Improving Cancer Patients' Insurance Choices

Not Applicable

Completed

• Conditions: Cancer; Health Services Accessibility; Health Literacy; Health Insurance; Informed Decision Making
• Interventions: Behavioral: I Can PIC

• Registration Number: NCT03592433
• Lead Sponsor: Washington University School of Medicine

Brief Summary

The goal of this research study is to find out if a decision aid (DA) created by investigators, I Can PIC, is effective in helping cancer patients make decisions about their health insurance. The investigators will evaluate I Can PIC compared to an attention control condition (existing website created by the American Cancer Society Cancer Action Network). The study hypothesis is that those randomly assigned to I Can PIC will have higher knowledge about health insurance terms and details, more certainty about the best health insurance plan for them, and more confidence in their health insurance decisions compared to those randomly assigned to the control condition.

Detailed Description

In a prior study, the investigators created a consumer-friendly online tool, Show Me Health Plans (SMHP), for those enrolling in health insurance in the ACA marketplace. I Can PIC was developed based on SMHP, with input from an advisory board, and incorporating feedback from semi-structured qualitative interviews with cancer survivors. The investigators created I Can PIC to focus on unique needs of cancer patients and survivors considering health insurance. In this study, the investigators will examine the effectiveness of I Can PIC by conducting a randomized experiment with 275 participants. The trial will compare the I Can PIC to an attention control website developed by the American Cancer Society Cancer Action Network. Primary outcomes include knowledge, decision self-efficacy, certainty about plan choice, and the match between plan choice and preferences. The investigators will also explore whether financial toxicity, cancer type, and time since diagnosis relate to outcomes.

Study Timeline

• Study First Submitted: 2018-06-26
• Study Start: 2018-06-27
• Study First Submitted QC: 2018-07-09
• Study First Posted: 2018-07-19
• Primary Completion: 2019-02-28
• Study Completion: 2019-02-28
• Status Verified: 2019-04
• Last Update Submitted: 2019-04-29
• Last Update Posted: 2019-05-01

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 263

Inclusion Criteria

• Ability to read English
• Diagnosed with cancer in the past 5 years
• Residing in Missouri or Illinois

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Exclusion Criteria

• Eligible for Medicaid or Medicare in Missouri or Illinois
• Enrolled in the following types of health insurance plans: Medicare, Medicaid, TRICARE or other military healthcare, or Indian Health Services

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
I Can PIC	I Can PIC	The I Can PIC website will be provided to participants randomized to the experimental/intervention group.

Primary Outcome Measures

Name	Time	Method
Certainty about Choice (Decisional Conflict Scale)	Completed immediately after using I Can PIC	The validated, 4-item SURE Test for clinical practice will be used. This scale measures whether individuals feel they have enough information to make a choice, are clear about their values for risks and benefits of their choice, and feel they have enough support to make a choice.
Knowledge Score	Completed immediately after using I Can PIC	The percent correct out of eight questions that were created by the research team based on information that is considered vital to making health insurance decisions.
Decision Self-efficacy	Completed immediately after using I Can PIC.	The validated decision self-efficacy scale will be used. This 11-item scale measures an individual's self-confidence or belief in their ability to make a decision. Individuals will be asked to rate how confident they feel taking actions involved in making an informed choice (e.g., gathering information, asking questions, and expressing opinions).

Secondary Outcome Measures

Name	Time	Method
Health Insurance Literacy Measure	3 month follow-up	Two items from the validated Health Insurance Literacy Measure will be used. This scale measures consumers' confidence in their ability to estimate their annual health care costs and their understanding of health insurance terms.; This measure will be assessed at follow-up to see if differences observed between groups immediately post-intervention, remain at follow-up.
Choice of Health Insurance Plan	3 month follow-up	Participants will be asked what health insurance plan they choose. Plan selections will be categorized by the type of plan, e.g., high deductible plan, PPO, silver-tier Marketplace plan, gold-tier Marketplace plan, and will be compared to our algorithmic prediction about good fit plans for users based on estimates of their health care expenses.; This measure will be assessed at follow-up to see if differences observed between groups immediately post-intervention, remain at follow-up.
Healthcare Utlization	3 month follow-up	Participants will be asked questions about how often they use healthcare services to see if their plan choice relates to their utilization
Knowledge Score	3 month follow-up	The percent correct out of eight questions that were created by the research team based on information that is considered vital to making health insurance decisions.; This measure will be assessed at follow-up to see if differences observed between groups immediately post-intervention, remain at follow-up.
Certainty about Choice (Decisional Conflict Scale)	3 month follow-up	The validated, 4-item SURE Test for clinical practice will be used. This scale measures whether individuals feel they have enough information to make a choice, are clear about their values for risks and benefits of their choice, and feel they have enough support to make a choice.; This measure will be assessed at follow-up to see if differences observed between groups immediately post-intervention, remain at follow-up.

Trial Locations

Locations (1)

Washington University School of Medicine; 🇺🇸 Saint Louis, Missouri, United States