Modifiable Factors Associated with Financial Burden: Improving Health Insurance Literacy

本申请是对特别利益通知(NOSI)的回应 标识为NOT-CA-21-055。父母助学金的目标是， 促进的 肿瘤学， R37CA255875技术 行为干预对不同类型门诊抑郁症患者的影响 我S对循证健康评价的有效性和实施情况 ： 信息技术(HIT)对癌症伴重度抑郁患者的行为治疗 症状。这一命中治疗结合了系统化、电子病历一体化 通过个人化的HIT干预来筛查抑郁症状 癌症患者在治疗抑郁症方面的差距。在这个基础设施下，我们 建议探索健康保险素养和财政负担(FB)的预测因素，包括 自付成本的影响。我们将开发和测试的可行性和可接受性 通过HIT平台提供健康保险教育，提高患者的HIL 在经历FB和/或低健康素养的同时，至少还有轻度抑郁症。 我们的具体目标包括：(1)确定患者报告的HIL和FB的预测因子及其协变量 包括前三个月的实际和自行报告的OOP成本以及患者报告的成本 症状。我们假设那些具有较高面向对象操作成本的人(无论是实际的还是自报的)， 受教育程度较低，焦虑和/或抑郁程度较高，自我效能较低， 说英语的人，那些接受姑息治疗的人会有更高的FB。 低文化程度、低自我效能感和有治疗意向的患者 可能有较低的HIL。(2)制作(通过文献回顾、专家和病人的意见)动画 信息图，教育视频(医疗保险知识初级读本《帮助》)，回顾基本知识 健康保险计划的要素。(三)试点纳入本办法的可接受性和可行性 为报告FB和/或FB的患者，在父母资助的我的癌症支持范围内的视频 低健康素养基线筛查问题及效果评价 1个月后对HIL进行干预。我们假设“帮助”视频的合并将是 可行和可接受的，HIL将在教育干预后立即改善， 这将持续一个月。那些改善HIL的预测者将是那些 低基线HIL，低基线HIL和高FB的组合，更高的教育水平， 和更高的自我效能感。

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.