Managed Care And Low-Income Populations: A Case Study of Texas

Published: Feb 27, 1997

This study is part of a larger initiative, funded by both the Henry J. Kaiser Family Foundation and The Commonwealth Fund. Case studies of seven states that are restructuring their health care systems for the Medicaid and uninsured populations: California, Florida, Minnesota, New York, Oregon, Tennessee, and Texas, are designed to provide early insights and timely analyses that will help states and other efforts shape rapidly evolving managed care systems and health reform programs for low-income populations. This case study, which is still in the early stages of implementing managed care initiatives, assesses the goals of Medicaid managed care initiatives in Texas.

  • Report: Managed Care and Low-Income Populations: A Case Study of Texas
Poll Finding

Survey of Americans’ Knowledge and Attitudes about Entitlements

Published: Feb 27, 1997

This Washington Post/Kaiser/Harvard University survey examines American’s knowledge and attitudes on entitlements, particularly Social Security and the Medicare program. The survey findings were reported in The Washington Post on Saturday, March 29th, 1997. The survey was conducted by Chilton Research.

Making Medicaid Managed Care Work:  An Action Plan for Persons Living with HIV

Published: Jan 30, 1997

Making Medicaid Managed Care Work: An Action Plan for Persons Living with HIV

This report, by the National Association of People with AIDS (NAPWA) with support from The Kaiser Family Foundation, describes nine key points for people living with HIV to keep in mind when trying to influence the development of a managed care system that will serve them effectively. Senator John Chafee (R-RI), an acknowledged ally of NAPWA, gratefully accepted the report upon its release.

National Survey of Women about their Knowledge, Attitudes, and Practices Regarding their Reproductive Health

Published: Jan 30, 1997

Survey of Women About Their Knowledge, Attitudes, and Practices Regarding Their Reproductive Health

Glamour; Kaiser Family Foundation; Princeton Survey Research Associates

Summary of Major Findings

February 1997

The Kaiser Family Foundation partnered with Glamour magazine on a national survey to find out how much women know about their reproductive health care needs and whether they are taking important steps to protect their reproductive health, covering such critical issues as: routine gynecological exams,contraception, emergency contraception, sexually transmitted disease, HIV/AIDS, the patient-physician relationship, health insurance coverage, and communication with sexual partners. To explore women’s awareness of these issues and others, Glamour and the Kaiser Family Foundation designed and Princeton Survey Research Associates conducted a nationally representative telephone survey of 1,001 women in the U.S., ages 18 to 44. The survey was conducted between July 10 and July 28, 1996. The margin of error for results based on the total sample is plus or minus four percentage points. The results of the survey are reported in the February 1997 issue of Glamour.

 

An Analysis of the Medicaid and Health-Related Provisions of the Personal Responsibility and Work Opportunity Reconcilation Act of 1996

Published: Jan 30, 1997
  • Report: An Analysis of the Medicaid and Health-Related Provisions of Act (P.L. 104-193)
Poll Finding

Kaiser/Harvard Health News Index, February 1997

Published: Jan 30, 1997

The February 1997 edition of the Kaiser Family Foundation/Harvard Health News Index includes questions about Government Panel Recommendations on Mammograms, Medicare and Expaning Insurance to Children (CHIP). The survey is based on a national random sample of 1,003 Americans conducted February 21-24, 1997 which measures public knowledge of health stories covered by news media during the previous month. The Health News Index is designed to help the news media and people inthe health field gain a better understanding of which health stories in the news Americans are following and what they understand about those health issues. Every two months Kaiser/Harvard issues a new index report.

Kaiser Family Foundation and Children Now National Surveys: Talking with Kids about Tough Issues

Published: Jan 30, 1997

New National Campaign Encourages Parents To Start Talking With Their Children Earlier About Some Of The Hardest-To-Talk-About Topics, Like Sex

Campaign Provides Resources to Help Parents Begin the Discussion On Tough Issues In Age-Appropriate Way that Incorporates Own Values

Campaign Survey Says Parents Are Not Talking Enough About Sex, AIDS, Violence, and Drug and Alcohol Abuse;And Children Say They Want More Information

Embargoed for release until: 10:00 AM EST, Wednesday, February 19, 1997

New York, NY — Talking With Kids About Tough Issues, is a new joint initiative by the Kaiser Family Foundation, Children Now, and The Advertising Council to encourage and help parents of young children start talking early about life’s tough issues, including sex, AIDS, violence, and alcohol and drug abuse. The campaign encourages parents to impart their own values and, most importantly, to create an atmosphere of open communication with their children on any issue.

