An innovative methodological approach to building successful community partnerships for improving insurance coverage, health, and health care in high-risk communities

Background: More than 48% of U.S. children are racial/ ethnic minorities, 21% are poor, and 6% are uninsured. It is unclear, however, what methods are most effective for identifying and engaging community partners in study enrollment of these children in high-risk communities. Objective: Evaluate a new methodological approach to the screening, identification, and intervention study enrollment of uninsured minority children. Methods: We developed, implemented, and evaluated a methodological approach consisting of four components: (1) identify communities with the highest proportions of low-income minority families with uninsured children, (2) hire minority research staff responsible for community engagement and data collection, (3) implement and evaluate a parent mentor (PM) intervention built on community partnerships and which creates jobs, and (4) successfully execute the research by engaging appropriate community partners. Results: PMs were successfully recruited (n = 15) and trained (test scores significantly improved). Large numbers (n = 97) of appropriate, diverse community partners were engaged. The most productive community partners for recruitment were schools and childcare establishments, community-based organizations, discount and niche stores, supermarkets, and churches. Community partnerships resulted in 49,631 candidate participants screened and 329 enrolled in the study. The intervention was highly successful, with PMs significantly more effective and faster than traditional outreach/enrollment in insuring uninsured minority children, sustaining coverage, improving care access, reducing out-of-pocket costs, and achieving parental satisfaction and care quality, while saving $6,045 per child insured per year. Conclusions: This innovative, community-based methodology is highly effective, and could prove useful for community-based interventions targeting a variety of childhood and adult health, health-care, and equity issues.