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.

本申请是为了响应特别利益通知 (NOSI) 而提交的 标识为 NOT-CA-21-055。家长补助金的目标， 便利化 肿瘤学， R37CA255875技术 不同门诊患者抑郁症的行为干预 是评估循证健康的有效性和实施情况 : 针对抑郁程度升高的癌症患者的信息技术 (HIT) 行为治疗 症状。这种 HIT 治疗结合了系统化、电子健康记录集成 通过个性化定制的 HIT 干预措施筛查抑郁症状，以解决 癌症患者抑郁症治疗方面的差距。在这个基础设施下，我们 建议探索健康保险素养和财务负担（FB）的预测因素，包括 自付费用的影响。我们将开发并测试其可行性和可接受性 通过 HIT 平台提供健康保险教育，以改善患者的 HIL 除了至少轻度抑郁之外，还经历过 FB 和/或健康素养较低。 我们的具体目标包括： (1) 通过协变量确定患者报告的 HIL 和 FB 的预测因子 包括前三个月实际和自我报告的 OOP 费用以及患者报告的费用 症状。我们假设那些具有较高 OOP 成本（无论是实际成本还是自我报告成本）的人， 教育水平较低、焦虑和/或抑郁程度较高、自我效能感较低、非 说英语的人以及那些接受姑息治疗的人将会有更高的 FB 感知度。 文化程度低、自我效能感低、以治疗为目的的患者 可能具有较低的 HIL。 (2) 开发（通过文献综述、专家和患者的意见）动画 信息图、教育视频（健康保险素养入门“帮助”），回顾基本知识 健康保险计划的要素。 （三）试点纳入的可接受性和可行性 家长补助金“我的癌症支持”中的“帮助”视频，适用于报告 FB 和/或 基线筛查问题的健康素养较低并评估筛查的有效性 一个月后进行 HIL 干预。我们假设“帮助”视频的合并将是 可行且可接受，并且 HIL 将在教育干预后立即得到改善， 并将持续一个月。改善 HIL 的预测因素是： 具有低基线 HIL、低基线 HIL 和高 FB 的组合、较高的教育水平、 和更高的自我效能感。