The effort centers around a national public service campaign featuring print, television, and radio advertisements developed by J. Walter Thompson New York, which volunteered its services, and local partnerships with Boys and Girls Clubs across the nation, the campaign’s principal community co-sponsors. A booklet, community forums, and other tools are being made available through the campaign to help parents.

A distinguished honorary committee, chaired by Linda Ellerbee, creator and host of Nickelodeon’s Nick News, and including entertainer Rosie O’Donnell, Dr. Alvin Poussaint of the Harvard Medical School, Kobe Bryant of the LA Lakers, and others, has given their support to the effort, which is also endorsed by such organizations as the National PTA, the American Academy of Pediatrics, and the National Council of La Raza.

The Campaign

The first public service messages, which are currently being distributed nationwide, focus on peer pressure to become sexually active and children’s fears about AIDS. One of the ads takes the unique perspective of a young boy struggling to deal with pressures to become sexually active and questioning “is that what girls are for?” Another shows a young child confused and worried about “whether all her friends will catch AIDS and die.” All of the ads encourage parents to talk with their children and to call the campaign’s toll-free number to get a free booklet to help them. Talking With Kids About Tough Issues, a guide for parents, is available free-of-charge by calling 1 800 CHILD 44.

“Sweeping tough issues under the rug will not prepare children for today’s world. Parents do not need to be told they are failing yet again, but they do need the type of encouragement and help this campaign offers,” said Drew E. Altman, Ph.D., President, Kaiser Family Foundation.

Lynne S. Dumas, a social researcher and author of parenting books, wrote the 60-page booklet, which was specifically developed for this campaign to help parents talk about tough issues with their children. The booklet provides general tips about how to initiate difficult conversations with children, as well as age-appropriate guidelines for bringing up specific topics and suggested responses to direct questions about such issues as sex, AIDS, violence, and drug and alcohol abuse.

Ten Tips for Parents from Talking With Kids About Tough Issues

  1. Start Early
  2. Initiate Conversations with Your Child
  3. … Even About Sex and Sexuality!
  4. Create An Open Environment
  5. Communicate Your Own Values
  6. Listen to Your Child
  7. Always Be Honest
  8. Be Patient
  9. Use Television as a Tool
  10. Talk About it Again. And, Again

Twenty Boys and Girls Clubs across the nation will help carry the campaign messages to local communities and extend the reach and scope of the campaign through a variety of activities, including holding town halls and parent clinics, and encouraging local newspapers and television and radio stations to support the effort. (See attached materials for a complete list of participating Boys and Girls Clubs and local launch events planned across the country.)

“The real hope of this initiative lies with our community partners, the Boys and Girls Clubs across the nation who will work most closely with parents, children, and the larger community to stimulate better and more frequent discussions on these tough issues,” said Lois Salisbury, President, Children Now.

The Survey of Parents and Children

According to a new survey conducted in conjunction with the campaign, most parents of 8-12 year olds say families today do not talk enough about such important topics as: relationships and becoming sexually active (77%), violence (75%), AIDS (68%), and alcohol and drugs (67%). When conversations do take place, 56 percent also say parents generally wait too long to begin talking with their children about issues like these.

The findings from a companion survey of children also suggests that parents may want to seek out opportunities to open the dialogue on tough issues. When asked about specific topics, majorities of 10-12 year old children of the parents surveyed said they wanted to know more about a variety of issues:

  • Being safe from violence (80%)
  • Protection against AIDS (73%)
  • Avoiding potentially violent situations (71%)
  • Sexually-transmitted diseases (66%)
  • Dealing with peer-pressure to have sex (58%)
  • Knowing when they’re ready to have a sexual relationship (54%)

While alcohol and drugs (94%) and violence (84%) are topics most parents of 8-12 year olds say have come up in conversations with their children, fewer say they have talked about AIDS (69%) or the basics of reproduction, the “birds and the bees” (62%). When it comes to such key issues as handling pressure to have sex, becoming sexually active, and preventing pregnancy, most parents of 8-12 year olds say they have not yet had these conversations with their children. By the time their child is a teenager, only 31 percent of parents will have talked about peer pressure to have sex, 30 percent about how to prevent an unwanted pregnancy, and 23 percent about when they might be ready to have a sexual relationship.

