Health Care Utilization
Conditions
Keywords
Justice Involved Adults, Re-entry Population, Health Coaching, Service Navigation
Brief summary
The goal of this randomized intervention study is to learn about effective health literacy teaching methods in Justice Involved Adults (JIA). Researchers will compare coach-guided health literacy or self-study design to see if there is a difference in the access and use of healthcare in this population. The main questions it aims to answer are: * Will this improve access and use of heath services? * Will this improve health insurance coverage and long term use of health services? Participants will: * Meet with a health coach and service navigator during 12 sessions or meet with service navigator and complete online training over 12 weeks. * Complete surveys at different time (6months, 1 year)
Detailed description
Health literacy refers to the skills needed to effectively access, understand, and use health resources. Inadequate health literacy annually costs the U.S. $100-$200 billion and is observed among justice involved adults (JIA)-a group of \ 20 million U.S. persons who are disproportionately non-elderly and African American, Black, and Hispanic due to systemic racism and over-policing. JIA face numerous barriers in accessing healthcare which contributes to a high, lifelong burden of chronic and infectious disease. Healthcare access is defined as 1) having health insurance coverage, 2) having a regular source of care and 3) obtaining healthcare in a timely manner. Health literacy interventions for JIA are critically needed but are unavailable and NIH-funded research that is inclusive of JIA is sorely lacking. This timely study addresses these gaps. This study will implement a longitudinal mixed-methods randomized clinical trial (RCT) to assess the impact of the UCSD RELINK coach-guided health literacy intervention vs. a self-study control group on JIA's healthcare access. To achieve this aim, 300 JIA ages 18+ will be recruited in San Diego, CA and randomized 1:1 to the Treatment Group (i.e., coach-guided health literacy intervention) or the Control Group (i.e., self-study of the intervention). This study is timely and may inform health literacy interventions for JIA, policies to build health literacy among JIA in institutional and community settings, and the service delivery models for JIA. The proposed intervention has great potential for increasing health literacy among JIA and thus improving the well-being of this sizeable and underserved community. Findings from this study may also have relevance for interventions seeking to build the health literacy of other low-income communities.
Interventions
BEHAVIORALUCSD RELINK
UCSD RELINK coach-guided health literacy intervention and in-person service navigation assistance
BEHAVIORALSelf-study
Self-studying of programmatic information and list of service referrals
Sponsors
Victoria D. Ojeda
National Institute on Minority Health and Health Disparities (NIMHD)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Provision of signed and dated informed consent form 2. Stated willingness to comply with all study procedures and availability for the duration of the study 3. Persons, aged 18 and over 4. Resident of San Diego County 5. Not incarcerated at time of enrollment 6. Justice involved in the past 3 years (on parole, probation, court diverted) 7. Understands English 8. Access to a cell phone
Exclusion criteria
1. Under the age of 18 years old 2. Not a resident of San Diego County 3. Incarcerated at enrollment 4. Not justice-involved within the last 3 years (i.e., not on probation or parole or was court-diverted in the past 3 years) 5. No access to a cell phone 6. Cannot provide informed consent 7. Does not understand English 8. Previously enrolled in the pilot UCSD RELINK program 9. Adults who have current or prior convictions related to sexual violence/abuse (Penal Code \[PC\] 290), lewd acts with a child (PC 288), child abduction (PC 280), or arson (PC 451)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recent Use of Health Services | 6 months | Any healthcare use in the past 6 months (vs. never received services or received services more than 6 months ago) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Health Insurance Coverage | 6 months | Defined as uninsured versus any insurance |
| Regular Source of Care | 6 months | Presence of one (or multiple) source(s) of care identified by participants |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORVictoria Ojeda, PhD, MPH
University of California, San Diego
Outcome results
None listed