees of Oswaldo Cruz Foundation and the University of Glasgow College of Medicine and Veterinary Life Sciences. The deidentified dataset will be provided to researchers, and data analysis will be performed in a safe computational environment without internet access. Study findings will be published in high quality peer-reviewed research articles. The published results will be disseminated in the social media and to policy-makers.
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spelling doaj-art-7c092ca2f1bc419aa63e2f5c4f5e34532025-08-20T02:27:46ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-039658Evaluating the impact of the Bolsa Familia conditional cash transfer program on premature cardiovascular and all-cause mortality using the 100 million Brazilian cohort: a natural experiment study protocolMauricio L Barreto0Alastair H Leyland1Liam Smeeth2Srinivasa Vittal Katikireddi3Peter Craig4Mirjam Allik5Estela M L Aquino6Sanni Ali7Julia M Pescarini8Leila Amorim98 Federal University of Bahia, Salvador, BrazilMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, Glasgow, UKDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UKPublic Health Scotland, Edinburgh, UKMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, Glasgow, UKMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, Glasgow, UK1 Public Health Institute, Federal University of Bahia, Salvador, BrazilCentro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Salvador, BrazilDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UKInstituto de Matemática e Estatística, Universidade Federal da Bahia, Salvador, BrazilIntroduction Brazil’s Bolsa Familia Program (BFP) is the world’s largest conditional cash transfer scheme. We shall use a large cohort of applicants for different social programmes to evaluate the effect of BFP receipt on premature all-cause and cardiovascular mortality.Methods and analysis We will identify BFP recipients and non-recipients among new applicants from 2004 to 2015 in the 100 Million Brazilian Cohort, a database of 114 million individuals containing sociodemographic and mortality information of applicants to any Brazilian social programme. For individuals applying from 2011, when we have better recorded income data, we shall compare premature (age 30–69) cardiovascular and all-cause mortality among BFP recipients and non-recipients using regression discontinuity design (RDD) with household monthly per capita income as the forcing variable. Effects will be estimated using survival models accounting for individuals follow-up. To test the sensitivity of our findings, we will estimate models with different bandwidths, include potential confounders as covariates in the survival models, and restrict our data to locations with the most reliable data. In addition, we will estimate the effect of BFP on studied outcomes using propensity score risk-set matching, separately for individuals that applied ≤2010 and >2011, allowing comparability with RDD. Analyses will be stratified by geographical region, gender, race/ethnicity and socioeconomic position. We will investigate differential impacts of BFP and the presence of effect modification for a combination of characteristics, including gender and race/ethnicity.Ethics and dissemination The study was approved by the ethics committees of Oswaldo Cruz Foundation and the University of Glasgow College of Medicine and Veterinary Life Sciences. The deidentified dataset will be provided to researchers, and data analysis will be performed in a safe computational environment without internet access. Study findings will be published in high quality peer-reviewed research articles. The published results will be disseminated in the social media and to policy-makers.https://bmjopen.bmj.com/content/10/11/e039658.full
spellingShingle Mauricio L Barreto
Alastair H Leyland
Liam Smeeth
Srinivasa Vittal Katikireddi
Peter Craig
Mirjam Allik
Estela M L Aquino
Sanni Ali
Julia M Pescarini
Leila Amorim
Evaluating the impact of the Bolsa Familia conditional cash transfer program on premature cardiovascular and all-cause mortality using the 100 million Brazilian cohort: a natural experiment study protocol
BMJ Open
title Evaluating the impact of the Bolsa Familia conditional cash transfer program on premature cardiovascular and all-cause mortality using the 100 million Brazilian cohort: a natural experiment study protocol
title_full Evaluating the impact of the Bolsa Familia conditional cash transfer program on premature cardiovascular and all-cause mortality using the 100 million Brazilian cohort: a natural experiment study protocol
title_fullStr Evaluating the impact of the Bolsa Familia conditional cash transfer program on premature cardiovascular and all-cause mortality using the 100 million Brazilian cohort: a natural experiment study protocol
title_full_unstemmed Evaluating the impact of the Bolsa Familia conditional cash transfer program on premature cardiovascular and all-cause mortality using the 100 million Brazilian cohort: a natural experiment study protocol
title_short Evaluating the impact of the Bolsa Familia conditional cash transfer program on premature cardiovascular and all-cause mortality using the 100 million Brazilian cohort: a natural experiment study protocol
title_sort evaluating the impact of the bolsa familia conditional cash transfer program on premature cardiovascular and all cause mortality using the 100 million brazilian cohort a natural experiment study protocol
url https://bmjopen.bmj.com/content/10/11/e039658.full
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