Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave, Campus, Box 8100, St. Louis, MO, 63110, USA.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, USA.
BMC Res Notes. 2022 Sep 10;15(1):298. doi: 10.1186/s13104-022-06189-8.
This study adapted Improving Cancer Patients' Insurance Choices (I Can PIC), an intervention to help cancer patients navigate health insurance decisions and care costs. The original intervention improved knowledge and confidence making insurance decisions, however, users felt limited by choices provided in insurance markets. Using decision trees and frameworks to guide adaptations, we modified I Can PIC to focus on using rather than choosing health insurance. The COVID-19 pandemic introduced unforeseen obstacles, prompting changes to study protocols. As a result, we allowed users outside of the study to use I Can PIC (> 1050 guest users) to optimize public benefit. This paper describes the steps took to conduct the study, evaluating both the effectiveness of I Can PIC and the implementation process to improve its impact.
Although I Can PIC users had higher knowledge and health insurance literacy compared to the control group, results were not statistically significant. This outcome may be associated with systems-level challenges as well as the number and demographic characteristics of participants. The publicly available tool can be a resource for those navigating insurance and care costs, and researchers can use this flexible approach to intervention delivery and testing as future health emergencies arise.
本研究改编了《改善癌症患者保险选择》（I Can PIC），这是一项旨在帮助癌症患者做出医疗保险决策和医疗费用决策的干预措施。原始干预措施提高了患者在保险决策方面的知识和信心，但用户感到受到保险市场提供的选择的限制。本研究使用决策树和框架来指导改编，将 I Can PIC 进行修改，重点放在使用而不是选择医疗保险上。COVID-19 大流行带来了意想不到的障碍，促使研究方案发生变化。因此，我们允许研究之外的用户使用 I Can PIC（超过 1050 位访客用户）来优化公共利益。本文描述了进行研究的步骤，评估了 I Can PIC 的有效性及其实施过程，以提高其影响力。
尽管 I Can PIC 用户的知识和健康保险素养高于对照组，但结果无统计学意义。这一结果可能与系统层面的挑战以及参与者的数量和人口统计学特征有关。这款公开可用的工具可以为那些正在寻找保险和医疗费用的人提供资源，研究人员可以在未来出现健康紧急情况时，使用这种灵活的干预措施交付和测试方法。
