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

Study Overview
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Brief Summary
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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
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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.

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

Conditions
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Uninsured Children Eligible for Medicaid or CHIP

Intervention / Treatment
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* Behavioral: Parent Mentors


Participation Criteria
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Eligibility Criteria
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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).

Ages Eligible for Study
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Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>After randomization to the control group, minority low-income parents of uninsured, Medicaid/CHIP-eligible children received only traditional Medicaid/Children's Health Insurance Program (CHIP) outreach and enrollment. | |
| Experimental: Parent Mentors<br>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. | Behavioral: Parent Mentors<br>* After random assignment to the Parent Mentor group, minority low-income parents of Medicaid/CHIP eligible children met with Parent Mentors to receive instruction and help on completing, submitting applications for, and maintaining Medicaid/CHIP coverage for their child.<br>* Other names: Kids' HELP;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Children With Health Insurance | 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. | One year after enrollment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Days From Study Enrollment to Obtaining Coverage | 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. | One year after enrollment | 
| Parental Satisfaction With the Process of Obtaining Coverage for Child | Parental satisfaction is assessed both using a five-point Likert-scale and open-ended questions | One year after enrollment | 
| Intervention Cost-Effectiveness Ratio (ICER) | The difference in total costs between the intervention group and controls | One year after enrollment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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minority health, child, Medicaid