Navigating Insurance Coverage Expansion (NICE)

NCT ID: NCT04263441

Last Updated: 2022-11-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

630 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-10-18

Study Completion Date

2021-05-14

Brief Summary

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The purpose of this research is to measure the effectiveness of an in-person assistance intervention on successful insurance enrollment, types of insurance coverage, rates of linkage to and retention in HIV-related health care, referrals to other HIV-associated health services, and health outcomes. The study population is Black and Hispanic men who have sex with men (MSM) and transgender persons who are at higher risk for HIV.

The study team will be testing the hypotheses that in-person health insurance enrollment assistance results in positive outcomes with regard to linkage to and retention in HIV-related health care. Analyses will be used to assess the efficacy of the intervention as an emerging practice.

Detailed Description

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The overall goal of this study is to test whether providing in-person assistance in enrolling in private health insurance or Medicaid for the first time, changing to a different insurance plan, or understanding how to use current insurance policies following HIV testing will (1) increase the proportion of participants who obtain health insurance; (2) result in better health outcomes among participants; (3) improve the linkage and retention rates of participants, especially those diagnosed with HIV; and (4) increase linkage and retention rates sufficiently to justify the cost of implementing the intervention (cost-benefit analysis).

Conditions

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HIV/AIDS

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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NICE Intervention

The proposed intervention will engage clients in the health care enrollment and navigation process in-person, at the time of the HIV testing event. Subjects will be asked to share thoughts on the satisfaction survey.

Group Type EXPERIMENTAL

NICE Intervention

Intervention Type BEHAVIORAL

Subjects enrolled in the intervention arm will be offered assistance in enrolling in healthcare coverage and provided assistance on where they can go for care immediately. Subjects will be followed for 1 year and information including lab tests and insurance coverage status will be collected. This information will be collected from medical record review.

Control Intervention

Subjects will be offered a handout on how to enroll in healthcare coverage This group will be provided with the site's standard healthcare enrollment and linkage to care, which is specific to the health care clinic they are visiting. Subjects will be followed for 1 year and information including lab tests and insurance coverage status will be collected. This information will be collected from medical record review. Subjects will be asked to share thoughts on the satisfaction survey.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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NICE Intervention

Subjects enrolled in the intervention arm will be offered assistance in enrolling in healthcare coverage and provided assistance on where they can go for care immediately. Subjects will be followed for 1 year and information including lab tests and insurance coverage status will be collected. This information will be collected from medical record review.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Black or Hispanic men who have sex with men (MSM) or transgender persons
* 18 or older

Exclusion Criteria

* Cisgender women
* Cisgender men who have not had anal or oral sex with a man in last 2 years
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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Howard Brown Health Center

OTHER

Sponsor Role collaborator

Chicago House and Social Service Agency

UNKNOWN

Sponsor Role collaborator

Centers for Disease Control and Prevention

FED

Sponsor Role collaborator

University of Chicago

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Howard Brown Health

Chicago, Illinois, United States

Site Status

Chicago House and Social Service Agency, Inc.

Chicago, Illinois, United States

Site Status

University of Chicago Medical Center

Chicago, Illinois, United States

Site Status

Countries

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United States

References

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Herbst JH, Jacobs ED, Finlayson TJ, McKleroy VS, Neumann MS, Crepaz N; HIV/AIDS Prevention Research Synthesis Team. Estimating HIV prevalence and risk behaviors of transgender persons in the United States: a systematic review. AIDS Behav. 2008 Jan;12(1):1-17. doi: 10.1007/s10461-007-9299-3. Epub 2007 Aug 13.

Reference Type BACKGROUND
PMID: 17694429 (View on PubMed)

Millett GA, Peterson JL, Flores SA, Hart TA, Jeffries WL 4th, Wilson PA, Rourke SB, Heilig CM, Elford J, Fenton KA, Remis RS. Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet. 2012 Jul 28;380(9839):341-8. doi: 10.1016/S0140-6736(12)60899-X. Epub 2012 Jul 20.

Reference Type BACKGROUND
PMID: 22819656 (View on PubMed)

Sullivan PS, Rosenberg ES, Sanchez TH, Kelley CF, Luisi N, Cooper HL, Diclemente RJ, Wingood GM, Frew PM, Salazar LF, Del Rio C, Mulligan MJ, Peterson JL. Explaining racial disparities in HIV incidence in black and white men who have sex with men in Atlanta, GA: a prospective observational cohort study. Ann Epidemiol. 2015 Jun;25(6):445-54. doi: 10.1016/j.annepidem.2015.03.006. Epub 2015 Mar 24.

Reference Type BACKGROUND
PMID: 25911980 (View on PubMed)

Khan L. Transgender health at the crossroads: legal norms, insurance markets, and the threat of healthcare reform. Yale J Health Policy Law Ethics. 2011 Summer;11(2):375-418. No abstract available.

Reference Type BACKGROUND
PMID: 22136012 (View on PubMed)

Hall G, Li K, Wilton L, Wheeler D, Fogel J, Wang L, Koblin B. A Comparison of Referred Sexual Partners to Their Community Recruited Counterparts in The BROTHERS Project (HPTN 061). AIDS Behav. 2015 Dec;19(12):2214-23. doi: 10.1007/s10461-015-1005-2.

Reference Type BACKGROUND
PMID: 25874753 (View on PubMed)

Matts JP, Lachin JM. Properties of permuted-block randomization in clinical trials. Control Clin Trials. 1988 Dec;9(4):327-44. doi: 10.1016/0197-2456(88)90047-5.

Reference Type BACKGROUND
PMID: 3203524 (View on PubMed)

Farnham PG, Sansom SL, Hutchinson AB. How much should we pay for a new HIV diagnosis? A mathematical model of HIV screening in US clinical settings. Med Decis Making. 2012 May-Jun;32(3):459-69. doi: 10.1177/0272989X11431609. Epub 2012 Jan 12.

Reference Type BACKGROUND
PMID: 22247422 (View on PubMed)

Gebo KA, Fleishman JA, Conviser R, Hellinger J, Hellinger FJ, Josephs JS, Keiser P, Gaist P, Moore RD; HIV Research Network. Contemporary costs of HIV healthcare in the HAART era. AIDS. 2010 Nov 13;24(17):2705-15. doi: 10.1097/QAD.0b013e32833f3c14.

Reference Type BACKGROUND
PMID: 20859193 (View on PubMed)

Horberg M, Raymond B. Financial policy issues for HIV pre-exposure prophylaxis: cost and access to insurance. Am J Prev Med. 2013 Jan;44(1 Suppl 2):S125-8. doi: 10.1016/j.amepre.2012.09.039. No abstract available.

Reference Type BACKGROUND
PMID: 23253752 (View on PubMed)

Related Links

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https://www.thetaskforce.org/wp-content/uploads/2019/07/ntds_full.pdf

Injustice at Every Turn: A Report of the National Transgender Discrimination Survey

https://files.hiv.gov/s3fs-public/bmsm-webinar-06252014.pdf

Moving Black MSM Along the HIV Care Continuum

https://www.chicago.gov/content/dam/city/depts/cdph/HIV_STI/World_AIDS_Day_Report_012717.pdf

Chicago Department of Public Health. HIV/STI Surveillance Report 2016

https://www.chicago.gov/content/dam/city/depts/cdph/infectious_disease/STI_HIV_AIDS/MSMReport2012.pdf

HIV Risk and Prevention Behaviors Among Men Who Have Sex With Men, Chicago, 2008 and 2011

Other Identifiers

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CDC

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

IRB16-1260

Identifier Type: -

Identifier Source: org_study_id

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