Initiatives varied in their channels, or methods, for reaching consumers (see Table 4 for common dissemination methods). All the initiatives used one or more of the following approaches: web-sites, direct phone or in-person assistance, events, one-on-one and group trainings, paper-based materials, and media campaigns.
|Mode of Dissemination||Financial||Health||Both|
|Web-sites, web-based tools and materials||15||6||4|
|Direct assistance (phone/ in person)||19||5||4|
|Other (DVD, fotonovela, television, or a variety, depending on grantee)||2||2||1|
Web-Sites and Web-Based Tools
Web-sites provide consumers with access to information to help them make financial and health decisions or learn what resources and tools are available to assist in decision making. Initiatives that use web-sites generally act as portals to complex or large quantities of information, and disseminate information, link consumers to community resources and service providers, provide access to web-based tools, coordinate information on different but related public assistance programs, and provide information to intermediaries and health providers. Overall, more web-sites associated with financial initiatives are interactive than are those associated with health education, although there certainly are important exceptions. Appendix E lists the addresses of those initiatives with web-sites.
AHRQs Consumers and Patients web page contains numerous plain language brochures, booklets, checklists, audiovisual materials, and podcasts aimed at raising consumer awareness of health issues and engaging consumers in preventive practices and value-based decision making. AHRQs Chartered Value Exchanges comprised of community-based collaboratives, which in turn include health care providers, employers and other health plan purchasers, health plans, and consumer advocacy organizations that provide consumers with information about the quality and value of providers at the local level. According to an AHRQ interview participant, most collaboratives have web-sites providing consumers with this information.
The Federal Reserve Systems consumer education web-site and Treasurys MyMoney.gov consolidate information from multiple federal agencies and provide interactive tools to assist consumers in financial decision making. ASHs HealthFinder.gov, a portal to a vast amount of health information and huge number of health tools, allows users to search for specific health resources or providers and materials on health literacy. CMSs Nursing Home Compare and Hospital Compare sites allow consumers to access information on the service quality of health care providers, with the goal of enhancing consumer or caregiver health-related decision making and engaging providers to care about service quality. CMSs Prescription Drug Plan Finder provides information on costs and medication choices for drug plans, in order to assist Medicare beneficiaries or their intermediaries in choosing a drug plan. AoAs Eldercare Locator allows seniors and caregivers to locate information such as fact sheets and brochures, and to connect with state or local organizations that can assist them in accessing services (e.g., transportation or housing assistance).
Most private organizations use web-sites and web-based tools for their initiatives. Most AARP initiatives use the web extensively through webinars, interactive web-based tools, articles and publications, and social media as part of their tactical approach to reaching consumers. ISU Extensions Small Steps to Health and Wealth consists of a four-week interactive online course in which consumers learn about and identify ways to achieve health and financial goals. NEFEs collaborations with Habitat for Humanity yielded the Recipes for Financial Fitness web-site. The web-site contains tutorials, checklists, and interactive tools to help Habitat for Humanity homeowners navigate the responsibilities of homeownership. NCOAs My Medicare Matters initiative was initially a community based education and outreach campaign across 27 states to offer face-to-face counseling to seniors on Medicare Part D. Since Medicare Part D implementation, the initiative has become primarily web-based and offers information for both, Medicare beneficiaries and counselors.
Direct Assistance Phone-Based and In-Person
Financial and health literacy initiatives use a range of approaches to assist consumers, including individualized assistance (in-person and telephone) and trainings (one-on-one and group). Approximately half (15) of the financial and health literacy initiatives use direct consumer interaction to provide information and assistance, training, and counseling.
In federal health literacy initiatives, direct assistance most often means answering consumer questions regarding benefits and eligibility for public assistance programs. For example, AoAs ten Benefits Enrollment Centers use varying approaches including in-person and phone-based assistance to help seniors and people with disabilities identify public benefits programs and enroll in them. Through AoAs initiative on Part D Outreach, states use one-on-one counseling to enroll and educate Medicare beneficiaries.
Apart from these two initiatives, few other federal health initiatives referenced direct person-to-person interaction. In one instance, health literacy initiatives were one component of a larger wellness program. ACFs Street Outreach Program embeds health promotion in a larger home-based training as part of a sexual abuse prevention program for youth. Overall, it appears that the health literacy initiatives that use direct interaction do so through one-time or as-needed interactions to communicate a prevention message or provide benefits-related assistance and advice to consumers.
