April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Health Insurance Literacy Training for Nigerian Students in the US
Introduction: There are currently over one million non-immigrant international students in the United States, making up 5.5% of students enrolled in higher education. A critical challenge facing international students is navigating the US healthcare and insurance system. In this project, we focused on Nigerian students studying in the US because they have the highest enrollment in the US among other African countries and are mandated to pay for health insurance. Health insurance literacy (HIL) is important for this population because the healthcare system in the US is vastly different from Nigeria, where healthcare is accessed as a prepaid service. We, therefore, designed a 15-minute tailored HIL training for Nigerian students to increase their HIL and self-efficacy to find in-network providers. Pre and post-tests using the Kaiser Family Foundation (KFF) HIL measures were administered to assess if increases in HIL occurred.
Results from the analysis demonstrated an increase in health insurance literacy among participants (N=39). Seven multiple-choice knowledge items with right/wrong answers were used to assess HIL. These items asked students to provide the correct answer to questions related to definitions/concepts such as: premiums, copays, co-insurance, deductibles, out-of-pocket limits, and in/out-of-network care. Correct answers were combined to form a composite "knowledge" measure for pre/post-training assessment. A paired samples t-test was performed to evaluate whether there was a difference in participants’ knowledge of HIL and self-efficacy before and after the HIL training. The results indicated that Nigerian students’ knowledge about health insurance literacy after the training (M = 5.38, SD = 1.29) was significantly higher than before they received the training (M = 3.51, SD = 1.77), t (38) = 5.52, p = < .001 with a large effect size d = 0.884. However, the results indicated that there was no difference in self-efficacy toward finding an in-network provider before (M = 3.66, SD = 1.36), and after (M = 3.84, SD = 1.57) t (38) = -.879, p = .385 the HIL training.
Discussion: Our analysis demonstrated an increase in knowledge of health insurance terms. We did not find any difference in participants' ability to find in-network healthcare providers before and after the training. Though, analysis demonstrated an increase in knowledge of health insurance definitions and terminologies, it also indicated the need for improving the training by focusing on concepts like copay, coinsurance, out-of-pocket limit, and annual health insurance deductible because there was still a significant knowledge deficit and lack of self-efficacy among the Nigerian Students. Additionally, the participants recommended including Menti.com, an online evaluation App, during the training to evaluate the students and keep the training short as it is currently. Furthermore, they suggested that the training be held at the beginning of the semester. We recommend that colleges and universities prioritize health insurance literacy by providing mandatory and tailored training sessions for Nigerian students to increase their knowledge and self-efficacy to use health care services, which can prevent them from falling into debt or, worse still, not using it for fear of huge costs.
Results from the analysis demonstrated an increase in health insurance literacy among participants (N=39). Seven multiple-choice knowledge items with right/wrong answers were used to assess HIL. These items asked students to provide the correct answer to questions related to definitions/concepts such as: premiums, copays, co-insurance, deductibles, out-of-pocket limits, and in/out-of-network care. Correct answers were combined to form a composite "knowledge" measure for pre/post-training assessment. A paired samples t-test was performed to evaluate whether there was a difference in participants’ knowledge of HIL and self-efficacy before and after the HIL training. The results indicated that Nigerian students’ knowledge about health insurance literacy after the training (M = 5.38, SD = 1.29) was significantly higher than before they received the training (M = 3.51, SD = 1.77), t (38) = 5.52, p = < .001 with a large effect size d = 0.884. However, the results indicated that there was no difference in self-efficacy toward finding an in-network provider before (M = 3.66, SD = 1.36), and after (M = 3.84, SD = 1.57) t (38) = -.879, p = .385 the HIL training.
Discussion: Our analysis demonstrated an increase in knowledge of health insurance terms. We did not find any difference in participants' ability to find in-network healthcare providers before and after the training. Though, analysis demonstrated an increase in knowledge of health insurance definitions and terminologies, it also indicated the need for improving the training by focusing on concepts like copay, coinsurance, out-of-pocket limit, and annual health insurance deductible because there was still a significant knowledge deficit and lack of self-efficacy among the Nigerian Students. Additionally, the participants recommended including Menti.com, an online evaluation App, during the training to evaluate the students and keep the training short as it is currently. Furthermore, they suggested that the training be held at the beginning of the semester. We recommend that colleges and universities prioritize health insurance literacy by providing mandatory and tailored training sessions for Nigerian students to increase their knowledge and self-efficacy to use health care services, which can prevent them from falling into debt or, worse still, not using it for fear of huge costs.