Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: To evaluate the efficacy of an early home-based intervention on the quality of maternal–infant attachment, maternal mood and child health parameters in a cohort of vulnerable families.

Intervention Results: At 4 month follow-up, 160 families (80 intervention, 80 control) were available for assessment. The intervention improved family functioning at 4 months. All aspects of the home environment, including the quality of maternal–infant attachment and mothers’ relationship with their child, were significantly enhanced. In particular, significant and positive differences were found in parenting with the intervention group feeling less restrictions imposed by the parenting role, greater sense of competence in parenting, greater acceptability of the child, and the child being more likely to provide positive reinforcement to the parent. Early differences in maternal mood were not maintained at 4 months. Various child health parameters were enhanced including immunization status, fewer parent-reported injuries and bruising, and researcher confirmed lack of smoking in the house or around the infant. The families were consistently more satisfied with their community health service.

Conclusion: This form of early home based intervention targeted to vulnerable families promotes an environment conducive for infant mental and general health and hence long-term psychological and physical well-being, and is highly valued by the families who receive it.

Study Design: RCT

Setting: Community (child health nurse home visits)

Population of Focus: Families with an infant and whose English literacy skills enabled them to complete a questionnaire

Data Source: Parent self-report and child’s personal health record book.

Sample Size: 181 families; Intervention (n=90), Control (n=91)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Motivational Interviewing, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: Premature infants are at high risk for respiratory disease, and secondhand smoke (SHS) exposure further increases their risk for developing respiratory illness and asthma. Yet, SHS exposure remains problematic in this vulnerable population. Our objective was to evaluate the effects of brief asthma education plus motivational interviewing counseling on reducing SHS exposure and improving respiratory outcomes in premature infants compared to asthma education alone.

Intervention Results: Caregivers in the treatment group reported significantly more home smoking bans (96% vs 84%, P = .03) and reduced infant contact with smokers after the intervention (40% vs 58%, P = .03), but these differences did not persist long term. At study end (8 months after neonatal intensive care unit discharge), treatment group infants showed significantly greater reduction in salivary cotinine versus comparison (−1.32 ng/mL vs −1.08 ng/mL, P = .04), but no significant differences in other clinical outcomes.

Conclusion: A community-based intervention incorporating motivational interviewing and asthma education may be helpful in reducing SHS exposure of premature infants in the short term. Further efforts are needed to support sustained protections for this high-risk group and ultimately, prevent acute and chronic respiratory morbidity. Strategies for successfully engaging families during this stressful period warrant attention.

Study Design: RCT

Setting: Community (home)

Population of Focus: Pre-term infants and SHSe

Data Source: Golisano Children’s Hospital. Rochester, NY

Sample Size: 165 caregivers and their infants born at ≤ 32 weeks’ gestational age, within 6 weeks of discharge from the NICU

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Patient-Centered Medical Home, CAREGIVER, Home Visit (caregiver), PATIENT/CONSUMER, Home Visits, Outreach (caregiver), Nurse/Nurse Practitioner, Enabling Services

Intervention Description: (1) To improve connections to the medical home for infants from one low-income neighborhood (2) To increase the number of families enrolled in a local home visiting program, and (3) To improve communication between medical staff and home visitors.

Intervention Results: Outcomes were timeliness of well child care and enrollment in home visiting. Time series analyses compared patients from the intervention neighborhood with a demographically similar neighborhood. Mean age at newborn visit decreased from 14.4 to 10.1 days of age. Attendance at 2- and 4-month well child visits increased from 68 to 79% and 35 to 59 %, respectively. Rates did not improve for infants from the comparison neighborhood. Confirmed enrollment in home visiting increased. After spread to 2 more clinics, 43 % of infants in the neighborhood were reached.

Conclusion: Neighborhood-based newborn registries, proactive nursing outreach, and collaboration with a home visiting agency aligned multiple clinics in a low-income neighborhood to improve access to health-promoting services.

Study Design: Quasi-experimental: Nonequivalent control group

Setting: Primary care clinics and a home visiting program in a neighborhood defined by two zip codes

Population of Focus: All children born in the intervention and comparison neighborhoods

Data Source: Data from the local children’s hospital’s Emergency Department was used to identify the most common primary medical providers for children from the study zip codes • Newborn registry data (maintained manually with a Microsoft Excel spreadsheet) • Electronic health record data (with an automated newborn registry) • Manual chart review • Automated report of appointment data • Outcome measures using clinic data • Process measures using clinic and home visiting agency data

Sample Size: n=237 (cumulative number of babies on a registry); n=30 (cumulative number of families enrolled in home visiting)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Other Person-to-Person Education, CAREGIVER, Education/Training (caregiver), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Motivational Interviewing, Motivational Interviewing/Counseling

Intervention Description: Intervention (INT) was a home-based asthma follow-up after ED visit and two visits for an environmental control educational program delivered by trained nurses and nurse practitioners to the child and caregiver. For caregivers of children with positive cotinine results, brief motivational interviewing sessions were conducted to implement total home smoking ban.

