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From confusion to confidence: what we learned about helping young adults navigate insurance
Manuel Hernández
CEO, The Diabetes Link (FKA, College Diabetes Network); poet
December 15, 2025
Here’s an understatement: navigating health insurance is a challenge! We all know the feeling of dread when you have to contact your health plan for the simplest of things (don’t even get me started on the crazy-making of prior authorizations). 
This transition into navigating the chaos happens hard and fast for those who have just turned 26, and as you may fondly remember, are getting the boot from their parents’ insurance. Young adults living with diabetes have no choice but to be prepared for that transition into adult life. Yet, few resources exist to adequately lay the groundwork for basic literacy and confidence to navigate (and mitigate) those WTF moments.
That is, until iHERO came about!
iHERO is a toolkit developed by The Diabetes Link in partnership with University Hospitals and a community advisory board. It stands for Insurance, Health, and Economic Resources Online. Because no self-respecting healthcare study is complete without a fun acronym.
Last November at ISPAD 2025 in Montreal, Julia Blanchette (Nurse Scientist Lead for Diabetes Care and Education and Program Director of Diabetes Research at University Hospitals), presented the interim findings of the iHERO study. Funded by The Helmsley Charitable Trust, this randomized controlled trial aims to evaluate the efficacy of the iHERO Toolkit on financial stress, Health Insurance Literacy (HIL), and diabetes outcomes among young adults (18-30 years old) with type 1 diabetes (T1D) in the US.
The study is not yet over (though recruiting for it was completed earlier this year). And here’s the key trend that is emerging:
“Over 4 weeks, HIL significantly increased by 14.2 points in the intervention group versus 1.6 points in the control group (F = 19.173, df = 1, P < 0.0001; see Figure 1).”
Got you there? I know. I am as lost about statistical jargon as the next person. Here’s what this really means:
This is a big deal. 
In plain English:
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Thus far, the toolkit works. A 14.2-point jump in health insurance literacy in just four weeks is not incremental. It shows that iHERO meaningfully improves understanding, bumping folks up at least ONE FULL LEVEL of HIL (from low to moderate, from moderate to high).
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This is not noise. It’s a real signal. That p-value (<0.0001) tells us this result is extremely unlikely to be due to chance. In research terms, this is strong evidence.
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Health insurance literacy is teachable. This finding challenges a quiet assumption in healthcare. That insurance confusion is inevitable or too complex to fix. It isn’t. And this is the case despite the fact that young adults often have low HIL and financial instability.
In just four weeks, iHERO helped young adults move from confusion to confidence.
The interim results of the study reflect the first cohort of participants, which was primarily white and privately insured. While this constitutes a limitation for the poster, these interim findings remain very promising. We are excited to analyze data from the whole cohort, which will be more diverse in terms of background and insurance type.
I want to commend the work of our team at The Diabetes Link, in connection with iHERO, particularly Mary Jane Roche, our Program Manager of Education (credited in the poster).
This is yet another example of how a dedicated, focused effort to develop resources for young adults with diabetes that meet them where they are and consider their unique needs is needed and leads to measurable impact. 
More to come: stay tuned for the rest of the study. 
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