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Exploring the Impact of Instruction on College Students' Health Insurance Literacy

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Abstract

Student health insurance literacy is an area of limited prior knowledge, and investigations into this topic have the potential to impact students' self-care strategies, self-efficacy, decision-making, and quality of life. The purpose of this study was to examine factors associated with health insurance literacy and knowledge among undergraduate students. In this study, undergraduate students at one mid-Atlantic public university in the United States who did and did not receive instruction on health insurance were surveyed. Students were recruited from a course that offers formal instruction about health insurance and students in a comparison group at the same university were recruited from a general education participant pool. Participants (n = 364) completed an online anonymous survey that included demographics, experience with health insurance, health insurance knowledge, and health insurance literacy self-efficacy. Hierarchical multiple regression results indicated participants in the course who received health insurance instruction scored higher on a measure of health insurance knowledge. Higher levels of health insurance self-efficacy was also associated with receiving instruction related to health insurance. Female gender and higher parental education were associated with a lower self-efficacy. Improving health insurance knowledge and self-efficacy among undergraduates is an important aspect of preparing students for post-graduate life where decisions about health insurance coverage and healthcare utilization will increase. Furthermore, increasing health insurance literacy may contribute to raising standards of health literacy, health care, and health care seeking across communities.

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References

  1. Kleinman, D., Baur, C., Rudd, R., & Rubin, D. (2019). Health Literacy, in issue briefs to inform development and implementation of healthy people 2030; Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030. Retrieved May 9, 2022, from https://www.healthypeople.gov/sites/default/files/HP2030_Committee-Combined-Issue%20Briefs_2019-508c.pdf

  2. Consumers union, university of maryland college park, American institutes for research. (2012) Measuring health insurance literacy: A call to action report from the health insurance literacy expert roundtable. Retrieved May 9, 2022, from https://www.air.org/sites/default/files/Health-Insurance-Literacy-Roundtable.pdf

  3. Joseph, R., Fernandes, S., Hyers, L., & O’Brien, K. (2016). Health literacy: A cross-disciplinary study in American undergraduate college students. Journal of Information Literacy, 10(2), 26. https://doi.org/10.11645/10.2.2103

    Article  Google Scholar 

  4. Brown, V., Russell, M., Ginter, A., Braun, B., Little, L., Pippidis, M., & McCoy, T. (2016). Smart choice health insurance©: A new, interdisciplinary program to enhance health insurance literacy. Health Promotion Practice, 17(2), 209–216. https://doi.org/10.1177/1524839915620393

    Article  PubMed  Google Scholar 

  5. Norton, M., Hamel, L., & Brodie, M. (2014). Assessing Americans' familiarity with health insurance terms and concepts. Kaiser Family Foundation. Retrieved May 9, 2022, from https://www.kff.org/health-reform/poll-finding/assessing-americans-familiarity-with-health-insurance-terms-and-concepts/

  6. Wiltshire, J., Liu, E., Dean, C. A., Colato, E. G., & Elder, K. (2021). Health insurance literacy and medical debt in middle-age Americans. Health Literacy Research and Practice, 5(4), e319–e332.

    PubMed  PubMed Central  Google Scholar 

  7. Tipirneni, R., Politi, M. C., Kullgren, J. T., Kieffer, E. C., Goold, S. D., & Scherer, A. M. (2018). Association between health insurance literacy and avoidance of health care services owing to cost. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2018.4796

    Article  PubMed  PubMed Central  Google Scholar 

  8. Barnes, A. J., & Hanoch, Y. (2017). Knowledge and understanding of health insurance: Challenges and remedies. Israel Journal of Health Policy Research, 6(1), 40. https://doi.org/10.1186/s13584-017-0163-2

    Article  PubMed  PubMed Central  Google Scholar 

  9. Politi, M. C., Kaphingst, K. A., Kreuter, M., Shacham, E., Lovell, M. C., & McBride, T. (2014). Knowledge of health insurance terminology and details among the uninsured. Medical Care Research and Review, 71(1), 85–98. https://doi.org/10.1177/1077558713505327

    Article  PubMed  Google Scholar 

  10. McCormack, L., Bann, C., Uhrig, J., Berkman, N., & Rudd, R. (2009). Health insurance literacy of older adults. Journal of Consumer Affairs, 43(2), 223–248. https://doi.org/10.1111/j.1745-6606.2009.01138.x

    Article  Google Scholar 

  11. Adegboyega, A., Nkwonta, C., & Edward, J. (2020). Health insurance literacy among international college students: A qualitative analysis. Journal of International Students, 10(1), 50–68.

