Evaluating the impact of a health insurance literacy video on cancer patients: Usability, acceptability, and knowledge effects.

334 Background: Low health insurance literacy (HIL) defined as a limited ability to understand, choose, and use health insurance, has been associated with financial hardship (FH) and other adverse cancer outcomes. Improving HIL, may help patients navigate the complexities of health insurance, improve access to care, and reduce unnecessary FH. The present study evaluates the usability, acceptability, and preliminary efficacy of an HIL video designed to improve literacy-associated outcomes among cancer patients. Methods: Participants were English- or Spanish-speaking adult cancer patients who endorsed FH on single item scores from the Comprehensive Score for financial Toxicity (COST-item 12) and/or the Single-Item Literacy Screener-2 (SILS2) Questionnaire. Participants were recruited from two cancer centers in the US and were randomized 1:1 to watch a brief animated video in English or Spanish explaining health insurance terms, or to usual care. Both groups completed four health insurance knowledge questions at baseline and one-month follow-up defining: premiums, copays, coinsurance, and deductibles; the intervention group additionally completed these items after watching the video along with questions about the video’s usability and acceptability. Logistic regression models accounted for the effects between the intervention group and the usual care group, as well as within groups across assessment periods. Results: Participants (N = 404) had a mean age of 56 years, were female (70.5%), White (77.5%), Non-Hispanic (74%) and English speakers (87.9%). Approximately 43% had private insurance and 54% had at least a bachelor’s degree. Within the intervention group (n = 193), 135 participants (70.3%) watched greater than 75% of the video and most agreed or strongly agreed the video was easy to use (83.3%), comfortable to use (83%), easy to understand (83.4%), and were satisfied with the video (84.3%). There was no significant difference in accurately answering health insurance knowledge questions between the intervention and usual care groups. Within the intervention group, correctly defining co-insurance improved from baseline (60.6%) to post-video assessment (72.9%) (SE = 0.20, p = 0.006). Similarly, correctly defining co-pay increased from baseline (47.3%) to post-video assessment (100%; SE = 0.04, p = 0.002) and remained higher at the one-month follow-up when compared to baseline (62.6%; SE = 0.03, p < 0.001). However, correctly defining co-pay declined between the post-video assessment (100%) and the one-month follow-up (62.6%; SE = 0.03, p < 0.001). Conclusions: A brief informational video targeting HIL demonstrated adequate usability and acceptability, with improved ability to define co-insurance and co-pay terms. These findings suggest that targeted educational videos are well-accepted by patients and can effectively enhance specific aspects of HIL. Clinical trial information: NCT05369429 .