The survey also indicates that an opportunity exists for parents to have a more significant impact on their children’s lives if conversations about difficult subjects start earlier. Most 10-12 year olds (54%) say their parents are an important resource for “other kids their age” on issues like sex, AIDS, violence, and drugs and alcohol. Teens, however, are less likely to name parents (40% of 13-15 year olds), and more likely to name friends as a common resource for other kids their age about topics like these (60% of 13-15 year olds as compared to 36% of 10-12 year olds).

Both children and teens say many youth today find out about issues like sex, AIDS, violence, and drugs and alcohol from the entertainment media — television, movies, and music (57% of 10-12 year olds and 61% of 13-15 year olds say kids their age get “a lot” of information from these sources). Another helpful booklet, entitled Television As A Tool, is also available through this campaign. It focuses on opportunities presented by television and other media to complement parent and children’s conversations about tough issues.

More Findings from the Surveys:

  • Many children surveyed say they would talk with their parent if they had a question about some tough issues, like the basic facts about sex (90%), how to prevent pregnancy (90%), and becoming sexually active (84%).
  • But, close to half — 48 percent — of 10-12 year olds agree they at least sometimes “try to avoid talking about these subjects with their parents” and 52 percent agree they at least sometimes “feel uncomfortable when a parent brings up one of these subjects.”
  • Most parents of 8-12 year olds who have talked about sexual subjects with their children say they did so only in response to something their child said or did: 62 percent who had discussed the “birds and bees,” 56 percent who had discussed preventing pregnancy, and 54 percent who had discussed becoming sexually active.
  • Almost half of parents surveyed (48%) say they have been caught off guard by something their child asked about sex.

Contacts:

Matt James or Tina Hoff, Kaiser Family Foundation (415) 854-9400Margaret Lyons or Ann Skinner, Children Now (916) 441-2444Day of Release (212) 446-9325

Visit the Children Now website at http://www.childrennow.org

Methodology:

The Kaiser Family Foundation, Children Now, and Princeton Survey Research Associates (PSRA) designed three surveys for the Talking with Kids About Tough Issues campaign. Overall, 1,961 people were interviewed by telephone by PSRA during the development of this campaign. The results reported here represent the responses of : 1) national random-sample of 421 parents of 8-12 year olds (margin of sampling error is plus or minus 8 percent; 2) national random-samples of 164 children ages 10-12 years and 201 teens ages 13-15 years, whose parents were interviewed (margin of sampling error for both groups is plus or minus 8 percent); and 3) a national random sample of 143 parents of 8-12 year olds (margin of sampling error plus or minus 9 percent). The first two surveys were conducted between October 3-29, 1996. (Children under the age of 10 were not able to be interviewed by telephone, and therefore were not included in the sample). The third survey was conducted November 6-10, 1996.

* * *The Kaiser Family Foundation, based in Menlo Park, California, is a non-profit independent national health care philanthropy and is not associated with Kaiser Permanente or Kaiser Industries.

Children Now is a nonpartisan, independent voice for America’s children, paying particular attention to the needs of children who are poor or at risk. Children Now uses innovative research and communications strategies to pioneer solutions to the problems facing children.

The Advertising Council, a private non-profit organization, is the leading producer of public service advertising in the United States. The Council supports campaigns for the public good, which are national in scope, generating strong, measurable results for the causes it serves. (Contact: Paula Veale at (212) 922-1500 ext. 230.)

J. Walter Thompson (JWT) New York is the flagship office of one of the nation’s largest global communications companies. JWT was instrumental in the founding of the Advertising Council, and the agency maintains a strong commitment to public service advertising. (Contact: Dorothy Marcus at (212) 210-7285.)

The questionnaire and toplines for the survey reported on in this release are available by calling the Kaiser Family Foundation’s publications request line at 1-800-656-4KFF. (Ask for #1230.)

Single copies of Talking With Kids About Tough Issues, the Kaiser Family Foundation and Children Now booklet to help parents discuss sensitive topics including sex, drugs and violence with their children, are available free-of-charge by calling 1-800-CHILD 44. (Television As A Tool, a second booklet, is available through the Foundation’s publications request line at 1-800-656-4KFF. Ask for #1229.)

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Talking With Kids About Tough Issues:Press Release Survey Children Now Booklet

Kaiser Family Foundation and Children Now National Surveys: Talking with Kids about Tough Issues – Toplines/Survey

Published: Jan 30, 1997

Talking With Kids About Tough Issues

National Surveys of Parents and Children for the “Talking With Your Kids” Campaign

Kaiser Family Foundation and Children Now

Conducted by Princeton Survey Research Associates

— Questionnaire and National Toplines —

Parent Interviews:

All responses here for parents of children ages 8-12; from children ages 10-12; or from teens ages 13-15

Q1. Do you think parents of school-age children discuss each of the following topics too much, too little, or about the right amount? (First/What about), (Insert item. Do not rotate), do parents discuss this with their children too much, too little, or about the right amount?

