Flores Glenn, Walker Candy, Lin Hua, Lee Michael, Fierro Marco, Henry Monica, Massey Kenneth, Portillo Alberto
Division of General Pediatrics, Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9063, USA; Division of General Pediatrics, Children's Medical Center Dallas, 1935 Medical District Dr, Dallas, TX 75235, USA.
Division of General Pediatrics, Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9063, USA.
Contemp Clin Trials. 2015 Jan;40:124-37. doi: 10.1016/j.cct.2014.11.015. Epub 2014 Dec 2.
BACKGROUND & OBJECTIVES: Six million US children have no health insurance, and substantial racial/ethnic disparities exist. The design, methods, and baseline characteristics are described for Kids' Health Insurance by Educating Lots of Parents (Kids' HELP), the first randomized, clinical trial of the effectiveness of Parent Mentors (PMs) in insuring uninsured minority children.
METHODS & RESEARCH DESIGN: Latino and African-American children eligible for but not enrolled in Medicaid/CHIP were randomized to PMs, or a control group receiving traditional Medicaid/CHIP outreach. PMs are experienced parents with ≥1 Medicaid/CHIP-covered children. PMs received two days of training, and provide intervention families with information on Medicaid/CHIP eligibility, assistance with application submission, and help maintaining coverage. Primary outcomes include obtaining health insurance, time interval to obtain coverage, and parental satisfaction. A blinded assessor contacts subjects monthly for one year to monitor outcomes.
Of 49,361 candidates screened, 329 fulfilled eligibility criteria and were randomized. The mean age is seven years for children and 32 years for caregivers; 2/3 are Latino, 1/3 are African-American, and the mean annual family income is $21,857. Half of caregivers were unaware that their uninsured child is Medicaid/CHIP eligible, and 95% of uninsured children had prior insurance. Fifteen PMs completed two-day training sessions. All PMs are female and minority, 60% are unemployed, and the mean annual family income is $20,913. Post-PM-training, overall knowledge/skills test scores significantly increased, and 100% reported being very satisfied/satisfied with the training.
Kids' HELP successfully reached target populations, met participant enrollment goals, and recruited and trained PMs.
美国有600万儿童没有医疗保险，且存在显著的种族/族裔差异。本文描述了“通过教育众多家长提供儿童健康保险”（Kids' HELP）项目的设计、方法和基线特征，这是首个关于家长导师（PMs）帮助未参保少数族裔儿童获得保险有效性的随机临床试验。
符合医疗补助/儿童健康保险计划（Medicaid/CHIP）资格但未参保的拉丁裔和非裔美国儿童被随机分为接受家长导师干预组或接受传统医疗补助/儿童健康保险计划推广服务的对照组。家长导师是有至少一名参加医疗补助/儿童健康保险计划的孩子的经验丰富的家长。家长导师接受为期两天的培训，并为干预家庭提供有关医疗补助/儿童健康保险计划资格的信息、协助提交申请以及帮助维持参保状态。主要结局包括获得医疗保险、获得保险的时间间隔以及家长满意度。一名盲态评估员在一年时间里每月联系受试者以监测结局。
在49361名筛查的候选人中，329人符合资格标准并被随机分组。儿童的平均年龄为7岁，照料者的平均年龄为32岁；三分之二为拉丁裔，三分之一为非裔美国人，家庭年均收入为21857美元。一半的照料者不知道他们未参保的孩子符合医疗补助/儿童健康保险计划的资格，95%的未参保儿童之前有过保险。15名家长导师完成了为期两天的培训课程。所有家长导师均为女性且属于少数族裔，60%失业，家庭年均收入为20913美元。家长导师培训后，总体知识/技能测试成绩显著提高，100%报告对培训非常满意/满意。
Kids' HELP项目成功接触到目标人群，实现了参与者招募目标，并招募和培训了家长导师。
