Effective Communication to Improve Decision Making About Health Care Plans

Not Applicable

Completed

Conditions: Health Services Accessibility
Health Insurance
Health Literacy

Interventions: Behavioral: Plain Language + Visuals
Behavioral: Plain Language
Behavioral: Plain Language + Narratives

Registration Number: NCT01986790

Lead Sponsor: Washington University School of Medicine

Brief Summary: The overall goal of the study is to better understand how communication strategies can help people make decisions about health insurance plans.

This study aims to:

* (Aim 1) Examine currently uninsured individuals' understanding of terminology and details of health insurance plans;

* (Aim 2) Apply three recommended strategies for communicating information about health insurance plans;

* (Aim 3) Test the effects of these strategies in a randomized experiment.

Detailed Description: First, this study will examine people's understanding of health insurance plan terminology and details through qualitative interviews with 50 uninsured individuals. These responses will then lead to the development of three communication strategies to improve understanding of health insurance plans: 1) plain language, 2) plain language plus visual displays and 3) plain language plus narratives.

The strategies will the be pilot tested with 30 individuals to assess readability, clarity of language, and layout. The revised communication strategies will be tested with 280 individuals in a randomized experiment. Individuals will be randomly assigned to either a plain language condition alone, a plain language + visual displays condition, and a plain language + narrative condition.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 343

Inclusion Criteria

Must be without health insurance currently
Must have been without health insurance at some point in the past 12 months
Must speak English

Exclusion Criteria

Currently has health insurance and has not had any lapses in coverage in the past 12 months
Does not speak English

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Plain Language + Visuals	Plain Language + Visuals	This intervention group will receive the plain-language table plus visuals that focus on specific features of the plans. Participants will be able to view the information about each health insurance feature one feature at a time, in the order they prefer.
Plain Language	Plain Language	This intervention group will receive a plain-language table describing the features and costs of health insurance plans, with definitions of health insurance terms incorporated into the table.
Plain Language + Narratives	Plain Language + Narratives	This intervention group will receive the plain language table plus narratives about how others might use and rate the insurance plans.

Primary Outcome Measures

Name	Time	Method
Knowledge	1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives)	Knowledge measures the degree at which participants understand the details about health insurance plans. Knowledge was scored on a scale from 0 to 7 based on number of correct answers to the 7 items. A higher value is considered to be a better outcome. Bivariate outcome data can be found below.
Uncertainty	1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives)	A survey will be administered in order to measure participants' confidence in the features of health insurance plans that matter most to them and the insurance plan they chose of the ones presented. Confidence in choice is scored on a scale from 0 to 100, with higher scores indicating more decisional conflict/more uncertainty/less confidence in choice. Bivariate outcome data can be found below.
Satisfaction	1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives)	A survey will be administered in order to measure the extent to which participants are satisfied with the information presented to them. Satisfaction was scored on a scale from 1 to 4, with higher scores indicating higher levels of satisfaction. Bivariate outcome data can be found below.