    Article  Google Scholar 

  12. Edward, J., Wiggins, A., Young, M. H., & Rayens, M. K. (2019). Significant disparities exist in consumer health insurance literacy: Implications for health care reform. Health Literacy Research and Practice, 3(4), e250–e258.

    PubMed  PubMed Central  Google Scholar 

  13. James, T. G., Sullivan, M. K., Dumeny, L., Lindsey, K., Cheong, J., & Nicolette, G. (2020). Health insurance literacy and health service utilization among college students. Journal of American College Health, 68(2), 200–206. https://doi.org/10.1080/07448481.2018.1538151

    Article  PubMed  Google Scholar 

  14. Nobles, A. L., Curtis, B. A., Ngo, D. A., Vardell, E., & Holstege, C. P. (2019). Health insurance literacy: A mixed methods study of college students. Journal of American College Health, 67(5), 469–478. https://doi.org/10.1080/07448481.2018.1486844

    Article  PubMed  Google Scholar 

  15. Tilley, L., Yarger, J., & Brindis, C. D. (2018). Young adults changing insurance status: Gaps in health insurance literacy. Journal of Community Health, 43(4), 680–687. https://doi.org/10.1007/s10900-018-0469-1

    Article  PubMed  Google Scholar 

  16. Association of public and land grant universities. (2021). How do college graduates benefit society at large? Retrieved May 9, 2022, from https://www.aplu.org/projects-and-initiatives/college-costs-tuition-and-financial-aid/publicuvalues/societal-benefits.html

  17. Paez, K. A., Mallery, C. J., Noel, H., Pugliese, C., McSorley, V. E., Lucado, J. L., & Ganachari, D. (2014). Development of the health insurance literacy measure (HILM): Conceptualizing and measuring consumer ability to choose and use private health insurance. Journal of Health Communication, 19(sup2), 225–239. https://doi.org/10.1080/10810730.2014.936568

    Article  PubMed  PubMed Central  Google Scholar 

  18. Laerd statistics. (2021). Hierarchical multiple regression: SPSS statistics. Retrieved May 9, 2022, from https://statistics.laerd.com/premium/spss/hmr/hierarchical-multiple-regression-in-spss-4.php

  19. O’Connor, G. E., & Kabadayi, S. (2020). Examining antecedents of health insurance literacy: The role of locus of control, cognitive style, and financial knowledge. Journal of Consumer Affairs, 54(1), 227–260. https://doi.org/10.1111/joca.12266

    Article  Google Scholar 

  20. Adepoju, O., Mask, A., & McLeod, A. (2019). Factors associated with health insurance literacy: proficiency in finding, selecting, and making appropriate decisions. Journal of Healthcare Management, 64(2), 79–89.

    Article  Google Scholar 

  21. National center for education statistics. (2021). Immediate college enrollment rate national center for education statistics. Retrieved May 9, 2022, from https://nces.ed.gov/programs/coe/indicator/cpa

  22. Yang, S. C., Luo, Y. F., & Chiang, C. H. (2017). The associations among individual factors, ehealth literacy, and health-promoting lifestyles among college students. Journal of Medical Internet Research, 19(1), e15. https://doi.org/10.2196/jmir.5964

    Article  PubMed  PubMed Central  Google Scholar 

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The authors received no financial support for the research, authorship, and/or publication of this article.

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Contributions

SSNU creating surveys for data collection, writing, formatting, and submission of manuscript. LKM data coding, cleaning, and analysis, writing of manuscript. AT data analysis, creating tables and figure, and writing of manuscript. DSH conceptualization of research, writing of manuscript.

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Correspondence to Sri Siddhi N. Upadhyay.

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All data collection was in accordance with IRB ethical standards of the APA (Research with Human Participants).

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Upadhyay, S.S.N., Merrell, L.K., Temple, A. et al. Exploring the Impact of Instruction on College Students' Health Insurance Literacy. J Community Health 47, 697–703 (2022). https://doi.org/10.1007/s10900-022-01096-2

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