PA students research the impact of a smartphone app on patients’ health insurance literacy

By Kate Hunger 

Health insurance can be complicated and intimidating, says Ana Diaz, a Physician Assistant Studies student set to graduate in December. 

That’s why Diaz, along with nine Physician Assistant Studies students, two medical students and four pharmacy students, participated in an interdisciplinary, community service-learning project aimed at increasing community health literacy.  Their goal: To test the effectiveness of a smartphone app designed to improve community health insurance literacy in a clinical setting. 

“Our vision was we could prove the app was effective by going into the community and partnering with a clinic,” Diaz said.

The students’ project is the latest initiative of Access Care Texas (ACT), a community service learning project of UT Health San Antonio’s Center for Medical Humanities and Ethics, said Melanie Stone, MPH, M.Ed, project mentor and assistant director of the Center’s Community Service Learning (CSL) program. The project is funded by CSL mini-grants, she said.

The students have presented the results of their experimental survey study, “Increasing Health Insurance Literacy through a Multimedia Platform,” at several conferences, including the 2019 International Conference on Communication in Healthcare in October.

ICCH is “one of the premier international health literacy conferences,” Stone said. 

Diaz is one of the project’s student leaders and an ACT officer. She and members of her PA Studies capstone project research team chose to participate in the ACT project as their program’s capstone project, which is why Diaz considers the project to be a blend of both CSL projects and capstone projects.

The student group partnered with University Health System to validate the effectiveness of a free bilingual app, SA Access, and measure its impact on users’ health insurance literacy. An earlier ACT project, SA Access was developed in 2013 in partnership with the Bexar County Health Collaborative. 

To carry out the study, PA and medical students enrolled 678 patients at the UHS Robert B. Green clinics. The experimental group of patients received brief training on how to use the app, while the control group was not trained. Students collected pre-survey and post-survey data measuring health insurance literacy and health insurance literacy self-confidence, and 206 participants completed follow-up phone surveys, Diaz said. Pharmacy students assisted with data collection. 

The data “confirmed that patients’ self-efficacy of health insurance literacy can be increased with statistical significance through both app usage and exposure,” Diaz said. 

“We all believe in the app,” Diaz said. “We believe that health literacy is very important. As future health care providers, health literacy is our responsibility. If our patients don’t understand us, they don’t trust us” 

A manuscript is in progress to publish the group’s findings, Diaz said, and the group will present its findings this spring at the Texas Public Health Association annual education conference in Dallas.

Other mentors for the project are Meredith Quinene, DHSc, MPAS, PA-C, academic coordinator and assistant professor in the Department of Physician Assistant Studies, and former UHS Robert G. Green, Express Med & Ambulatory Connections Clinic, Medical Director, Liem Du, MD.