Insuring Good Health: Outcomes and Acceptability of a Participatory Health Insurance Literacy Intervention in Diverse Urban Communities

Autor/inn/en	Patel, Minal R.; Israel, Barbara A.; Song, Peter X. K.; Hao, Wei; TerHaar, Lindsay; Tariq, Madiha; Lichtenstein, Richard
Titel	Insuring Good Health: Outcomes and Acceptability of a Participatory Health Insurance Literacy Intervention in Diverse Urban Communities
Quelle	In: Health Education & Behavior, 46 (2019) 3, S.494-505 (12 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1090-1981
DOI	10.1177/1090198119831060
Schlagwörter	Health Insurance; Literacy; Intervention; Web Sites; Federal Legislation; Disadvantaged; Video Technology; Information Sources; Participatory Research; Adults; Metropolitan Areas; Self Efficacy; Knowledge Level; Help Seeking; Poverty; Comparative Analysis; Health Services; Eligibility; Race; Ethnic Groups; Intention; Prevention; Michigan (Detroit) + Suchen Sie Ihr Suchwort? Krankenversicherung; Alphabetisierung; Schreib- und Lesefähigkeit; Web-Design; Bundesrecht; Information source; Informationsquelle; Forschungstätigkeit; Ballungsraum; Self-efficacy; Selbstwirksamkeit; Wissensbasis; Help-seeking behavior; Help-seeking behaviour; Hilfe suchendes Verhalten; Armut; Health service; Gesundheitsdienst; Gesundheitswesen; Eignung; Rasse; Abstammung; Ethnie; Prävention; Vorbeugung
Abstract	Background: The U.S. uninsured rate has dropped significantly since the passage of the Affordable Care Act (ACA), yet insurance coverage remains lower in historically marginalized communities than in the overall population. New consumer engagement approaches that involve these populations are needed. The purpose of this study was to evaluate the effectiveness of the Insuring Good Health Intervention, a website and video series designed to improve engagement with health insurance and ACA reforms. The study was designed and implemented using a community-based participatory research approach. Method: We conducted a lagged-control cluster randomized controlled trial to evaluate Insuring Good Health with racially and ethnically diverse adults seeking services in medically underserved areas within the Detroit, Michigan metropolitan area. Outcomes were assessed at baseline and at 6 and 9 months postintervention, and including self-efficacy, knowledge, beliefs, and intention to seek help with insurance navigation and care. Results: Among 243 participants, mean age was 43.4 (SD = 13) years, and all participants met federal guidelines for poverty. The study had an 86% response rate at 9-month follow-up (n = 209). Compared with the lagged-control group, intervention participants had more positive beliefs concerning preventive care (estimate 0.51, standard error 0.16; p < .01), and intention to seek help with insurance navigation and care (estimate 0.43, standard error 0.17; p < .001) at 9-month follow-up. Hispanic participants benefitted the most from the intervention, including improved knowledge of health insurance eligibility over 9 months compared with other racial/ethnic groups (estimate -0.97, standard error 0.40, p < .01). Discussion: Insuring Good Health was associated with increased intention to seek help with insurance navigation and care, and improved beliefs around preventive care. Conclusions: Insuring Good Health has the potential to be an important consumer engagement tool to reduce disparities in health insurance coverage and care seeking. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2020/1/01