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Developing a Health Insurance Navigation Program for Survivors of Childhood Cancer
NA trial testing Health Insurance Navigation Program in Health Insurance in 82 participants. Completed in 31 December 2022.
| Lead sponsor | Massachusetts General Hospital |
|---|---|
| Phase | NA |
| Status | Completed |
| Study type | INTERVENTIONAL |
| Allocation | randomized |
| Design | parallel |
| Masking | none |
| Primary purpose | treatment |
| Enrollment | 82 |
| Start date | 25 August 2020 |
| Primary completion | 31 December 2022 |
| Estimated completion | 31 December 2022 |
| Sites | 1 location across United States |
Massachusetts General Hospital
18 and older, any sex, with Health Insurance or Childhood Cancer Survivors. Patients with the condition only — healthy volunteers not accepted.
Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.
10-point (1-10; 1= least helpful and 10= most helpful) scale rating of program quality, including the following (higher scores indicate higher levels of acceptability)- * program materials * scheduling * communication with navigator * length and number of sessions (investigator created scale)
| Group | Value | 95% CI |
|---|---|---|
| Navigation Intervention | 8.9 | ± 1.2 |
Program feasibility is measured by the percentage of participants completing all 4 intervention sessions.
| Group | Value | 95% CI |
|---|---|---|
| Navigation Intervention | 33 |
6 items rating familiarity with key Affordable Care Act (ACA) protections (scores range from 0-6; higher scores indicate higher degree of familiarity) (scale adapted from CCSS Health Insurance Survey)
| Group | Value | 95% CI |
|---|---|---|
| Navigation Intervention | 1.7 | ± 1.7 |
| Enhanced Usual Care | 0.5 | ± 1.6 |
16 items with a 4-category Likert scale ranging from 16-64 (higher scores denoting lower literacy) of confidence on understanding of health insurance terms (higher scores indicate higher levels of health insurance literacy). We report mean health insurance literacy change from baseline to follow-up. Scale adapted from the Urban Institute Health Reform Monitoring Survey- * premium * deductible * co-payments * co-insurance
| Group | Value | 95% CI |
|---|---|---|
| Navigation Intervention | 9.1 | ± 7.6 |
| Enhanced Usual Care | 1.8 | ± 7.9 |
Dr. Park and her colleagues published findings in the Journal of Clinical Oncology demonstrating that CCSS survivors, compared to siblings, were significantly more likely to be uninsured and to have difficulties obtaining health insurance. Given the current insurance landscape and the additional insurance burden that childhood cancer survivors face, the present study seeks to develop and pilot a health insurance navigation program targeted at feasibility and acceptability with survivors, and improving health insurance literacy and ameliorating financial distress related to medical costs. The proposed health insurance navigation will involve 4 navigator-led health insurance navigation sessions. The study investigators propose that, compared to the control arm (who will receive a health insurance information guide, but will not receive the navigation intervention), participants in the intervention arm will have improved health insurance literacy and decreased financial distress related to medical costs.
4 peer-reviewed publications reference this trial (live from Europe PMC):
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