Intervention Results: Over half of children in the study tested positive for SHS. Targeting SHS exposure was major component of the intervention [but] no significant reduction in cotinine exposures was associated with the intervention at 12 months.

Conclusion: In this study, a home-based EC intervention was not successful in reducing asthma ED revisits in children with poorly controlled asthma with SHS exposure. Allergic sensitization, young age, and increased controller medication use were important predictors of asthma ED visits.

Study Design: Prospective randomized controlled trial

Setting: Home-based (following ED visit)

Population of Focus: Children with physician diagnosed persistent asthma, having two or more ED asthma visits or more than one hospitalization over the past 12 months and residing in the Baltimore metropolitan area

Data Source: For SHS exposure, child saliva samples collected during the ED visit and at 6- and 12-month follow up visits.

Sample Size: 222 inner city children ages 3-12

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, Peer Counselor, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling

Intervention Description: To test an air cleaner and health coach intervention to reduce secondhand smoke exposure compared with air cleaners alone or no air cleaners in reducing particulate matter (PM), air nicotine, and urine cotinine concentrations and increasing symptom-free days in children with asthma residing with a smoker.

Intervention Results: The overall follow-up rate was high (91.3%). Changes in mean fine and coarse particulate matter (PM) concentrations (baseline to 6 months) were significantly lower in both air cleaner groups compared with the control group. No differences were noted in air nicotine or urine cotinine concentrations. The health coach provided no additional reduction in PM concentrations. Symptom-free days were significantly increased in both air cleaner groups compared with the control group.

Conclusion: Although the use of air cleaners can result in a significant reduction in indoor PM concentrations and a significant increase in symptom-free days, it is not enough to prevent exposure to secondhand smoke.

Study Design: 3-arm RCT

Setting: Hospital and home

Population of Focus: Inner-city children with asthma and SHSe

Data Source: Caregiver self-report, urine cotinine levels, and air nicotine concentrations

Sample Size: 126 children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, PROVIDER/PRACTICE, Provider Audit/Practice Audit, Nurse/Nurse Practitioner

Intervention Description: To assess the effects on cervical screening rates in one small general practice based on uptake and the benefits of multiple strategies.

Intervention Results: Over 18 months there was a 27% improvement from a biannual screening rate of 53% at baseline to 67.5% at the end of the audit. Over the past 6 months, 49% of women elected for the 'screening only' test provided by a nurse.

Conclusion: Strategies are feasible and associated with a considerable increase in screening rates. Patients can choose to have their test performed by a nurse in general practice. This study suggests that each strategy's improvement in uptake is independently additive.

Study Design: QE: pretest-posttest

Setting: General practice in Bundaberg, Queensland

Population of Focus: Women attending the practice living within Bundaberg

Data Source: Chart review

Sample Size: Baseline (n=1,540) Follow-up (n=1,431)

Age Range: 18-69

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Nurse/Nurse Practitioner, PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, CAREGIVER, Educational Material (caregiver)

Intervention Description: The aim of this study was to evaluate the effectiveness of a nursing educational intervention with mothers of sick children to decrease passive smoking exposure.

Intervention Results: Baseline comparison showed no significant differences between the two groups in the mothers’ actions to protect the children from passive smoking exposure. More mothers in the intervention group than the control group had always moved the children away when they were exposed to the fathers’ smoke at home at 3‐month follow up (78·4% vs. 71·1%; P = 0·01) but became non‐significant at 6 and 12 months.

Conclusion: A simple health education intervention provided by nurses to the mothers in a busy clinical setting can be effective in the short-term to motivate the mothers to take actions to protect the children from exposure to passive smoking produced by the fathers.

Study Design: RCT

Setting: Hospital (pediatric ward/outpatient departments)

Population of Focus: Non-smoking mothers of sick children admitted to the pediatric ward/smoking husbands living in the same household

Data Source: Parental self-report.

Sample Size: 1483 mothers of sick children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PAYER, Expanded Insurance Coverage, HEALTH_CARE_PROVIDER_PRACTICE, Public Insurance (Health Care Provider/Practice), Educational Material (Provider), Collaboration with Local Agencies (State), Collaboration with Local Agencies (Health Care Provider/Practice), Nurse/Nurse Practitioner, PROFESSIONAL_CAREGIVER, Patient Navigation (Assistance), Care Coordination, STATE, Multicomponent Approach

Intervention Description: The Healthy Beginnings system of care in Atlanta, GA connects children and their families to health insurance and a medical home model of care to support children’s health and development. The main components are care management + education and parent engagement + collaborative partnerships. A registered nurse, known as the health navigator, supports parents and helps them learn how to work with health care professionals on behalf of their children; they also connect parents to the Center for Working Families to ensure that they receive public benefits for which they are eligible.

