NDLI: Assessment of Children's Public Health Insurance Program enrollment applications: a health literacy perspective.

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Assessment of Children's Public Health Insurance Program enrollment applications: a health literacy perspective.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Wallace, Lorraine S. DeVoe, Jennifer E. Hansen, Julie S.
Spatial Coverage	United States
Description	Country affiliation: United States Author Affiliation: Wallace LS ( Department of Family Medicine, University of Tennessee Graduate School of Medicine, U-67, 1924 Alcoa Hwy, Knoxville, TN 37920, USA. lwallace@mc.utmck.edu)
Abstract	INTRODUCTION: More than half of uninsured children in the United States qualify for Medicaid or the Children's Health Insurance Program (CHIP). Application readability and other complex features may be barriers to enrollment for some of these families. The purpose of this study was to conduct a literary assessment of state-issued English- and Spanish-language Medicaid/CHIP Internet-based enrollment applications, including an evaluation of reading demands, layout characteristics, and document complexity. METHOD: In May 2010, we downloaded all currently available English-language (n = 50) and Spanish-language (n = 39) Internet-based, state-issued Medicaid/CHIP enrollment applications. We estimated the reading demands of each CHIP enrollment application 'Signature' page using the Lexile Analyzer. We assessed layout characteristics using the User-Friendliness Tool and we evaluated document complexity using the PMOSE/IKIRSCH scale. RESULTS: On average, Medicaid/CHIP enrollment application 'Signature' pages were written at a high school reading level (English language = 12th- to 13th-grade reading level; Spanish language = 10th- to 11th-grade reading level). Five Medicaid/CHIP enrollment applications (5.6%) consistently used a 12-point or larger font size throughout. Most Medicaid/CHIP enrollment applications (n = 83; 93.3%) needed 'some' or 'much' improvement in the amount of white space. Document complexity ranged from level 3 (moderate) to level 5 (very high), with the majority of Medicaid/CHIP enrollment applications ranked at level 4 (high). DISCUSSION: Revisions are required in almost all state Medicaid/CHIP enrollment applications to achieve consistency and to meet standard low-literacy guidelines (e.g., written at a 6th grade or lower reading level and using a font of 12 points or larger). Additionally, to increase access to Medicaid/CHIP for eligible Hispanic children, all states should provide an online Spanish-language version of the Medicaid/CHIP enrollment application.
File Format	HTM / HTML
ISSN	08915245
Issue Number	2
Volume Number	25
e-ISSN	1532656X
Journal	Journal of Pediatric Health Care
Language	English
Publisher	Elsevier
Publisher Date	2011-03-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pediatrics Child Health Services Economics Health Literacy Insurance, Health Utilization Medicaid Child Humans United States Journal Article
Content Type	Text
Resource Type	Article
Subject	Pediatrics, Perinatology and Child Health

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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Assessment of Children's Public Health Insurance Program enrollment applications: a health literacy perspective.

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