Abstract
Objective
Seven million US children lack health insurance. Community health workers are effective
in insuring uninsured children, and parent mentors (PMs) in improving asthmatic children's
outcomes. It is unknown, however, whether a training program can result in PMs acquiring
knowledge/skills to insure uninsured children. The study aim was to determine whether
a PM training program results in improved knowledge/skills regarding insuring uninsured
minority children.
Methods
Minority parents in a primary-care clinic who already had Medicaid/Children's Health
Insurance Program (CHIP)-covered children were selected as PMs, attending a 2-day
training session addressing 9 topics. A 33-item pretraining test assessed knowledge/skills
regarding Medicaid/CHIP, the application process, and medical homes. A 46-item posttest
contained the same 33 pretest items (ordered differently) and 13 Likert-scale questions
on training satisfaction.
Results
All 15 PMs were female and nonwhite, 60% were unemployed, and the mean annual income
was $20,913. After training, overall test scores (0–100 scale) significantly increased,
from a mean of 62 (range 39–82) to 88 (range 67–100) (P < .01), and the number of wrong answers decreased (mean reduction 8; P < .01). Significant improvements occurred in 6 of 9 topics, and 100% of PMs reported
being very satisfied (86%) or satisfied (14%) with the training. Preliminary data
indicate PMs are significantly more effective than traditional Medicaid/CHIP outreach/enrollment
in insuring uninsured minority children.
Conclusions
A PM training program resulted in significant improvements in knowledge and skills
regarding outreach to and enrollment of uninsured, Medicaid/CHIP-eligible children,
with high levels of satisfaction with the training. This PM training program might
be a useful model for training Patient Protection and Affordable Care Act navigators.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic PediatricsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Community health workers, promotores, and parent mentors: innovative, community-based approaches to improving the health and healthcare of children.in: Shapiro L. Big Ideas 2012: Children in the Southwest. First Focus, Washington, DC2012 (Available at:) (Accessed October 8, 2014)
- Outcomes of community health worker interventions. Evidence Report/Technology Assessment No. 181. Prepared by the RTI International–University of North Carolina Evidence-based Practice Center under contract 290 2007 10056 I. AHRQ Publication 09-E014.Agency for Healthcare Research and Quality, Rockville, Md2009 (Available at: http://www.ahrq.gov/research/findings/evidence-based-reports/comhwork-evidence-report.pdf. Accessed October 8, 2014.)
- Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases.Cochrane Database Syst Rev. 2010; : CD004015
- A randomized, controlled trial of the effectiveness of community-based case management in insuring uninsured Latino children.Pediatrics. 2005; 116: 1433-1441
- Improving asthma outcomes in minority children: a randomized, controlled trial of parent mentors.Pediatrics. 2009; 124: 1522-1532
- How Medicaid and the State Children's Health Insurance Program can do a better job of insuring uninsured children: the perspectives of parents of uninsured Latino children.Ambul Pediatr. 2005; 5: 332-340
Leverenz D, Flores G, Bridon C. Why are so many eligible children still uninsured? The perspectives of parents of uninsured African-American children. Paper presented at the 2010 American Public Health Association meeting. Available at: https://apha.confex.com/apha/138am/webprogram/Paper219447.html. Accessed October 8, 2014.
DeNavas-Walt C, Proctor BD, Smith JC; US Census Bureau. Income, Poverty, and Health Insurance Coverage in the United States, 2012. Washington, DC: US Government Printing Office; 2013. Current Population Report P60-245. Available at: http://www.census.gov/prod/2013pubs/p60-245.pdf. Accessed October 8, 2014.
- Gains for Children: Increased Participation in Medicaid and CHIP in 2009.Urban Institute, Washington, DC2011 (Available at:) (Accessed October 8, 2014)
Fish-Parcham C. Navigators need not be licensed as insurance brokers or agents. Families USA Issue Brief, March 2011. Available at: http://familiesusa.org/product/navigators-need-not-be-licensed-insurance-brokers-or-agents. Accessed October 8, 2014.
Article info
Publication history
Published online: November 30, 2014
Accepted:
September 13,
2014
Received:
May 29,
2014
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