Financial initiatives are more likely than health initiatives to incorporate multiple trainings or ongoing counseling for consumers. Each of the eight pilot programs funded through Treasurys Community Financial Access Pilot contains a financial education component as part of the overall goal to increase access to financial services and financial education for low- and moderate-income people (Treasury interview participant). Five initiatives represented in the interviews (Microenterprise Development Program, Refugee Agricultural Partnership Program, Refugee IDA, Cash and Counseling, and Assets for Independence) contain a financial assistance component in conjunction with in-person guidance on proper utilization of funds and achievement of financial goals. Although cash assistance programs are most likely to contain a direct training or counseling component, some financial initiatives provide only financial education to consumers. For example, certain grantees of AoAs WISER initiative deliver consumer education workshops on retirement planning.
Most of the private organizations that we interviewed were involved in initiatives to directly reach out to and engage consumers. AARPs multiple education campaigns make use of in-state events, seminars, or tele-town halls, to educate consumers about programs and interactive web-based tools. ISU Extensions Sharpen Your Financial Coaching Skills trains intermediaries, such as community-based professionals or volunteers who work with low-income families, to provide coaching and education to families experiencing financial difficulties. Through a six-week community-based participative workshop, Stanfords Chronic Disease Self-Management Program reaches individuals in a variety of settings, such as senior centers, churches, and hospitals. EARNs IDA and Savings Account for Education (SAFE) matched savings programs, and a financial coaching program for alumni of its IDA program requires participants to attend one-time in-person workshops or ongoing counseling and coaching, depending on the specific initiative. Multiple NCOA initiatives, which were created in partnership with other organizations, involve direct assistance. Their reverse mortgage counseling initiative, the Reverse Mortgage Counseling Services network, offers telephone and face-to-face counseling to seniors who may be considering a reverse mortgage. As part of an Economic Security Initiative, NCOA established pilot centers where low-income seniors could receive in-person assistance with obtaining and managing federal and state benefits. NCOAs My Medicare Matters campaign uses trained counselors to educate and counsel beneficiaries about Medicare Part D prescription drug plans. The Pack Your Bags campaign, established through a partnership between NCOA and CVS, allows seniors to receive an in-person consultation with a pharmacist in order to address medication-related questions and issues.
Outreach and Education
Our inclusion criteria emphasized initiatives that engaged consumers to improve their financial or health literacy. This led us to exclude initiatives solely aimed at raising awareness of a particular issue (e.g., diabetes) or broad-based programs (e.g., Medicaid). Because media campaigns are more often used to raise awareness than to engage consumers, the initiatives we reviewed were not likely to include these modes of outreach and message delivery. However, there were three exceptions, described below.
First, through the Medicare & You handbook, CMS aims to educate consumers about Medicare benefits; preventive services, such as flu shots and the Welcome to Medicare physical exam; and health plan choices to assist beneficiaries in decision making about Medicare coverage options. CMS disseminates hard copies of the handbook to all Medicare beneficiaries, and electronic copies are publicly available, as well. Second, AHRQs Office of Communications and Knowledge Transfer uses public media campaigns, including print and audiovisual and radio public service announcements, to encourage consumers to engage with providers, ask for information about care and treatment, and seek health information. Third, ASPEs Own Your Future campaign enables individual states to implement campaigns to raise awareness among Medicare beneficiaries and prospective beneficiaries of ways to plan for long-term care costs that are not covered by Medicare. All participating states distribute direct mailings to residents between the ages of 45 and 70, and hold press conferences to launch the campaign. However, additional activities vary by state and can include media campaigns using television and radio public service announcements, internet advertising, newspaper articles, partnerships with large employers within the state, and resources for consumers on a state government web-site.
Some initiatives use media campaigns as a part of their initiative. AoAs Part D Outreach enrollment initiative, Aging and Disability Resource Center, and Benefits Enrollment Centers require grantees to conduct outreach campaigns about the assistance available through the programs. For example, through AoAs Part D Outreach, states receive funding to conduct outreach and enrollment activities. They, in turn, may use a variety of strategies, such as media campaigns and mailings to encourage Medicare beneficiaries to use their services. Examples of outreach efforts include but are not limited to public service announcements, enrollment events, and health fairs.
Of the private organizations included in this study, AARP discussed its comprehensive media campaigns to raise public awareness of its activities. AARPs programs for Medicare beneficiaries, baby boomer women, pre-retirees, and unbanked individuals incorporate community-based seminars, tele-town halls, advertisements, public service announcements, and in-state events held with state AARP offices.