Clinical trial NCT02841930: ActionHealthNYC Research Study
Official title: ActionHealthNYC: A Health Care Access Program for the Uninsured
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Health Services Accessibility
Keywords: Healthcare Access
Undocumented Immigrants
Primary Prevention
Lead sponsor: New York City Department of Health and Mental Hygiene
Sponsor class: OTHER_GOV
Collaborators: name: American Institutes for Research
name: Public Health Solutions
name: The New York Academy of Medicine
name: New York City Health and Hospitals Corporation
name: New York City Human Resources Administration
name: New York City Mayor's Office of Immigrant Affairs
First posted: 2016-07-22
Enrollment: 2428
Sex: ALL
Minimum age (years): 19
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The ActionHealthNYC program is a year-long demonstration program to improve access to high quality health care for NYC resident immigrants who do not qualify for public insurance with incomes at or below 200% of the Federal Poverty Level (FPL). The purpose of this study is to determine whether improved access and care coordination services provided through the ActionHealth NYC program allows participants to have easier access to healthcare (particularly primary care and preventive services) than non-participants.

Detailed description: The ActionHealthNYC program is a year-long demonstration program to improve access to high quality health care for NYC resident immigrants who do not qualify for public insurance with incomes at or below 200% of the Federal Poverty Level (FPL). Our goal in piloting the program and conducting the research study is to understand the following questions:

* For clients participating in the ActionHealthNYC program, do they report having easier access to health care?
* What are the differences in health care utilization for participants in the ActionHealthNYC program and those not in the program?
* Do the participants in the ActionHealthNYC program report fewer barriers to needed care when compared to those not in the program?
* Are the participants in the ActionHealthNYC program more likely to have received preventive services according to the United States Preventive Services Task Force (USPTF) or recommended services for those with a qualifying condition through their medical home?
* How does the likelihood of receiving a new diagnosis compare between the ActionHealthNYC member group and the study group?
* How does emergency department and hospital use compare between the ActionHealthNYC member group and the study group?

We will be conducting a randomized controlled trial (RCT) where we will be enrolling 2,400 people that meet the eligibility criteria and randomizing half into the ActionHealth NYC program. We will be employing a mixed methods approach to address differences between participants randomized to receive enhanced services through ActionHealthNYC (AHNYC) and those receiving usual care, utilizing surveys, secondary data analysis, key informant interviews and participant focus groups.

Eligibility criteria: Inclusion Criteria:

* New York City residents who are uninsured, 19 and older and
* Not currently eligible for Medicaid, Essential Plan, or
* Not currently eligible for private insurance via federal insurance marketplace subsidies due to their immigration status.

Exclusion Criteria:

* Not a New York City resident
* Currently eligible for Medicaid, Essential Plan or private insurance at state exchange with federal subsidies
* Income above 200% of the federal poverty level (FPL)

Enrollees are required to have the NYC Municipal identification card (IDNYC). If they do not have the card, however, they can obtain it and come back for enrollment.

Primary outcomes:
measure: Improved access to healthcare
timeFrame: One year
Secondary outcomes:
measure: Enhanced healthcare utilization
timeFrame: One year
measure: Reduced barriers to needed care
timeFrame: One year
measure: Enhanced utilization of preventive services
timeFrame: One year
measure: Increased number of new diagnoses
timeFrame: One year
Other outcomes:
Locations:
city: Long Island City
country: United States
facility: New York City Department of Health and Mental Hygiene
state: New York
Study officials:
affiliation: New York City Department of Health and Mental Hygiene
name: Rishi Sood, MPH
role: PRINCIPAL_INVESTIGATOR
References: