Background: Colorectal cancer survivors are at-risk for being underinsured and experiencing health insurance-related financial burden. Low health insurance literacy (HIL) reduces survivors’ ability to utilize health insurance. We conducted a pilot randomized controlled trial to assess the feasibility and preliminary effects of a virtually-delivered health insurance navigation tool (HINT) intervention to improve HIL and decrease financial burden among colorectal survivors. Methods: We tested a theoretically-driven 5-session intervention that included: 1) Learning About Survivorship Healthcare Needs; 2) Learning About Your Plan in Relation to Policy; 3) Navigating One’s Own Plan and Overcoming Obstacles; 4) Managing Care Costs; and 5) Understanding Your Medical Bills and Review. Eligibility included patients treated for colorectal cancer at Mass General Cancer Center, insured, and with access to wireless device. We assessed the feasibility and preliminary effects of HINT vs enhanced usual care (EUC; health insurance booklet) on HIL (assessing knowledge and confidence with health insurance terms and activity, knowledge of Affordable Care Act [ACA]), psychological financial burden (assessing worry due to medical costs), and satisfaction with health insurance coverage. Paired t-tests and cohen’s d were used to explore pre-post changes within the HINT and EUC groups from baseline (BL) to 5-month follow-up (FU). Results: From 1/22-2/23, we enrolled 34 participants (63% enrollment rate); 41.7% female; 88.2% white, Mean age=49.7 years. 82.7% of HINT participants completed all 5 intervention sessions. There were gaps in HIL (HIL mean 29.1, sd=7.9; 16-60 (high-low); 41.2% were not familiar with the ACA. 31/34 (91%) completed the 5-month follow-up survey. Among HINT participants, HINT significantly improved HIL and ACA knowledge; there was a non-significant trend toward reduced psychological financial burden and decreased health insurance satisfaction (see Table). Among EUC participants, there was a non-significant trend toward reduced psychological financial burden and no changes in any other variables. Clinical trial information: NCT05002608.

¹lower scores are better; ²higher scores are better