Breaking Health Insurance Knowledge Barriers Through Games: Pilot Test of Health Care America

Abstract

Background: Having health insurance is associated with a number of beneficial health outcomes. However, previous research suggests that patients tend to avoid health insurance information and often misunderstand or lack knowledge about many health insurance terms. Health insurance knowledge is particularly low among young adults.

Objective: The purpose of this study was to design and test an interactive newsgame (newsgames are games that apply journalistic principles in their creation, for example, gathering stories to immerse the player in narratives) about health insurance. This game included entry-level information through scenarios and was designed through the collation of national news stories, local personal accounts, and health insurance company information.

Methods: A total of 72 (N=72) participants completed in-person, individual gaming sessions. Participants completed a survey before and after game play.

Results: Participants indicated a greater self-reported understanding of how to use health insurance from pre- (mean=3.38, SD=0.98) to postgame play (mean=3.76, SD=0.76); t₇₁=-3.56, P=.001. For all health insurance terms, participants self-reported a greater understanding following game play. Finally, participants provided a greater number of correct definitions for terms after playing the game, (mean=3.91, SD=2.15) than they did before game play (mean=2.59, SD=1.68); t₃₁=-3.61, P=.001. Significant differences from pre- to postgame play differed by health insurance term.

Conclusions: A game is a practical solution to a difficult health issue-the game can be played anywhere, including on a mobile device, is interactive and will thus engage an apathetic audience, and is cost-efficient in its execution.

Keywords: games, experimental; health insurance; information literacy; young adult.

Figure 1

Examples of the user interface and game play of the health insurance game.

Figure 2

Design of game meters: (1) Healthcare assistance fund and (2) community wellness.

Figure 3

An example of the community wellness meter options.