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Identifying the Core Functions of a Health Insurance Literacy Program for Adolescent and Young Adult Cancer Survivors
Cheyenne R Wagi1, Austin R Waters2,3, Anne C Kirchhoff3,4
1Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Journal of Adolescent and Young Adult Oncology
|February 28, 2026
Summary
This study identified core functions of CHAT, a program helping young cancer survivors (AYAs) understand health insurance. CHAT is effective, feasible, and acceptable for improving health insurance literacy.
Area of Science:
- Health Services Research
- Psychology
- Oncology
Background:
- Adolescent and young adult (AYA) cancer survivors often face challenges navigating health insurance.
- Health insurance literacy is crucial for AYAs to access and utilize healthcare services effectively.
- Virtual navigation programs offer a promising avenue to address these challenges.
Purpose of the Study:
- To identify the core functions of the CHAT (Cancer survivor Health insurance Assistance Tool) program.
- To understand the effectiveness-driving features of CHAT.
- To refine the theory of change underlying CHAT's intervention.
Main Methods:
- Qualitative study utilizing 7 semistructured interviews with CHAT developers and implementers.
- Development of a preliminary list of core functions based on interview data.
- Member-checking exercise to achieve consensus on the final list of core functions and theory of change.
Main Results:
- Identified a consensus list of core functions for the CHAT program.
- Established the underlying theory of change for CHAT.
- Confirmed CHAT's feasibility, acceptability, and preliminary efficacy in improving health insurance literacy.
Conclusions:
- The identified core functions provide a foundation for refining and disseminating the CHAT program.
- Understanding CHAT's theory of change enhances its potential for targeted intervention development.
- CHAT shows promise as a tool to improve health insurance literacy among AYA cancer survivors.
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