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Effective Communication to Improve Decision Making About Health Care Plans

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ClinicalTrials.gov Identifier: NCT01986790
Recruitment Status : Completed
First Posted : November 18, 2013
Results First Posted : June 9, 2016
Last Update Posted : June 9, 2016
Sponsor:
Collaborator:
Agency for Healthcare Research and Quality (AHRQ)
Information provided by (Responsible Party):
Washington University School of Medicine

Tracking Information
First Submitted Date  ICMJE November 4, 2013
First Posted Date  ICMJE November 18, 2013
Results First Submitted Date  ICMJE February 11, 2016
Results First Posted Date  ICMJE June 9, 2016
Last Update Posted Date June 9, 2016
Study Start Date  ICMJE April 2012
Actual Primary Completion Date March 2014   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: May 2, 2016)
  • Knowledge [ Time Frame: 1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives) ]
    Knowledge measures the degree at which participants understand the details about health insurance plans. Knowledge was scored on a scale from 0 to 7 based on number of correct answers to the 7 items. A higher value is considered to be a better outcome. Bivariate outcome data can be found below.
  • Uncertainty [ Time Frame: 1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives) ]
    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. Confidence in choice is scored on a scale from 0 to 100, with higher scores indicating more decisional conflict/more uncertainty/less confidence in choice. Bivariate outcome data can be found below.
  • Satisfaction [ Time Frame: 1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives) ]
    A survey will be administered in order to measure the extent to which participants are satisfied with the information presented to them. Satisfaction was scored on a scale from 1 to 4, with higher scores indicating higher levels of satisfaction. Bivariate outcome data can be found below.
Original Primary Outcome Measures  ICMJE
 (submitted: November 11, 2013)
Knowledge [ Time Frame: 1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives) ]
Knowledge measures the degree at which participants understand the details about health insurance plans.
Change History
Current Secondary Outcome Measures  ICMJE Not Provided
Original Secondary Outcome Measures  ICMJE
 (submitted: November 11, 2013)
  • Uncertainty [ Time Frame: 1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives) ]
    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.
  • Satisfaction [ Time Frame: 1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives) ]
    A survey will be administered in order to measure the extent to which participants are satisfied with the information presented to them.
  • Choice [ Time Frame: 1 day (Immediately following showing the participant the assigned intervention (plain language table, plain language table + visuals, or plain language table + narratives) ]
    A survey will be administered to identify the insurance plan participants chose of the ones presented.
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Effective Communication to Improve Decision Making About Health Care Plans
Official Title  ICMJE Effective Communication to Improve Decision Making About Health Care Plans
Brief 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.
Detailed 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.

Study Type  ICMJE Interventional
Study Phase  ICMJE Not Applicable
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Prevention
Condition  ICMJE
  • Health Literacy
  • Health Insurance
  • Health Services Accessibility
Intervention  ICMJE
  • Behavioral: Plain Language
  • Behavioral: Plain Language + Visuals
  • Behavioral: Plain Language + Narratives
Study Arms  ICMJE
  • Experimental: Plain Language
    This intervention group will receive a plain-language table describing the features and costs of health insurance plans, with definitions of health insurance terms incorporated into the table.
    Intervention: Behavioral: Plain Language
  • Experimental: Plain Language + Visuals
    This intervention group will receive the plain-language table plus visuals that focus on specific features of the plans. Participants will be able to view the information about each health insurance feature one feature at a time, in the order they prefer.
    Intervention: Behavioral: Plain Language + Visuals
  • Experimental: Plain Language + Narratives
    This intervention group will receive the plain language table plus narratives about how others might use and rate the insurance plans.
    Intervention: Behavioral: Plain Language + Narratives
Publications *

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: May 2, 2016)
343
Original Estimated Enrollment  ICMJE
 (submitted: November 11, 2013)
360
Actual Study Completion Date  ICMJE June 2014
Actual Primary Completion Date March 2014   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

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
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 64 Years   (Adult)
Accepts Healthy Volunteers  ICMJE Yes
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT01986790
Other Study ID Numbers  ICMJE HS020309
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE Not Provided
Responsible Party Washington University School of Medicine
Study Sponsor  ICMJE Washington University School of Medicine
Collaborators  ICMJE Agency for Healthcare Research and Quality (AHRQ)
Investigators  ICMJE
Principal Investigator: Mary Politi, PhD The Washington University in St. Louis School of Medicine
PRS Account Washington University School of Medicine
Verification Date May 2016

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP