A Randomized Controlled Trial to Improve Health Insurance Literacy and Surveillance Among Young Adult Cancer Survivors
University of Utah
Summary
We will conduct a randomized controlled trial to test a 4-session virtual health insurance navigation intervention that will increase knowledge about health insurance, reduce financial burden, and improve surveillance for recurrence among 300 young adult cancer survivors ages 26 to 39. We will combine self-reported survey data with electronic health records and claims data to examine the trial outcomes and efficacy. We will also conduct an economic evaluation using cost-effectiveness and budget impact analyses, to establish the sustainability of the intervention at improving outcomes of young adult survivors through increasing their health insurance knowledge and decreasing their financial burden.
Description
The first year after cancer treatment ends is a critical time to establish survivorship care for young adult (YA) cancer survivors ages 26 to 39. Receipt of evidence-based survivorship care, including surveillance for cancer recurrence based on national guidelines, remain low among YA survivors. At the same time, YAs ages 26 to 39 have the highest rate of both uninsurance and underinsurance among adults in the United States. Our team's prior work demonstrated that YA cancer survivors report low understanding of their health insurance and the services it covers, which affects their ability to n…
Eligibility
- Age range
- 26–45 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: Participants are eligible for this study if they: 1. Were diagnosed with breast, testicular, lymphoma, sarcoma, and colorectal cancer, 2. Are between the ages of 26 to 45 years (preferably between 26-39, but no older than 45), 3. Have completed initial treatment (i.e., radiation, chemotherapy, or surgery) within the past year, 4. Are a patient at the University of Utah/Huntsman Cancer Institute or Intermountain Healthcare, and 5. Speak English. Exclusion Criteria: Potential participants will be excluded if they: 1. Are unable to participate due to developmental delay,…
Interventions
- BehavioralCHAT-S
The CHAT-S intervention will include 4 videoconference sessions over a 2-month time period that is delivered by a patient navigator. Session 1 will include content to educate participants about survivorship care and common types of follow-up care required for their specific cancer, as well as, basic insurance terms and concepts. Session 2 will teach participants about their own insurance plan (e.g., coverage, benefits, breakdown of bills, and explanation of benefits) so they can better navigate both the medical and insurance systems. Session 3 reviews health insurance laws (e.g., ACA, FMLA, No Surprises Act) and how to proceed with an appeals process. Session 4 explains how to manage the costs through budgeting and cost-of-care conversations with their medical providers.
- BehavioralUsual Care
Usual care will consist of a resource list that describes organizational and community resources available on insurance, financial burden, and survivorship care. Further, we will track whether participants were referred or engaged in services using the follow-up surveys and via the EHR/claims data.
Locations (2)
- Intermountain HealthMurray, Utah
- University of UtahSalt Lake City, Utah