ASPO Abstracts
The HIAYA CHAT project: Incorporating Pilot Testing Data in the Refinement of a Health Insurance Education Program for Adolescent and Young Adult Cancer Patients
Category: Behavioral Science & Health Communication
Conference Year: 2021
Abstract Body:
Purpose: To pilot test a patient navigator delivered, telehealth-based health insurance education program
(HIEP) for adolescents and young adult cancer patients (AYAs).
Methods: The HIEP consists of four 30-45 minute sessions about insurance types, terminology, and strategies
to manage health care costs during cancer treatment. We pilot tested and iteratively updated the HIEP with
N=9 individuals. The research team pilot tested the HIEP with 3 AYAs. We obtained content feedback on the
applicability and clarity of the HIEP materials and incorporated changes. Patient navigators then pilot tested
the HIEP with 2 AYAs and 4 research/administrative staff (2 staff only completed 1 session) to provide input on
the content and clarity of materials and identify optimal HIEP delivery (e.g. tone, technology, length). We
created memos on the feedback and made corresponding program modifications.
Results: Overall, feedback from the pilot sessions was positive and supported the use of patient navigators to
deliver the HIEP. Patients expressed concerns about the reading level of the content and difficulty
understanding insurance concepts. Staff members highlighted the importance of delicately handling
emotionally charged subjects like treatment costs and insurance legislation. Based on feedback, the following
improvements to the HIEP were made: 1) alternative definitions of complex health insurance terms and
concepts were added; 2) new educational modalities were added to improve the clarity of the materials through
flowcharts and other visuals (e.g., we added a figure showing different types of insurance coverage); and 3)
patient navigator training was revised to address emotionally charged topics.
Conclusions: While quantitative analysis of an intervention provides important early-stage assessment of
materials, pilot testing is an important step to ensure that interventions are appropriately implemented and
meet the needs of their target audience. Iteratively pilot testing and incorporating feedback from patients and
staff on both content and delivery resulted in a more patient-centered HIEP. Next steps include the delivery of
the materials in a randomized controlled trial to ascertain participant feasibility, acceptability, and satisfaction
with the HIEP.
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