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U.S. Department of Health and Human Services

Office of Minority Health

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University of Massachusetts Boston

Boston, MA 02125

Project: Closing the Health Insurance Gap for Spanish and Portuguese Speaking Communities: A Faith-based Model

Amount: $237,816

Project Abstract

In Massachusetts, Latinos continue to be insured at lower rates than any other racial group in the state, and experience disparities including disproportionate rates of infant mortality, HIV/AIDS, and early death from cancer and heart disease. In a high-enrollment state like Massachusetts, barriers to health insurance continue for significant portions of the Latino community, as 9.4 percent of Latinos remain uninsured. Closing the Health Insurance Gap for Spanish and Portuguese Speaking Communities: A Faith-based Model intends to help close the enrollment gap for the Affordable Care Act (ACA) in Massachusetts, and serve as a model for other states with even larger disparities in coverage for underserved Latinos and other linguistic minorities. The program is designed to make an impact on access to quality health care that can, in turn, help to decrease health disparities based on racial, ethnic, and linguistic characteristics.

The project will develop effective strategies for increasing enrollment in segments of urban and rural Spanish and Portuguese speaking communities that remain uninsured, and that could potentially benefit from targeted outreach and education about eligibility and coverage options under the ACA. In six faith-based communities, staff will provide linguistically, culturally, and literacy appropriate information and assistance about the Marketplace, ensure that enrollment assistance is accessible, and provide accurate information about immigration status and insurance eligibility. Additionally, at least five religious lay leaders and volunteers from each of the six church sites will receive training on enrollment, outreach, and education from the Boston Public Health Commission each year. These leaders will assist community members with health insurance enrollment through the Marketplace, Medicaid, or the Children’s Health Insurance Program (CHIP). They will also support churches in effectively reaching out to potential enrollees through Spanish and Portuguese print, broadcast, and social media.   

Expected outcomes for this project include:

  • Identified, addressed, and reduced barriers to health insurance enrollment for underserved and hard-to-reach Spanish and Portuguese speaking communities;
  • Increased awareness and knowledge about the role of health insurance in the reduction of Latino health disparities; and
  • Enhanced capacity of churches to provide accessible, linguistically and culturally appropriate outreach, education, and assistance aimed at increasing health insurance enrollment for Spanish and Portuguese speakers.

Performance measures for this project include:

  • Number of church members receiving linguistically, culturally, and literacy appropriate information about health insurance enrollment;
  • Number of church leaders and volunteers that become qualified to assist underserved Spanish and Portuguese speakers to enroll in health insurance;
  • Number of churches that develop effective Spanish and Portuguese language media outreach strategies for attracting potential enrollees; and
  • Number of participants who overcome fear and misunderstanding in regards to immigration status and health insurance enrollment.

The evaluation will assess the success of the program through multiple methods. Site Coordinators will keep records of program metrics, including the number of people from the target population enrolled in health insurance, the number and type of educational activities, and the number of people reached by those activities. Additionally, the Dissemination and Communication Coordinator will track the number and type of informational/educational materials and media efforts disseminated by the program. A survey will be administered to community partners quarterly to measure their perspective on the program implementation. Finally, an initial baseline survey of individuals who attend enrollment events will document their understanding of the significance of health insurance to maintain good health status, and their knowledge about the eligibility criteria and options for health insurance coverage. Follow-up surveys at succeeding contacts with program staff and volunteers will monitor changes in knowledge, eligibility criteria, characteristics of available options, and enrollment status. Additionally, a student and professor will collect qualitative data through focus groups and in-depth interviews, on the experiences of enrollees, their literacy levels in terms of health insurance, and how they expect health insurance to impact their lives.

Awareness: Increase awareness of the significance of health disparities, their impact on the nation, and the actions necessary to improve health outcomes for racial, ethnic, and other disparities populations.
Cultural and Linguistic Competency: Improve cultural and linguistic competency and the diversity of the health-related workforce.
Health System and Life Experience: Improve health and healthcare outcomes for racial, ethnic, and underserved populations.


  • AHS-1: Increase the proportion of persons with health insurance.
11/12/2015 6:13:00 PM