The Health Insurance Navigation Tools (HINT) intervention adapted for colorectal cancer survivors: a pilot trial

Colorectal cancer (CRC) survivors are at risk for experiencing healthcare-related financial burden, which can be exacerbated by low health insurance literacy (HIL). This pilot RCT assessed the feasibility, acceptability, and preliminary efficacy of a virtual health insurance navigation intervention adapted for CRC survivors (Health Insurance Navigation Tools; HINT-C).

Insured adult CRC survivors at the MGH Cancer Center with access to a wireless device were eligible. Participants were randomized to HINT-C, a five-session Zoom-based intervention, or enhanced usual care (EUC). Feasibility was assessed by proportion of enrolled individuals and sessions completed. Measures of patient satisfaction and program helpfulness assessed acceptability. Program efficacy was measured as changes in HIL, ACA knowledge, familiarity with health care legislation, and financial burden between baseline and five-month post-intervention.

From 01/2022 to 02/2023, 36 participants enrolled (22.6% enrollment rate; 47.2% female; 88.9% White, M_age = 52.1). Most (82.4%) completed all sessions and rated the program positively, highlighting the program's flexibility and helpful interaction with the navigator. HINT-C improved participants' HIL (p = 0.01) and ACA knowledge (p = 0.002), whereas such improvements were not observed in the EUC.

The HINT-C intervention demonstrated feasibility, acceptability, and preliminary efficacy for improving CRC survivors' HIL and ACA knowledge. Future research will assess this intervention more broadly among CRC survivors.

Interventions are needed for enhancing CRC survivors' ability to understand, choose, and utilize the best health insurance option for their unique healthcare needs. To our knowledge, the present intervention tailored to CRC survivors is the first of its kind.