Responses for Parents with Children Ages 8-12

TooMuchTooLittleRightAmountDKa.Alcohol or drugs667234=100b.How to handle potentially violent situations575164=100c.The basic facts about sexual reproduction, as in the “birds and the bees”471223=100d.Issues about relationships and becoming sexually active677161=100e.How to prevent pregnancy472231=100f.AIDS668224=100Q2. Some parents begin talking with their children about sensitive subjects when the child is very young, others wait until their child becomes a teenager. In general, do you think most parents begin talking with their children about these topics at about the right age, when the child is too young, or when the child is too old?

Responses for Parents with Children Ages 8-12

26At about the right age13When child is too young56When child is too old 5Don’t know100 Q3. On a different topic… Which of the following subjects, if any, have you, yourself, ever discussed with your (age) year old (boy/girl)? (First/Next) how about (Insert. Do not rotate.) — have you discussed this with (him/her), or not?

Responses for Parents with Children Ages 8-12

YesNoAlcohol and Drugs94%6%Handle Violent Situations84%16%AIDS69%31%Basic Facts about Sexual Reproduction62%38%Becoming Sexually Active42%58%How to Prevent Pregnancy30%70%Q4. Did (this/these) conversation(s) [about sexual reproduction] start because of something your child asked or said, or did you bring up the subject yourself?

Based on those parents with children ages 8-12 who had discussions about sexual reproduction

62Child asked or said something14Respondent brought up subject21Sometimes child and sometimes respondent (vol.) 3Don’t know/Refused100 Q5. Did (this/these) conversation(s) [about relationships and becoming sexually active] start because of something your child asked or said, or did you bring up the subject yourself?

Based those parents with children ages 8-12 who had discussions about becoming sexually active

54Child asked or said something23Respondent brought up subject19Sometimes child and sometimes respondent (vol.) 4Don’t know/Refused100 Q6. Did (this/these) conversation(s) [about how to prevent pregnancy] start because of something your child asked or said, or did you bring up the subject yourself?

Based on those parents with children ages 8-12 who had discussions about preventing pregnancy

56Child asked or said something31Respondent brought up subject11Sometimes child and sometimes respondent (vol.) 2Don’t know/Refused100 Q7. Now I’m going to read a list of specific topics that sometimes come up in discussions between parents and children. For each one, please tell me whether you have discussed this with your (age) year old (boy/girl), or not. (First,) have you ever discussed:

Responses for Parents with Children Ages 8-12

DiscussedTopica.Ways to avoid being part of a gang or group that might use violence61b.How to avoid violence when conflicts arise83c.Whether (he/she) is afraid of being the victim of violence53d.Issues about homosexuality50e.How to act in a relationship with a (girl/boy)45f.How to know when (he/she) is ready to have a sexual relationship23g.How to handle pressure from friends or a (boy/girl)friend to have sex31h.How girls get pregnant57i.What kinds of birth control are available22j.Where to get birth control14k.What sexually transmitted diseases are50l.What AIDS is and how someone can get the virus that causes AIDS72m.How to protect against getting AIDS52n.Whether (he/she) is afraid of being the victim of AIDS19Q8. Has there ever been a time when you were caught off-guard by something your (age) year old said or something (he/she) asked about sex?

Responses for Parents with Children Ages 8-12

48Yes51No 1Don’t know/Refused100 Q9. Which of these two statements comes closer to the way you feel?

Responses for all Parents

85Children are better prepared to make wise choices when their parents talk to them openly about sensitive subjects from an early age12If parents talk to their children about sensitive subjects from an early age, it leads children to experiment and get into trouble 3Don’t know100

Children and Teen Interviews:

Interviews with children should be conducted privately, i.e., no parent on the line. If a parent wants to listen in, say: In our experience, children find it easier to answer these questions if they can answer privately and confidentially. For parents who are concerned, we usually suggest that they sit in the room with their child while the interview is taking place. Is it OK if you let us talk privately now?

