Creating culture-centered health and health insurance literacy resources: lessons learned from Haitian Creole, Mandarin, Native American, and Vietnamese communities

ABSTRACT

Background

To improve health insurance literacy, the Centers for Medicaid and Medicare Services launched From Coverage to Care (C2C) to help individuals translate health insurance into appropriate healthcare utilization. One aim of C2C is to extend its health communication tools to vulnerable populations, including providing materials in several languages in addition to English and Spanish. Understanding the experiences of organizations and populations that utilize these materials is critical for ensuring meaningful and effective conveyance of health literacy information.

Methods

The authors evaluated C2C, which included a qualitative case study approach of four communities using C2C products. The authors draw on findings from interviews with organizations that used C2C materials and focus groups with Haitian Creole, Mandarin, Native American, and Vietnamese consumers.

Results

Five key lessons learned are described that are relevant to public health education and campaigns. Lessons include: the importance of culture-centered materials in building empathy and trust; emphasizing appropriate and salient translations of materials; choosing targeted venues for dissemination that are responsive to the constraints and preferences of minority populations; drawing on educational tools in conjunction with individually tailored approaches; and, working with other local organizations to amplify dissemination.

Conclusions

Increasing health insurance literacy among vulnerable populations is critical. National efforts, such as C2C, are an important step, but moving beyond simply providing educational materials in additional languages and adopting a culture-centered perspective throughout an initiative is important for creating positive change.

KEYWORDS:

• Culture-centered communication
• vulnerable populations
• health literacy
• health insurance literacy

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Centers for Medicaid and Medicare Services under contract HHSM-500-2014-00036I which ended on September 30, 2019. The views expressed in this article are the authors’ and do not necessarily represent the views of the U.S. Department of Health and Human Services or the Centers for Medicare & Medicaid Services.

Notes on contributors

Elizabeth L. Petrun Sayers

Elizabeth L. Petrun Sayers, PhD is a Full Behavioral and Social Scientist with the RAND Corporation in Arlington, Virginia. Her areas of expertise include science (risk, health, environment), strategic, and organizational communication. Dr. Petrun Sayers received her PhD in communication from the University of Kentucky.

Kathryn E. Bouskill

Kathryn E. Bouskill, PhD, MPH is a Full Social Scientist with the RAND Corporation and Professor at the Pardee RAND Graduate School in Santa Monica, California. Dr. Bouskill applies ethnography to public health research. She has a PhD in anthropology and an MPH in epidemiology from Emory University.

Thomas W. Concannon

Thomas W. Concannon, PhD is a Senior Policy Researcher with the RAND Corporation in Boston, Massachusetts. Dr. Concannon is also an Assistant Professor of Medicine at Tufts University School of Medicine. Dr. Concannon earned his PhD in health policy at Harvard University and his MA in political science at McGill University.

Laurie T. Martin

Laurie T. Martin, ScD, MPH is a Senior Policy Researcher with the RAND Corporation in Arlington, Virginia. Her research interests include issues of health and financial literacy and the consumer experience in health care and social services. Dr. Martin received her master's degree from Boston University School of Public Health and her doctorate from the Harvard School of Public Health.