title: Parent Mentors and Insuring Uninsured Children: A Randomized Controlled Trial.
abstract: 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.
  
  
  
  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.
  
  
  
  We enrolled 237 participants (114 controls; 123 in PM group). PMs were more effective (P< .05 for all comparisons) than traditional methods in insuring children (95% vs 68%), and achieving faster coverage (median = 62 vs 140 days), high parental satisfaction (84% vs 62%), and coverage renewal (85% vs 60%). PM children were less likely to have no primary care provider (15% vs 39%), problems getting specialty care (11% vs 46%), unmet preventive (4% vs 22%) or dental (18% vs 31%) care needs, dissatisfaction with doctors (6% vs 16%), and needed additional income for medical expenses (6% vs 13%). Two years post-PM cessation, more PM children were insured (100% vs 76%). PMs cost $53.05 per child per month, but saved $6045.22 per child insured per year.
  
  
  
  PMs are more effective than traditional Medicaid/CHIP methods in insuring uninsured minority children, improving health care access, and achieving parental satisfaction, but are inexpensive and highly cost-effective.
authors.affiliation: Medica Research Institute, Minnetonka, Minnesota; glenn.flores@medica.com.
authors.forename: Glenn
authors.initials: G
authors.lastname: Flores
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas;
authors.forename: Hua
authors.initials: H
authors.lastname: Lin
authors.affiliation: Texas Scottish Rite Hospital for Children, Dallas, Texas;
authors.forename: Candy
authors.initials: C
authors.lastname: Walker
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas; Children's Health System of Texas, Dallas, Texas;
authors.forename: Michael
authors.initials: M
authors.lastname: Lee
authors.affiliation: Center for Health and Well-Being, Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, New Jersey; and.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Currie
authors.affiliation: Center for Strategic Decision Support, Texas Health and Human Services Commission, Austin, Texas.
authors.forename: Rick
authors.initials: R
authors.lastname: Allgeyer
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas;
authors.forename: Marco
authors.initials: M
authors.lastname: Fierro
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas;
authors.forename: Monica
authors.initials: M
authors.lastname: Henry
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas;
authors.forename: Alberto
authors.initials: A
authors.lastname: Portillo
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas;
authors.forename: Kenneth
authors.initials: K
authors.lastname: Massey
mesh_terms: D002648:Child; D054626:Consumer Health Information; D003362:Cost-Benefit Analysis; D006266:Health Education / Q000379:methods*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008484:Medicaid; D017057:Medically Uninsured; D008611:Mentors; D008913:Minority Groups; D010290:Parents; D013781:Texas; D014481:United States