Effective Communication to Improve Decision Making About Health Care Plans

NCT ID: NCT01986790

Last Updated: 2016-06-09

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

343 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-04-30

Study Completion Date

2014-06-30

Brief Summary

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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

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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.

Conditions

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Health Literacy Health Insurance Health Services Accessibility

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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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.

Group Type EXPERIMENTAL

Plain Language

Intervention Type BEHAVIORAL

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.

Group Type EXPERIMENTAL

Plain Language + Visuals

Intervention Type BEHAVIORAL

Plain Language + Narratives

This intervention group will receive the plain language table plus narratives about how others might use and rate the insurance plans.

Group Type EXPERIMENTAL

Plain Language + Narratives

Intervention Type BEHAVIORAL

Interventions

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Plain Language

Intervention Type BEHAVIORAL

Plain Language + Visuals

Intervention Type BEHAVIORAL

Plain Language + Narratives

Intervention Type BEHAVIORAL

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Maximum Eligible Age

64 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role collaborator

Washington University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mary Politi, PhD

Role: PRINCIPAL_INVESTIGATOR

The Washington University in St. Louis School of Medicine

Locations

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The Washington University in St. Louis School of Medicine

St Louis, Missouri, United States

Site Status

Countries

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United States

References

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Reference Type BACKGROUND
PMID: 10151887 (View on PubMed)

Harris-Kojetin LD, McCormack LA, Jael EF, Sangl JA, Garfinkel SA. Creating more effective health plan quality reports for consumers: lessons from a synthesis of qualitative testing. Health Serv Res. 2001 Jul;36(3):447-76.

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Hibbard JH, Jewett JJ, Engelmann S, Tusler M. Can Medicare beneficiaries make informed choices? Health Aff (Millwood). 1998 Nov-Dec;17(6):181-93. doi: 10.1377/hlthaff.17.6.181.

Reference Type BACKGROUND
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Peters E, Dieckmann N, Dixon A, Hibbard JH, Mertz CK. Less is more in presenting quality information to consumers. Med Care Res Rev. 2007 Apr;64(2):169-90. doi: 10.1177/10775587070640020301.

Reference Type BACKGROUND
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Hibbard JH, Slovic P, Jewett JJ. Informing consumer decisions in health care: implications from decision-making research. Milbank Q. 1997;75(3):395-414. doi: 10.1111/1468-0009.00061.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Kreuter MW, Green MC, Cappella JN, Slater MD, Wise ME, Storey D, Clark EM, O'Keefe DJ, Erwin DO, Holmes K, Hinyard LJ, Houston T, Woolley S. Narrative communication in cancer prevention and control: a framework to guide research and application. Ann Behav Med. 2007 Jun;33(3):221-35. doi: 10.1007/BF02879904.

Reference Type BACKGROUND
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McCormack LA, Uhrig JD. How does beneficiary knowledge of the Medicare program vary by type of insurance? Med Care. 2003 Aug;41(8):972-8. doi: 10.1097/00005650-200308000-00010.

Reference Type BACKGROUND
PMID: 12886176 (View on PubMed)

Hoadley J. Medicare Part D: simplifying the program and improving the value of information for beneficiaries. Issue Brief (Commonw Fund). 2008 May;39:1-15.

Reference Type BACKGROUND
PMID: 18536148 (View on PubMed)

Lubalin JS, Harris-Kojetin LD. What do consumers want and need to know in making health care choices? Med Care Res Rev. 1999;56 Suppl 1:67-102; discussion 103-12. doi: 10.1177/1077558799056001S04.

Reference Type BACKGROUND
PMID: 10354679 (View on PubMed)

Kolstad JT, Chernew ME. Quality and consumer decision making in the market for health insurance and health care services. Med Care Res Rev. 2009 Feb;66(1 Suppl):28S-52S. doi: 10.1177/1077558708325887. Epub 2008 Nov 24.

Reference Type BACKGROUND
PMID: 19029288 (View on PubMed)

Hibbard JH, Jewett JJ. Will quality report cards help consumers? Health Aff (Millwood). 1997 May-Jun;16(3):218-28. doi: 10.1377/hlthaff.16.3.218.

Reference Type BACKGROUND
PMID: 9141339 (View on PubMed)

Uhrig JD, Harris-Kojetin L, Bann C, Kuo TM. Do content and format affect older consumers' use of comparative information in a Medicare health plan choice? Results from a controlled experiment. Med Care Res Rev. 2006 Dec;63(6):701-18. doi: 10.1177/1077558706293636.

Reference Type BACKGROUND
PMID: 17099122 (View on PubMed)

Kreuter MW, Wray RJ. Tailored and targeted health communication: strategies for enhancing information relevance. Am J Health Behav. 2003 Nov-Dec;27 Suppl 3:S227-32. doi: 10.5993/ajhb.27.1.s3.6.

Reference Type BACKGROUND
PMID: 14672383 (View on PubMed)

Hinyard LJ, Kreuter MW. Using narrative communication as a tool for health behavior change: a conceptual, theoretical, and empirical overview. Health Educ Behav. 2007 Oct;34(5):777-92. doi: 10.1177/1090198106291963. Epub 2006 Dec 15.

Reference Type BACKGROUND
PMID: 17200094 (View on PubMed)

Hibbard JH, Peters E. Supporting informed consumer health care decisions: data presentation approaches that facilitate the use of information in choice. Annu Rev Public Health. 2003;24:413-33. doi: 10.1146/annurev.publhealth.24.100901.141005. Epub 2001 Nov 6.

Reference Type BACKGROUND
PMID: 12428034 (View on PubMed)

Politi MC, Kaphingst KA, Kreuter M, Shacham E, Lovell MC, McBride T. Knowledge of health insurance terminology and details among the uninsured. Med Care Res Rev. 2014 Feb;71(1):85-98. doi: 10.1177/1077558713505327. Epub 2013 Oct 24.

Reference Type BACKGROUND
PMID: 24163306 (View on PubMed)

Politi MC, Kaphingst KA, Liu JE, Perkins H, Furtado K, Kreuter MW, Shacham E, McBride T. A Randomized Trial Examining Three Strategies for Supporting Health Insurance Decisions among the Uninsured. Med Decis Making. 2016 Oct;36(7):911-22. doi: 10.1177/0272989X15578635. Epub 2015 Apr 3.

Reference Type DERIVED
PMID: 25840904 (View on PubMed)

Other Identifiers

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HS020309

Identifier Type: -

Identifier Source: org_study_id

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