Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

Sign up for MCHalert eNewsletter

Evidence Tools
MCHbest. Adequate Insurance.

MCHbest Logo

Strategy. Outreach Using School Staff

Approach. Use trained school staff to assist families in getting insurance coverage

Return to main MCHbest page >>

Overview. Schools can be a point of intervention for enrolling young children in public health insurance and as a source of trusted information for parents experiencing economic challenges. In one study, school nurses and administrative staff attend regional trainings on how to use a required health assessment form, submitted at school entry, to identify uninsured children who could be eligible but are not enrolled in public insurance.[1]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • School staff training records and engagement data
  • Family feedback on school-based assistance
  • Sustainability and integration into school systems

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Health Care Access for All MCH Populations.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Case Management (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of school nurses and administrative staff who attend regional trainings on insurance outreach. (Measures workforce development for the intervention)
  • Number of families contacted by school staff to offer assistance with insurance enrollment. (Quantifies the reach of direct outreach efforts)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of school staff who demonstrate proficiency in assessing eligibility and assisting with insurance enrollment after training. (Evaluates the quality of workforce preparation)
  • Percent of identified uninsured families who are successfully contacted by school staff. (Measures the efficiency and persistence of outreach efforts)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of community partners engaged by schools to support insurance outreach and enrollment efforts. (Leverages external resources and expertise)
  • Number of referrals made by school staff to local health insurance navigators for complex cases. (Ensures warm handoffs for families needing more intensive support)
  • Number of students who establish a medical home and receive comprehensive care after gaining insurance coverage. (Reflects the broader health impact beyond enrollment)
  • Number of school days attended by students who were previously absent due to untreated health conditions. (Demonstrates the link between health and academic engagement)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of eligible schools in the district that participate in insurance outreach and enrollment efforts. (Measures the reach and saturation of the intervention)
  • Percent of school districts in the state that adopt the model of using health assessment forms for insurance outreach. (Measures the spread and replication of the approach)
  • Percent reduction in the uninsured rate among school-age children in the district. (Evaluates the population-level impact on coverage rates)
  • Percent increase in the number of students meeting age-appropriate health and development benchmarks. (Reflects the long-term impact on child health and wellbeing)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Jenkins JM. Healthy and Ready to Learn: Effects of a school‐based public health insurance outreach program for kindergarten‐aged children. Journal of School Health. 2018 Jan;88(1):44-53.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.