M08A - A Financial and Health Insurance Education Toolkit for Emerging Adults with Type 1 Diabetes

Key Takeaways of Your Research 1. The Type 1 Financial Toolkit developed through community action research, improves financial stress, health insurance literacy, diabetes-specific quality of life and healthcare navigation readiness over three months in emerging adults with type 1 diabetes (T1D). 2. Providing common online financial or health insurance education resources to emerging adults also improves financial stress, health insurance literacy, diabetes-specific quality of life, and healthcare navigation readiness over three months in emerging adults with T1D. 3. The T1 Financial Toolkit engages emerging adults with T1D and can be implemented by the DCES and into DSMES in the future.

Background/Purpose: Only 14% of emerging adults, ages 18-25, with type 1 diabetes (T1D) meet their A1C goals, and high financial stress and low health insurance literacy are significant contributors. Although crucial for independent navigation of healthcare, developmentally tailored financial and health insurance resources are lacking. Therefore, this study aimed to evaluate preliminary efficacy of a financial and health insurance literacy education toolkit for emerging adults with T1D. Research Hypothesis and/or Research Questions and Specific

Aims: RQ1: Is there a difference in the primary outcomes (financial stress, health insurance literacy, diabetes-specific quality of life and healthcare navigation readiness) by study group (intervention vs control)? RQ2: Do differences in primary outcomes (financial stress, health insurance literacy, diabetes-specific quality of life and healthcare navigation readiness) change over time? Methods/Methodology: The preliminary effects of a randomized controlled pilot trial with assignment to the intervention group (T1 Financial Toolkit) (n=20) or the control group (common online resources administered in clinical practice) (n=19) on financial stress, health insurance literacy, healthcare navigation readiness and diabetes-specific quality of life were evaluated over three months. Completion of resource review was confirmed via Qualtrics analytics. Two-way ANOVA of primary outcomes by study group over time revealed that primary outcomes did not differ by study group, but all primary outcomes in both groups improved over time, Greenhouse-Geiser F=7.068 (df=1.636), p=.003 (Financial Stress); Greenhouse-Geiser F= 19.906 (=1.407), p<.001 (Health Insurance Literacy); F=14.24 (df=2), p<.001 (Healthcare Navigation Readiness) and F= 6.867 (df=2), p=.002 (Diabetes-Specific QoL). Conclusions (Impact on Diabetes Care and Education): When resources are administered to emerging adults, there are significant improvements in financial stress, health insurance literacy, healthcare navigation readiness, and diabetes-specific quality of life over time. The T1 Financial Toolkit is a developmentally tailored resource that is promising in improving barriers to self-management for emerging adults with T1D. Future research should assess implementation of the toolkit by DCES in practice on a larger scale. Source of Funding for this Research: This study was funded by the Association for Diabetes Care and Education Specialists (ADCES) and Certification Board for Diabetes Care and Education Specialists (CBDCE) mentored post-doctoral fellowship in integrated diabetes management.