A Randomized Trial of Effects of Parent Mentors on Insuring Minority Children

Not Applicable

Completed

Brief Summary: The Kids' HELP trial rigorously documented that a Parent Mentor intervention results in multiple benefits: more children are insured faster, children's access to healthcare and parental satisfaction improve, quality of well-child care is enhanced, thousands of dollars are saved per child, jobs are created, disparities are eliminated, and the intervention potentially could save our nation billions of dollars.

Detailed Description: Background: Six million US children are uninsured, despite two-thirds being eligible for Medicaid/Children's Health Insurance Program (CHIP), and minority children are at especially high risk. The most effective way to insure uninsured children, however, is unclear.

Methods: We conducted a randomized trial of the effects of parent mentors (PMs) on insuring uninsured minority children. PMs were experienced parents with \>=1 Medicaid/CHIP-covered child who received 2 days of training, then assisted families for 1 year with insurance applications, retaining coverage, medical homes, and social needs; controls received traditional Medicaid/CHIP outreach. The primary outcome was obtaining insurance 1 year post-enrollment.

Recruitment & Eligibility

Inclusion Criteria

The parent/guardian is a primary caretaker of a least one child 0-18 years old who currently has no health insurance
The parent/guardian self-identifies the uninsured child as Hispanic/Latino, African-American/Black, or both
The uninsured child is eligible for either Medicaid or CHIP
The parent/guardian is willing to be contacted monthly by telephone, or in the form of a home visit (if no functioning telephone is present in the household).

Exclusion Criteria

Not provided

Arm && Interventions

Group	Intervention	Description
Parent Mentors	Parent Mentors	After randomization to the Parent Mentor group, minority low-income parents of uninsured Medicaid/CHIP-eligible children received face-to-face instruction and guidance from Parent Mentors on obtaining and keeping Medicaid/CHIP for their child; getting a doctor, dentist, and pharmacist; and addressing social determinants of health.

Primary Outcome Measures

Name	Time	Method
Number of Children With Health Insurance	One year after enrollment	A study child is considered insured once official written notification of insurance is confirmed, either through an electronic or hard copy of the state coverage letter, or via verification from the Texas Health and Human Services Center.

Secondary Outcome Measures

Name	Time	Method
Number of Days From Study Enrollment to Obtaining Coverage	One year after enrollment	Zero time (the point at which the maneuver is imposed) is the data and time of study enrollment. Occurrence of the main outcome event is the date and time of official notification that the child is insured.
Intervention Cost-Effectiveness Ratio (ICER)	One year after enrollment	The difference in total costs between the intervention group and controls
Parental Satisfaction With the Process of Obtaining Coverage for Child	One year after enrollment	Parental satisfaction is assessed both using a five-point Likert-scale and open-ended questions