The overall purpose of the study is to better understand how the investigators previously
developed decision support (DS) tool can help people make decisions about health insurance
plans available through the federal exchanges created by the Affordable Care Act (ACA). The
investigators will evaluate the DS tool compared to the federal government website. The
investigators will also evaluate the feasibility of disseminating this tool. There are two
primary aims to be completed in this project: (1) examine the reach and effectiveness of the
health insurance DS tool; and (2) collect stakeholders' feedback to improve the likelihood of
implementation of the DS tool.
First, for Aim 1 part 1, the investigators will recruit 40 key stakeholders (uninsured
participants, health providers, community advisors, and health policy experts) to refine the
DS tool through a series of individual semi-structured interviews. Next, the investigators
will use their feedback to program the DS strategies into an online DS tool. After its
initial production, the tool will be pilot tested with 30 individuals to assess readability,
message clarity, format, and function of the tool as well as to test the randomized trial
study procedures. Then, for Aim 1 part 2, the investigators will test the DS tool in a
randomized trial with 362 participants eligible for the Affordable Care Act (ACA) exchanges.
Half will use the DS tool and the other half will use the federal government site to learn
about the exchanges. The investigators will use computerized random assignment to assign
participants to study condition, after which they will all complete the same short survey.
For Aim 2, the investigators will collect 40 stakeholders' feedback on likelihood of adoption
and implementation of the DS tool to plan for dissemination and implementation. Stakeholders
will be asked both open-ended and closed-ended questions in order to gather feedback about
delivering the DS tool. These stakeholders will be different from those who were interviewed
in Aim 1 as to ensure broader applicability of the DS tool.
- Must be without health insurance currently; or
- Must be enrolled in one of the ACA exchange plans in the past 1 year; and
- Must speak English
- Currently has health insurance that was not provided by being enrolled in one of the
ACA exchange plans in the past year
- Currently has health insurance that is provided through public insurance or private
- Does not speak English