Effective Communication to Improve Decision Making About Health Care Plans

Health Literacy Clinical Trial

Official title:

Effective Communication to Improve Decision Making About Health Care Plans

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01986790
• Other study ID #: HS020309
• Status: Completed
• Phase: N/A
• First received: November 4, 2013
• Last updated: June 23, 2014
• Start date: April 2012
• Est. completion date: June 2014

Study information

• Verified date: June 2014
• Source: Washington University School of Medicine
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

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.

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 420
• Est. completion date: June 2014
• Est. primary completion date: March 2014
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: 18 Years to 64 Years

Eligibility

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

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention

Related Conditions & MeSH terms

• Health Insurance
• Health Literacy
• Health Services Accessibility

Intervention

Behavioral:
• Plain Language

• Plain Language + Visuals

• Plain Language + Narratives

Locations

Country	Name	City	State
United States	The Washington University in St. Louis School of Medicine	St. Louis	Missouri

Sponsors (2)

Lead Sponsor	Collaborator
Washington University School of Medicine	Agency for Healthcare Research and Quality (AHRQ)

Country where clinical trial is conducted

United States, 

References & Publications (18)

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Harris-Kojetin LD, McCormack LA, Jaël 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. — View Citation

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

Hibbard JH, Jewett JJ. Will quality report cards help consumers? Health Aff (Millwood). 1997 May-Jun;16(3):218-28. — View Citation

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. Epub 2001 Nov 6. Review. — View Citation

Hibbard JH, Slovic P, Jewett JJ. Informing consumer decisions in health care: implications from decision-making research. Milbank Q. 1997;75(3):395-414. Review. — View Citation

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. Epub 2006 Dec 15. — View Citation

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. — View Citation

Knutson DJ, Kind EA, Fowles JB, Adlis S. Impact of report cards on employees: a natural experiment. Health Care Financ Rev. 1998 Fall;20(1):5-27. — View Citation

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. Review. — View Citation

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. Review. — View Citation

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. Review. — View Citation

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. Review. — View Citation

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. — View Citation

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. — View Citation

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. — View Citation

Scanlon DP, Chernew M, Lave JR. Consumer health plan choice: current knowledge and future directions. Annu Rev Public Health. 1997;18:507-28. Review. — View Citation

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. — View Citation

* Note: There are 18 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Knowledge	Knowledge measures the degree at which participants understand the details about health insurance plans.	1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives)	No
Secondary	Uncertainty	A survey will be administered in order to measure participants' confidence in the features of health insurance plans that matter most to them and the insurance plan they chose of the ones presented.	1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives)	No
Secondary	Satisfaction	A survey will be administered in order to measure the extent to which participants are satisfied with the information presented to them.	1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives)	No
Secondary	Choice	A survey will be administered to identify the insurance plan participants chose of the ones presented.	1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives)	No