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OpenTrials
Completed

NCT Number: NCT03592433

Improving Cancer Patients' Insurance Choices

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.

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Key information

Conditions

Cancer Health Insurance Health Literacy Health Services Accessibility Informed Decision Making Neoplasms

Age range

18 year–64 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Washington University School of Medicine

St Louis, Missouri, 63110, United States

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

I Can PIC

Behavioral

Participants will be shown (on a computer or via email link) a website called I Can PIC. I Can PIC provides health insurance education, suggests ways to learn about the costs of cancer care and follow-up, shows resources to help offset the high costs of care, and helps individuals estimate (based on national data) how much they might spend on health insurance in the upcoming year.

Other names: Decision Aid (DA)

Primary outcomes

  1. Knowledge Score

    Time frame: Completed immediately after using I Can PIC

    The percent correct out of eight questions that were created by the research team based on information that is considered vital to making health insurance decisions.

  2. Decision Self-efficacy

    Time frame: Completed immediately after using I Can PIC.

    The validated decision self-efficacy scale will be used. This 11-item scale measures an individual's self-confidence or belief in their ability to make a decision. Individuals will be asked to rate how confident they feel taking actions involved in making an informed choice (e.g., gathering information, asking questions, and expressing opinions).

  3. Certainty about Choice (Decisional Conflict Scale)

    Time frame: Completed immediately after using I Can PIC

    The validated, 4-item SURE Test for clinical practice will be used. This scale measures whether individuals feel they have enough information to make a choice, are clear about their values for risks and benefits of their choice, and feel they have enough support to make a choice.

Secondary outcomes

  1. Health Insurance Literacy Measure

    Time frame: Completed immediately after using I Can PIC

    Two items from the validated Health Insurance Literacy Measure will be used. This scale measures consumers' confidence in their ability to estimate their annual health care costs and their understanding of health insurance terms.

  2. Health Insurance Literacy Measure

    Time frame: 3 month follow-up

    Two items from the validated Health Insurance Literacy Measure will be used. This scale measures consumers' confidence in their ability to estimate their annual health care costs and their understanding of health insurance terms.

    This measure will be assessed at follow-up to see if differences observed between groups immediately post-intervention, remain at follow-up.

  3. Choice of Health Insurance Plan

    Time frame: Completed immediately after using I Can PIC

    Participants will be asked what health insurance plan they would choose. Plan selections will be categorized by the type of plan, e.g., high deductible plan, PPO, silver-tier Marketplace plan, gold-tier Marketplace plan, and will be compared to our algorithmic prediction about good fit plans for users based on estimates of their health care expenses.

  4. Choice of Health Insurance Plan

    Time frame: 3 month follow-up

    Participants will be asked what health insurance plan they choose. Plan selections will be categorized by the type of plan, e.g., high deductible plan, PPO, silver-tier Marketplace plan, gold-tier Marketplace plan, and will be compared to our algorithmic prediction about good fit plans for users based on estimates of their health care expenses.

    This measure will be assessed at follow-up to see if differences observed between groups immediately post-intervention, remain at follow-up.

  5. Healthcare Utlization

    Time frame: 3 month follow-up

    Participants will be asked questions about how often they use healthcare services to see if their plan choice relates to their utilization

  6. Knowledge Score

    Time frame: 3 month follow-up

    The percent correct out of eight questions that were created by the research team based on information that is considered vital to making health insurance decisions.

    This measure will be assessed at follow-up to see if differences observed between groups immediately post-intervention, remain at follow-up.

  7. Certainty about Choice (Decisional Conflict Scale)

    Time frame: 3 month follow-up

    The validated, 4-item SURE Test for clinical practice will be used. This scale measures whether individuals feel they have enough information to make a choice, are clear about their values for risks and benefits of their choice, and feel they have enough support to make a choice.

    This measure will be assessed at follow-up to see if differences observed between groups immediately post-intervention, remain at follow-up.

Sponsors and collaborators

Lead sponsor

Washington University School of Medicine

Other

Collaborators

  • American Cancer Society, Inc.

Registry information

Official study title

Supporting Cancer Survivors' Health Insurance Marketplace Decisions

Acronym: I Can PIC

Important dates

Study start
2018
Primary completion
2019
Study completion
2019
First posted
Jul 19, 2018
Registry last updated
May 1, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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