The Use of Community Advocacy Educational Toolkits: Explaining “Explanation of Benefits” to Support Adolescent and Young Adult Health in Pennsylvania

Explanations of Benefits (EOBs) are claims documents sent by health insurers to notify policyholders of charges for their and their covered dependents' medical care. EOBs can result in a breach of patient confidentiality for dependents; dependents may also avoid seeking health care services from fear of potential disclosure. We conducted an online survey in Fall 2021 with a convenience sample of adolescents and young adults (AYA) to gather pilot data on EOB-related barriers for AYA in Pennsylvania, which contributed to creating an informational toolkit. We characterized the sample using descriptive statistics and analyzed open-ended text responses using rapid-turnaround qualitative methods. Sixty-six AYA completed the survey; most were aged 18 to 25 and reported being dependent on a parent's or guardian's insurance plan. Key themes emerged, including health care avoidance due to fear of adult disapproval and desire for educational resources. Informed by these data and with the support of community organizations, we employed health communication strategies to develop a digital toolkit to engage AYA around this privacy issue and pending EOB-related legislation in Pennsylvania. The toolkit contains educational materials (e.g., text, images, infographics), social media prompts (e.g., templated text), and links to additional educational and advocacy resources to empower AYAs to make informed decisions about their health and health care needs.