If respondent wants to know more about the study, read the following:

This study is being conducted for “Children Now” a children’s advocacy group and the Kaiser Family Foundation, a health policy research organization. If you have any questions about the project, you may call Laura Kalb collect at Princeton Survey Research during regular business hours. The phone number there is (609) 924-9204. She can answer any other questions you may have about this survey. Q1. Which of the following specific things, if any, would you like to know more about? Would you like to know more about:

ChildrenAges 10-12TeensAges 13-15YesYesa.Ways to avoid being part of a gang or group that might use violence6847b.How to avoid violence when conflicts arise7156c.How you can be safe from violence8067d.Issues about homosexuality4123e.How to act in a relationship with a (girl/boy)5347f.How to know when you are ready to have a sexual relationship5448g.How to handle pressure from friends or a (boy/girl)friend to have sex5847h.How girls get pregnant3319i.What kinds of birth control are available4536j.Where to get birth control3532k.What sexually transmitted diseases are6647l.What AIDS is and how someone can get the virus that causes AIDS5946m.How to protect against getting AIDS7354Q2. If you had a question about (Insert), who would you be most likely to ask — your mother or father, a teacher, a friend, someone else, or would you try to find an answer some other way?

Total exceeds 100 percent due to multiple responses

  1. The basic facts about sexual reproduction

    ChildrenAges 10-12TeensAges 13-15Mother or Father9063A teacher27Friend1321Someone else22Some other way88Would neither ask nor try to find out another way (vol.)00Don’t know/Refused22

  2. Issues related to relationships and becoming sexually active

    ChildrenAges 10-12TeensAges 13-15Mother or Father8460A teacher12Friend522Someone else34Some other way612Would neither ask nor try to find out another way (vol.)00Don’t know/Refused31

  3. How to prevent pregnancy

    ChildrenAges 10-12TeensAges 13-15Mother or Father9071A teacher37Friend17Someone else24Some other way712Would neither ask nor try to find out another way (vol.)01Don’t know/Refused11

Q3. I’m going to read a few sentences and I want you to tell me which of them, if any, describe the way you feel about talking about these subjects. For each statement, please tell me whether it is completely true, mostly true, mostly false, or completely false in describing you.

  1. You try to avoid talking about these subjects with your (parent interviewed):

    ChildrenAges 10-12TeensAges 13-15Completely True1314Mostly True3533Mostly False2831Completely False2221DK/Refused 2 1100100

  2. You feel uncomfortable when your (parent interviewed) brings up one of these subjects:

    ChildrenAges 10-12TeensAges 13-15Completely True1513Mostly True3733Mostly False2831Completely False1823DK/Refused 2 1100100

Q4. How much do you think children your age find out about the subjects we’ve been discussing from (Insert item. Rotate list) — a lot, a little, or nothing at all?

  1. Parents

    ChildrenAges 10-12TeensAges 13-15A Lot5440A Little3653Nothing At All95DK/Refused 1 2100100

  2. Friends

    ChildrenAges 10-12TeensAges 13-15A Lot3660A Little5032Nothing At All147DK/Refused * 1100100

  3. Entertainment media, like TV, magazines, movies and music

    ChildrenAges 10-12TeensAges 13-15A Lot5761A Little3232Nothing At All106DK/Refused 1 1100100

  4. Schools and teachers

    ChildrenAges 10-12TeensAges 13-15A Lot2945A Little5241Nothing At All1814DK/Refused 1 *100100

  5. Churches and other religious organizations

    ChildrenAges 10-12TeensAges 13-15A Lot2913A Little4550Nothing At All2434DK/Refused 2 3100100

Q5. When something is bothering you, are you able to talk it over with your parent always, usually, sometimes, or never?

ChildrenAges 10-12Always31Usually32Sometimes35Never2DK/Refused 0100


Survey Methodology

The Kaiser Family Foundation, Children Now, and Princeton Survey Research Associates (PSRA) designed three surveys for the Talking with Kids About Tough Issues campaign. Overall, 1,961 people were interviewed by telephone by PSRA during the development of this campaign. The results reported here represent the responses of: 1) national random-sample of 421 parents of 8-12 year olds (margin of sampling error is plus or minus 8 percent); 2) national random-samples of 164 children ages 10-12 years and 201 teens ages 13-15 years whose parents were interviewed (margin of sampling error for both groups is plus or minus 8 percent); and 3) a national random sample of 143 parents of 8-12 year olds (margin of sampling error plus or minus 9 percent). The first two surveys were conducted between October 3-29, 1996. (Children under the age of 10 were not able to be interviewed by telephone, and therefore were not included in the sample). The third survey was conducted November 6-10, 1996.

Prepared for the Talking With Kids About Tough Issues Campaign Launch, Wednesday, February 19, 1997

96-1465-07c

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Talking With Kids About Tough Issues: Press Release Survey Children Now Booklet