Efficacy of a Health Insurance Literacy Intervention: A Retrospective Pretest Assessment of Knowledge Acquisition and Gained Confidence for Center for Independent Living Staff

Abstract

In the United States, health insurance is important for adults with disabilities, who make up nearly 30% of the general population. A national network of publicly-funded programs called Centers for Independent Living (CILs) provide a wide range of services to persons with disabilities (called “consumers). CIL staff, however, lack training on assisting consumers in their health insurance selections. This study used the ADDIE Model and iPAT to develop a health insurance training curriculum for CIL staff. Using a Retrospective Pretest design, the study assessed health insurance knowledge acquisition and self-confidence increases using the training content. Cohort 1 consisted of 61 adult CIL staff that participated in one of three web-based real time trainings and Cohort 2 consisted of 83 adult CIL staff that participated in one of two on-demand video trainings. Post-retrospective data for each module were collected using a participant Knowledge and Self-Confidence Questionnaire and confidence intervals were calculated based on non-paired group means for each module. A process evaluation measure assessed relevancy of the training, usefulness of content, materials quality, and trainer quality and group means were calculated. Results showed statistically significant increases for both cohorts and high process evaluation scores. Limitations of the study include the use of a convenience sample, differential cohort sizes and attrition rates, and the use of unweighted evaluation criteria. Nevertheless, the study suggests the importance of more focused attention on educating disability organization staff and the feasibility of combining ADDIE and iPAT methodologies to address the needs of persons with disabilities.