Modifiable Factors Associated with Financial Burden: Improving Health Insurance Literacy

与财务负担相关的可改变因素：提高健康保险素养

• 批准号: 10436080
• 负责人: BETINA YANEZ
• 金额: $ 10万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10436080
• 关键词: Address; Anxiety; Behavior Therapy; Cancer Diagnostics; Cancer Patient; Caregivers; Combined Modality Therapy; Complement; Counseling; Data; Development; Direct Costs; Disease; Education; Educational Background; Educational Intervention; Effectiveness of Interventions; Electronic Health Record; Elements; Enrollment; Financial Hardship; Goals; Health Insurance; Healthcare Systems; Heart Diseases; Household; Individual; Infrastructure; Insurance; Intervention; Knowledge; Lead; Malignant Neoplasms; Mental Depression; Methods; Oncology; Outcome; Patient Self-Report; Patients; Persons; Population; Reporting; Resources; Review Literature; Risk; Self Efficacy; Symptoms; Technology; Therapeutic; United States; Vulnerable Populations; acceptability and feasibility; cancer diagnosis; cancer therapy; college; coping; cost; depressive symptoms; effectiveness evaluation; ethnic minority population; evidence base; experience; feasibility testing; financial literacy; health care service; health information technology; health literacy; higher education; improved; interest; literacy; novel strategies; palliative; parent grant; programs; racial and ethnic; racial minority; response; screening; side effect; sociodemographic predictors

This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA-21-055. The goal of the parent grant, Facilitated Oncology, R37CA255875 Technology Behavioral Intervention for Depression among Diverse Patients in Ambulatory i s to evaluate the effectiveness and the implementation of an evidence-based health : information technology (HIT) behavioral treatment for cancer patients with elevated depressive symptoms. This HIT treatment combines systematic, electronic health record-integrated screening for depressive symptoms with an individually-tailored HIT intervention to address gaps in the treatment of depression among cancer patients. Under this infrastructure, we propose to explore predictors of health insurance literacy and financial burden (FB) including the impact of out-of-pocket costs. We will develop and test the feasibility and acceptability of delivering health insurance education via the HIT platform to improve HIL in patients experiencing FB and/or low health literacy in addition to at least mild depression. Our specific aims include: (1) Identify predictors of patient-reported HIL and FB with covariates including actual and self-reported OOP costs for the previous three months and patient-reported symptoms. We hypothesize that those with higher OOP costs (either actual or self-reported), lower education level, higher levels of anxiety and/or depression, lower self-efficacy, non- English speaking, and those being treated with palliative intent will have higher perceived FB. Those with low education level, low self-efficacy, and those being treated with curative intent may have lower HIL. (2) Develop (via literature review, expert and patient input) an animated infographic, educational video (HEalth insurance Literacy Primer “HELP”) that reviews basic elements of health insurance plans. (3) Pilot the acceptability and feasibility of incorporating the “HELP” video within the parent grant's, My Cancer Support, for patients that report FB and/or low health literacy on baseline screening question and evaluate the effectiveness of the intervention on HIL at one month. We hypothesize that incorporation of the “HELP” video will be feasible and acceptable and HIL will improve immediately following an educational intervention, which will be sustained at one month. Predictors of those who improve HIL will be those that have low baseline HIL, a combination of low baseline HIL and high FB, higher education level, and higher self-efficacy.

该申请是根据特殊利益通知（NOSI）提交的 被确定为非CA-21-055。父母赠款的目标， 便利 肿瘤学， R37CA255875技术 卧床中不同患者抑郁的行为干预 我要评估基于证据的健康的有效性和实施 ： 抑郁症的癌症患者的信息技术（HIT）行为治疗 症状。这种命中处理结合了系统的，电子健康记录集成 筛查抑郁症状，采用单独量身定制的命中干预措施来解决 癌症患者抑郁症治疗的差距。在这个基础设施下，我们 提议探讨健康保险素养和金融伯恩（FB）的预测指标 自付费用的影响。我们将开发和测试 通过热门平台提供健康保险教育，以改善患者的HIL 除了至少温和的抑郁症外，还经历了FB和/或健康素养。 我们的具体目的包括：（1）与协变量确定患者报告的HIL和FB的预测指标 包括过去三个月的实际和自我报告的OOP费用和患者报告 症状。我们假设那些OOP成本较高的人（实际或自我报告）， 较低的教育水平，较高的焦虑和/或抑郁水平，降低自我效能感，非 - 讲英语的人和接受姑息意图的人将具有更高的感知FB。 教育水平低，自我效能低下的人，以及接受治疗意图的人 可能有较低的HIL。 （2）开发（通过文献评论，专家和患者输入）动画 信息图表，教育视频（健康保险素养入门“帮助”），审查基本 健康保险计划的要素。 （3）企图合并的可接受性和可行性 我的癌症支持中的“帮助”视频是报告FB和/或报告的患者 关于基线筛查问题的健康素养低，并评估 一个月的HIL干预。我们假设合并的“帮助”视频将是 可行且可接受和HIL将在教育干预后立即改善， 将在一个月内维持。那些改善HIL的人将是那些 具有低基线HIL，低基线HIL和高FB，高等教育水平的组合， 和更高的自我效能。