Flores G, Lin H, Walker C, Lee M, Currie J, Allgeyer R, Fierro M, Henry M, Portillo A, Massey K. Parent mentoring program increases coverage rates for uninsured Latino children. Health Affairs. 2018 Mar 1;37(3):403-12.
Intervention Components (click on component to see a list of all articles that use that intervention): Parent Mentors, Consultation (Parent/Family), Training (Parent/Family),
Intervention Description: The aim of the Kids’ Health Insurance by Educating Lots of Parents (Kids’ HELP) study was to evaluate the effects of parent mentors – Latino parents with children covered by Medicaid or the Children’s Health Insurance Program (CHIP) – on insuring Latino children in a community-based trial of uninsured children from 2011-2015. Parent mentors were trained to assist families in getting insurance coverage, accessing health care, and addressing social determinants of health. The intervention group was assigned parent mentors – trained, fluently bilingual Latino parents who had at least one child insured by Medicaid or CHIP for at least one year. The study team recruited parent mentors from a primary care clinic or a school and via referrals from other mentors. Mentor candidates were screened and interviewed to recruit people characterized by reliability, promptness, organizational skills, persistence, and motivation to help families with uninsured children. The team aimed to match ZIP codes of residence for mentors and participants to promote neighborhood relationships, social support, and economic investment. Mentors were paid $15/hour. Parent mentors attended a two-day training and received training manuals in English and Spanish with 9 training topics and one on sharing experiences. Parents mentors provided 8 services to intervention children and families (e.g., teaching about types of insurance programs and application processes; helping parents complete and submit children’s insurance applications; acting as family advocates by liaising between families and Medicaid or CHIP agencies; and helping parents complete and submit applications for coverage renewal).
Intervention Results: The study found that parent mentors were more effective than traditional methods in insuring children (95% vs. 69%), achieving faster coverage and greater parental satisfaction, reducing unmet health care needs, providing children with primary care providers, and improving the quality of well-child and subspecialty care. Children in the parent-mentor group had higher quality of overall and specialty care, lower out-of-pocket spending, and higher rates of coverage two years after the end of the intervention (100% vs. 70%). Parent mentors are highly effective in insuring uninsured Latino children and eliminating disparities. Parent mentors, as a special category of community health workers, could be an excellent fit with and complement to current state community health worker models. Kids’ HELP also would seem to be a promising intervention at the federal level, regardless of the outcome of federal debates about Medicaid, CHIP, and future directions and financing of these programs. More covered Latino children, better outcomes, reduced costs, higher care quality, improved parental satisfaction, and job creation would seem to constitute a potent combination of benefits for the nation. This RCT documented that the Kids’ HELP intervention is significantly more efficacious than traditional Medicaid and CHIP methods of insuring Latino children. Kids’ HELP eliminates coverage disparities for Latino children, insures children more quickly and with greater parental satisfaction than among control parents, enhances health care access, reduces unmet needs, improves the quality of wellchild and subspecialty care, reduces out-of-pocket spending and family financial burden, empowers parents, ad creates jobs. Kids’ HELP could be implemented as part of existing state community health worker models and federal Medicaid and CHIP outreach and enrollment grants.
Conclusion: A rigorous randomized controlled trial documented that the Kids’ HELP intervention is significantly more efficacious than traditional Medicaid and CHIP methods of insuring Latino children. Kids’ HELP eliminates coverage disparities for Latino children, insures children more quickly and with greater parental satisfaction than among control parents, enhances health care access, reduces unmet needs, improves the quality of well-child and subspecialty care, reduces out-of-pocket spending and family financial burden, empowers parents, and creates jobs. Kids’ HELP could be implemented as part of existing state community health worker models and federal Medicaid and CHIP outreach and enrollment grants.
Study Design: RCT
Setting: Community (Communities in Dallas County, Texas with the highest proportions of uninsured and low-income minority children)
Population of Focus: Parents and Children
Sample Size: 155 subjects (children and parents); 75 in the control group and 80 in the intervention group)
Age Range: 0-18 years
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