ASPO Abstracts
The HIAYA CHAT Project: Qualitative Feedback on a Health Insurance Education Program for Adolescent and Young Adult Cancer Patients
Category: Behavioral Science & Health Communication
Conference Year: 2021
Abstract Body:
Purpose: To integrate qualitative feedback in the adaptation of a health insurance education program (HIEP)
for adolescents and young adults (AYAs) with cancer.
Method: From October 2019-March 2020 we interviewed N=24 AYA patients and survivors ages 18-39 who
were currently insured. Participants were interviewed over the phone to provide feedback on the HIEP's four
sessions: 1) Insurance terms/definitions; 2) Insurance coverage components; 3) Insurance legislation; and 4)
Cost management, and the suitability of the intervention delivery. Interviews were audio recorded, transcribed,
and deductively analyzed using NVivo 12. We classified feedback into two sub-categories: 1) Endorsements,
which included anything participants agreed with or found helpful and 2) Recommendations, which included
content participants felt should be added to or re-ordered in the sessions.
Results: AYA participants were primarily female (58%), non-Hispanic White (79%), on treatment (79%), and
mostly had employer-sponsored insurance (75%). Most endorsed the need for AYA cancer patients to learn
about health insurance. Survivors in particular reflected back on their treatment experience where having more
knowledge of insurance (e.g. appeals process) would have been useful. AYAs endorsed session content about
insurance policies, legal protections, and how legislation impacts health care costs. AYAs recommended
evaluating patients' health insurance literacy before starting the HIEP because some participants already
understand some insurance components. AYAs recommended providing examples of a medical bill,
explanation of insurance benefits and budgeting tools to help manage cancer care cost and personal
expenses. AYAs expressed that 3 to 4 sessions seemed feasible, but that sessions should be no more than 30
minutes each and delivered through an online platform. Most recommendations were incorporated in the final
HIEP.
Conclusion: AYA cancer patients report low insurance and health care cost literacy. AYA endorsed learning
about insurance policies and protections, recommended tangible examples and brief sessions. Describing AYA
cancer patients' preferences for a HIEP may improve relevance and efficacy of the intervention, and ultimately
enhance health insurance and cost literacy.
Keywords: AYA, health insurance, insurance education