This paper is based on data collected from site visits to selected states and quarterly Covering Kids & Families (CKF) grantee reports for the same states. The evaluators asked questions about the strategies grantees were using to identify and enroll hard-to-reach populations of children, and the challenges they faced in doing this.
In site visit interviews, evaluators learned of many barriers to reaching special populations. These included:
- trust and stigma barriers, which occur when families mistrust public programs or associate them with groups they hold in low esteem.;
- cultural barriers that arise especially among immigrants, who may have different views on the necessity of health insurance and how health care should be used;
- language barriers, which prevent immigrant parents from understanding and, therefore, participating in programs; and
- target population accessibility, especially in rural regions, where word-of-mouth information-sharing is resource-intensive.