Online Program

Connecting underserved populations to health care reform benefits through 2-1-1: A communication network perspective

Monday, November 4, 2013

Katherine Eddens, PhD, MPH, Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, KY
Socioeconomically disadvantaged populations stand to benefit greatly from the 2010 Patient Protection and Affordable Care Act (ACA). This study explored knowledge and attitudes of the ACA in a low-income population and investigated sources of this knowledge and related communication by mapping social and communication networks. Participants were recruited from an information and referral hotline (2-1-1) that reaches predominantly low-income and racial/ethnic minority callers with unmet basic needs. A telephone survey assessed social and communication networks, sources of information, knowledge, attitudes, and personal relevance of the ACA. Regression models were built to determine the importance of network and non-network characteristics in predicting ACA knowledge. Results (n=398) show participants had lower knowledge of ACA benefits than the U.S. population. African-Americans (aOR=2.95, p<.01), those who got ACA information from the Internet (aOR=3.35, p<.01), trust people in their neighborhood “a lot” (aOR=2.45, p<.01) and have a higher proportion of their social network they can talk to about health information (aOR=2.38, p=0.03) had higher scores on ACA knowledge. ACA knowledge is low in this disadvantaged population, with knowledge significantly lower in the poorest members of the sample. Low ACA knowledge in this population indicates a need for action to educate the population most likely to benefit from the ACA, particularly through the extensive reach of the 2-1-1 system. Understanding how networks in disadvantaged populations influence access to information and resources and, therefore, health outcomes is important for shaping intervention and policy approaches to improve access to and use of health care services for disadvantaged Americans.

Learning Areas:

Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Demonstrate knowledge of the Affordable Care Act in a low-income, underserved population. Identify health communication networks in a low-income, underserved population. Describe the opportunity of 2-1-1 information and referral systems as a navigator for enrolling low-income and underserved populations into benefits under the Affordable Care Act.

Keyword(s): Underserved Populations, Health Care Reform

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator or research coordinator on several grants investigating the utility of 2-1-1 information and referral systems to reach underserved populations with health information and to link them to health care services. I have conducted several studies using social network analysis, and have co-edited a supplement to American Journal of Preventive Medicine on research collaboration with 2-1-1 systems to eliminate health disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.