Modifiable Factors Associated with Financial Burden: Improving Health Insurance Literacy

本申请是根据特别利益通知（NOSI）提交的。 标识为NOT-CA-21-055。家长补助金的目标， 促进 肿瘤学， R37 CA 255875技术 不同类型门诊患者抑郁情绪的行为干预 评估循证健康教育的有效性和实施情况， : 信息技术（HIT）对癌症患者抑郁水平升高行为治疗 症状这种HIT治疗结合了系统的，电子健康记录集成 筛选抑郁症状与个性化的HIT干预，以解决 癌症患者中抑郁症治疗的差距。在这种基础设施下，我们 建议探索健康保险知识和财务负担（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，以改善患者的HIL 除了至少轻度抑郁症之外，还经历FB和/或低健康素养。 我们的具体目标包括：（1）确定患者报告的HIL和FB的预测因子和协变量 包括前三个月的实际和自我报告的OOP成本以及患者报告的OOP成本 症状我们假设那些OOP成本较高的人（无论是实际的还是自我报告的）， 受教育程度低，焦虑和/或抑郁水平高，自我效能低，非 讲英语的人，以及那些接受姑息治疗的人会有更高的感知FB。 受教育程度低、自我效能感低、正在接受治疗的患者 可能有更低的HIL。(2)开发（通过文献综述、专家和患者输入）动画 信息图，教育视频（健康保险扫盲入门“帮助”）， 健康保险计划的要素。(3)试验将 父母补助金中的“帮助”视频，我的癌症支持，针对报告FB和/或 基线筛查问题的健康素养低，并评估其有效性 在一个月时对HIL进行干预。我们假设，纳入“帮助”视频将是 可行且可接受，且HIL在教育干预后会立即改善， 这将持续一个月。那些改善HIL的预测者将是那些 具有低基线HIL，低基线HIL和高FB的组合，较高的教育水平， 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.