Insuring Uninsured Children

为没有保险的儿童提供保险

• 批准号: 6795566
• 负责人: GLENN FLORES
• 金额: $ 9.98万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-18 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6795566
• 关键词: Hispanic Americans; child (0-11); clinical research; focus groups; health insurance; health science research analysis /evaluation; health services research tag; human subject; pediatrics

The long-term career goal of the candidate, Glenn Flores, MD, is to become a recognized leader in child health services research through outstanding contributions as an investigator, clinician, mentor, and advocate. He has endeavored to conduct research that has the potential to have an immediate impact on children's health, particularly those who are minority, poor, and under- served by the health care system. Dr. Flores considers his publications, research funding, track record as a mentor, and national recognition as a speaker and consultant to be strong evidence of his success as an investigator and potential to make future contributions to the field. The candidate's career development plan includes: 1) refining research skills in conducting focus groups and randomized trials; 2) regular meetings with a senior advisory team; 3) completing a course on the responsible conduct of research; 4) mentoring minority health services researchers; and 5) developing and using collaborative policy links. The institutional environment provides excellent resources, including departmental commitment to protect 80 percent of Dr. Flores's effort for the proposed research, a senior advisory team of renown pediatric health services researchers, and needed support staff and equipment. The aims of the proposed research are to 1) use focus groups to identify the reasons why parents are unable to obtain health insurance for their uninsured children, with an emphasis on Latinos; and 2) conduct a randomized trial to evaluate whether case managers are more effective than traditional methods in insuring uninsured children. Eleven million children are uninsured in the US, and the number grows yearly, despite the Children's Health Insurance Programs (CHIP). States are having difficulty identifying and enrolling uninsured children, and unused CHIP fiends are in danger of being lost. We will conduct 6 focus groups on obstacles to insuring children in the communities identified by pilot work to have particularly high proportions of uninsured children. Focus group data will be used to train case managers to assist families with insurance eligibility, applications, and maintaining coverage. Uninsured children (N = 300) will be recruited and randomized to trained case managers, or a control group with access only to traditional methods of insurance enrollment. Outcomes examined will include: the proportion of children obtaining health insurance coverage, the time from study enrollment to obtaining coverage, the proportion of children with episodic coverage, and parental satisfaction with the process of obtaining coverage. Subjects in both groups will receive participation incentives and be contacted monthly to monitor outcomes for 1-2 years (depending on time of enrollment); intervention subjects also will be contacted monthly for ongoing assistance by case managers. Pilot work has identified several communities with high proportions of uninsured children that are willing to participate in research. The proposed project is timely because it rigorously evaluates the effectiveness of a specific, reproducible approach in a high-risk population. If successful, the intervention could serve as a national model for insuring uninsured children.

候选人格伦·弗洛雷斯 (Glenn Flores) 医学博士的长期职业目标是通过作为研究者、临床医生、导师和倡导者的杰出贡献，成为儿童健康服务研究领域公认的领导者。 他致力于开展可能对儿童健康产生直接影响的研究，特别是那些少数族裔、贫困儿童和医疗保健系统服务不足的儿童。 弗洛雷斯博士认为他的出版物、研究经费、作为导师的记录以及作为演讲者和顾问的国家认可是他作为一名研究人员的成功以及未来为该领域做出贡献的潜力的有力证据。候选人的职业发展计划包括：1）提高进行焦点小组和随机试验的研究技能； 2）与高级顾问团队定期举行会议； 3）完成有关负责任的研究行为的课程； 4) 指导少数族裔卫生服务研究人员； 5) 开发和使用协作政策链接。 机构环境提供了优良的资源，包括部门承诺保护弗洛雷斯博士 80% 的拟议研究成果、由著名儿科健康服务研究人员组成的高级咨询团队，以及所需的支持人员和设备。拟议研究的目的是 1) 利用焦点小组来确定父母无法为未参保的孩子获得健康保险的原因，重点是拉丁裔； 2) 进行一项随机试验，以评估个案管理者在为未投保儿童提供保险方面是否比传统方法更有效。 尽管有儿童健康保险计划 (CHIP)，美国仍有 1100 万儿童没有保险，而且这个数字还在逐年增加。 各州很难识别和登记未投保的儿童，而未使用的 CHIP 恶魔则面临着丢失的危险。 我们将针对试点工作确定的未参保儿童比例特别高的社区中的儿童投保障碍开展 6 个焦点小组活动。 焦点小组数据将用于培训案例经理，以协助家庭获得保险资格、申请和维持保险范围。 未参保的儿童 (N = 300) 将被招募并随机分给经过培训的个案管理员，或对照组，只能使用传统的保险登记方法。 检查的结果将包括：获得健康保险的儿童比例、从入学到获得保险的时间、偶发性保险的儿童比例以及家长对获得保险过程的满意度。 两组受试者都将获得参与奖励，并每月与他们联系以监测结果，持续 1-2 年（取决于入学时间）；每月还会联系干预对象以获得案件管理员的持续协助。 试点工作已经确定了几个未参保儿童比例较高且愿意参与研究的社区。 拟议的项目是及时的，因为它严格评估了高危人群中特定的、可重复的方法的有效性。 如果成功，该干预措施可以成为为未参保儿童提供保险的全国模式。