Assessing the effect of virtual navigation interventions to improve health insurance literacy and decrease financial burden: A CCSS randomized trial

评估虚拟导航干预措施对提高健康保险知识和减轻经济负担的效果:一项 CCSS 随机试验

基本信息

  • 批准号:
    10632063
  • 负责人:
  • 金额:
    $ 70.77万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2022
  • 资助国家:
    美国
  • 起止时间:
    2022-06-01 至 2027-03-31
  • 项目状态:
    未结题

项目摘要

Childhood cancer survivors often have complex health needs that require medical surveillance, requiring them to navigate the complexities of the health care system. Despite the Affordable Care Act’s expansion of insurance, many childhood cancer survivors continue to experience underinsurance and barriers to care. Adequate health insurance literacy is a key skill for survivors to obtain and utilize health insurance and to prevent high out-of-pocket costs or unmet health care needs. Interventions are critically needed to support childhood cancer survivors in addressing issues of insurance, but to date no intervention has been developed to improve childhood survivors’ health insurance literacy. Guided by Andersen and Aday’s Behavioral Model of Health Services Use, we developed a patient navigation intervention and health insurance booklet, targeted for survivors. We conducted a pilot randomized trial comparing intervention, Health Insurance Navigation Tools (HINT-S), delivered synchronously via Zoom, to enhanced usual care (EUC; digital health insurance booklet only) among 82 survivors in the Childhood Cancer Survivor Study (CCSS) cohort. HINT-S incorporates a strong psychoeducational component, with 4 45-minute sessions designed to improve survivors’ conceptual knowledge of health insurance and cost. Preliminary results support its feasibility, acceptability, and preliminary efficacy. In response to RFA-CA-20-027, we propose a Type 1 hybrid effectiveness-implementation trial to test HINT-S vs. EUC to promote health insurance literacy, as well as improving downstream financial hardship and health care. We will randomize 520 survivors from the CCSS cohort to: HINT-S, HINT-A (4 prerecorded, asynchronous navigator sessions, which has the potential to be cost-effective and scalable), and EUC. All study activities, including recruitment, data collection, and navigation, will be conducted virtually, via the CCSS mHealth platform and patient portal. We will investigate whether HINT-S improves health insurance literacy over EUC at 6 months (primary outcome) and explore the relative difference in effect size and cost of HINT-S compared to HINT-A. We will explore moderators (e.g., sociodemographics, insurance status, state Medicaid expansion status, cancer and health history, and baseline literacy) of the intervention effects. The association of health insurance literacy with longer-term outcomes, such as financial hardship (worry, unmet healthcare needs, and financial consequences of medical costs), decreases in out-of-pocket-costs, and improvements in healthcare utilization at 18 months will be investigated. Implementation evaluation will assess the intervention’s reach, engagement, acceptability, fidelity, and sustainability (including cost). This study is innovative for the 1) comparison of digital intervention delivery, 2) focus on health insurance literacy, and 3) access to a national sample of long-term childhood cancer survivors. Digitally-delivered interventions that address health insurance literacy can lead to national sustainable improvements in childhood survivors’ health care costs and care.
儿童癌症幸存者往往有复杂的健康需求,需要医疗监测,需要他们

项目成果

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Anne C Kirchhoff其他文献

Anne C Kirchhoff的其他文献

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{{ truncateString('Anne C Kirchhoff', 18)}}的其他基金

A Randomized Controlled Trial to Improve Health Insurance Literacy and Surveillance among Young Adult Cancer Survivors
提高年轻成年癌症幸存者的健康保险知识和监测的随机对照试验
  • 批准号:
    10660663
  • 财政年份:
    2023
  • 资助金额:
    $ 70.77万
  • 项目类别:
Assessing the effect of virtual navigation interventions to improve health insurance literacy and decrease financial burden: A CCSS randomized trial
评估虚拟导航干预措施对提高健康保险知识和减轻经济负担的效果:一项 CCSS 随机试验
  • 批准号:
    10458154
  • 财政年份:
    2022
  • 资助金额:
    $ 70.77万
  • 项目类别:
Identifying the role of short-term fine particulate matter air pollution in the heart and lung health outcomes of adolescent and young adult cancer survivors
确定短期细颗粒物空气污染对青少年和年轻成年癌症幸存者的心脏和肺部健康结果的作用
  • 批准号:
    10308109
  • 财政年份:
    2020
  • 资助金额:
    $ 70.77万
  • 项目类别:
Improving Health Insurance Experiences for Adolescent and Young Adult Cancer Patients
改善青少年癌症患者的健康保险体验
  • 批准号:
    10204974
  • 财政年份:
    2019
  • 资助金额:
    $ 70.77万
  • 项目类别:
Improving Health Insurance Experiences for Adolescent and Young Adult Cancer Patients
改善青少年癌症患者的健康保险体验
  • 批准号:
    9978750
  • 财政年份:
    2019
  • 资助金额:
    $ 70.77万
  • 项目类别:
Health and socioeconomic outcomes for adolescent and young adult cancer survivors
青少年和年轻成人癌症幸存者的健康和社会经济成果
  • 批准号:
    8490832
  • 财政年份:
    2013
  • 资助金额:
    $ 70.77万
  • 项目类别:
Health and socioeconomic outcomes for adolescent and young adult cancer survivors
青少年和年轻成人癌症幸存者的健康和社会经济成果
  • 批准号:
    8638908
  • 财政年份:
    2013
  • 资助金额:
    $ 70.77万
  • 项目类别:

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