Clinical trial NCT03592433: Improving Cancer Patients' Insurance Choices
Official title: Supporting Cancer Survivors' Health Insurance Marketplace Decisions
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Cancer
Health Literacy
Health Insurance
Health Services Accessibility
Informed Decision Making
Keywords: Decision Making
Decision Support
Health Literacy
Lead sponsor: Washington University School of Medicine
Sponsor class: OTHER
Collaborators: name: American Cancer Society, Inc.
First posted: 2018-07-19
Enrollment: 263
Sex: ALL
Minimum age (years): 18
Maximum age (years): 64
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

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.

Eligibility criteria: Inclusion Criteria:

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

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

Primary outcomes:
measure: Knowledge Score
timeFrame: Completed immediately after using I Can PIC
measure: Decision Self-efficacy
timeFrame: Completed immediately after using I Can PIC.
measure: Certainty about Choice (Decisional Conflict Scale)
timeFrame: Completed immediately after using I Can PIC
Secondary outcomes:
measure: Health Insurance Literacy Measure
timeFrame: Completed immediately after using I Can PIC
measure: Health Insurance Literacy Measure
timeFrame: 3 month follow-up
measure: Choice of Health Insurance Plan
timeFrame: Completed immediately after using I Can PIC
measure: Choice of Health Insurance Plan
timeFrame: 3 month follow-up
measure: Healthcare Utlization
timeFrame: 3 month follow-up
measure: Knowledge Score
timeFrame: 3 month follow-up
measure: Certainty about Choice (Decisional Conflict Scale)
timeFrame: 3 month follow-up
Other outcomes:
Locations:
city: Saint Louis
country: United States
facility: Washington University School of Medicine
state: Missouri
Study officials:
affiliation: Washington University School of Medicine
name: Mary C Politi, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Housten AJ, Furtado K, Kaphingst KA, Kebodeaux C, McBride T, Cusanno B, Politi MC. Stakeholders' perceptions of ways to support decisions about health insurance marketplace enrollment: a qualitative study. BMC Health Serv Res. 2016 Nov 8;16(1):634. doi: 10.1186/s12913-016-1890-8.
citation: Politi MC, Barker AR, Kaphingst KA, McBride T, Shacham E, Kebodeaux CS. Show Me My Health Plans: a study protocol of a randomized trial testing a decision support tool for the federal health insurance marketplace in Missouri. BMC Health Serv Res. 2016 Feb 16;16:55. doi: 10.1186/s12913-016-1314-9.
citation: Politi MC, Kuzemchak MD, Liu J, Barker AR, Peters E, Ubel PA, Kaphingst KA, McBride T, Kreuter MW, Shacham E, Philpott SE. Show Me My Health Plans: Using a Decision Aid to Improve Decisions in the Federal Health Insurance Marketplace. MDM Policy Pract. 2016 Jul;1(1):2381468316679998. doi: 10.1177/2381468316679998. Epub 2016 Nov 16.