College students' knowledge and attitudes toward the US healthcare system, health insurance industry practices, and recently passed healthcare reform legislation

Background: Recently passed healthcare reform legislation will attempt to expand insurance coverage as well as contain healthcare costs over the next decade. One group that will benefit from reform components being implemented right away is young adults. This is also the group that will look to obtain insurance coverage in a fully reformed healthcare system a few years from now. The purpose of this study was to determine the association between knowledge of and attitudes toward the US healthcare system, health insurance industry practices, and recently passed healthcare reform legislation among full-time undergraduate college students. Methods: The study used a cross sectional design with a convenience sample of 200 undergraduate students at a large Midwestern public University. A panel of six experts assisted in establishing face and content validity of the instrument. The development of the instrument also included calculation of Cronbach's alpha and test retest reliability. Descriptive and inferential statistics were used to answer the research questions. Results: Overall knowledge of the US healthcare system is low among college students. There are significant differences in knowledge based on student characteristics. Higher level of knowledge is associated with favorable attitudes towards healthcare reform. Conclusion: There is a need to raise the level of knowledge of the US healthcare system among college students. Health education interventions can be designed to accomplish this goal. Recommendations for developing such interventions are discussed.