Intervention Results: Healthy Beginnings coordinated care approach has ensured that participating children and families have health insurance (97%) and receive regular immunizations (92%), ongoing health care from a primary care physician and dental health provider, and regular developmental screenings (98%) and follow-up care. Healthy Beginnings has dramatically increased children’s access to health care and forms the basis for a cost-effective approach that can be replicated in other communities.

Conclusion: By building upon the partnerships formed through the foundation’s community change effort, Healthy Beginnings has dramatically increased neighborhood children’s access to health care and forms the basis for a cost-effective approach that can be replicated in other communities.

Study Design: Program evaluation

Setting: Community (Community-based organizations in Atlanta, Georgia)

Population of Focus: Low-income young children and families

Data Source: Questionnaire data

Sample Size: 279 children

Age Range: 0-10 years

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Motivational Interviewing, Telephone Support, Peer Counselor, Midwife, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: The aim of this pilot study was to evaluate the implementation of the American College of Obstetricians and Gynecologists' 5 A's smoking cessation intervention among pregnant women being cared for by 5 A's-trained midwives working with a team of nurse researchers in an effort to reduce prenatal smoking exposure. The evidence-based 5 A's smoking cessation program has been recommended for use in prenatal care by health care providers.

Intervention Results: Among the 35 women who enrolled in the study, 32 (91.4%) decreased smoking and 3 (8.6%) quit smoking by one month after the intervention. For those who continued to smoke, the average number of cigarettes smoked was reduced from 10 cigarettes per day at baseline to 8 cigarettes per day at one month, 7 cigarettes per day at 2 months, and 6 cigarettes per day by the end of pregnancy. The women further reduced their tobacco exposure by delaying the timing of initiating smoking in the morning and by increasing indoor smoking restrictions.

Conclusion: Midwives and nurses can be trained in the implementation of the evidence-based 5 A's smoking cessation program for incorporation into regular prenatal care of pregnant women who smoke. By guiding women in techniques aimed at reducing the amount and frequency of cigarette smoking, nurses and midwives facilitate a decrease in prenatal smoking exposure.

Study Design: Single group pre-post test evaluation pilot

Setting: Prenatal care clinics

Population of Focus: Pregnant women who smoked and were willing to quit or cut down smoking receiving prenatal care

Data Source: Surveys (self-report questionnaires)

Sample Size: 35

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, PATIENT_CONSUMER, Community Events, COMMUNITY, Nurse/Nurse Practitioner, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: The study aimed to evaluate the effectiveness of a cervical cancer prevention education program for rural Korean immigrant women. A total of 46 Korean immigrant women who had not been screened in the past three years participated. The experimental group participated in the intervention program once a week for four weeks and completed a post-program survey in week 12.

Intervention Results: The experimental group participated in the intervention program once a week for four weeks and completed a post-program survey in week 12. Compared to the control group, significant increases were detected in level of knowledge of cervical cancer prevention (p = .001), behavioral attitude toward cervical cancer prevention (p = .029) and behavioral intention regarding cervical cancer prevention (p = .005) in the experimental group. Pap screening rate of the experimental group was significantly increased (p = .029), but the rate of change in the selection of primary care providers was not significant.

Conclusion: The results suggest the need for a multilevel approach to address cultural and systemic barriers to Korean immigrant women in promotion of cervical cancer prevention behavior.

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Nurse/Nurse Practitioner,

Intervention Description: Assignment of a nurse practitioner–pediatrician dyad partnering with families in a structured complex care clinic to provide intensive care coordination and comprehensive plans of care.

Intervention Results: Of 144 participants randomized, 141 had complete health administrative data, and 139 had complete baseline surveys. The median (IQR) age of the participants was 29 months (9-102); 83 (60%) were male. At 12 months, scores for utility of care planning tools improved in the intervention group compared with the waitlist group (adjusted odds ratio, 9.3; 95% CI, 3.9-21.9; P < .001), with no difference between groups for the other 2 co-primary outcomes. There were no group differences for secondary outcomes of child outcomes, parent outcomes, and health care system utilization and cost. At 24 months, when both groups were receiving the intervention, no primary outcome differences were observed. Total health care costs in the second year were lower for the intervention group (median, CAD$17 891; IQR, 6098-61 346; vs CAD$37 524; IQR, 9338-119 547 [US $13 415; IQR, 4572-45 998; vs US $28 136; IQR, 7002-89 637]; P = .01).

Conclusion: The CCKO program improved the perceived utility of care planning tools but not other outcomes at 1 year. Extended evaluation periods may be helpful in assessing pediatric complex care interventions.

Study Design: The study design was a pragmatic randomized controlled trial (RCT) that compared the effectiveness of structured care coordination for children with medical complexity (CMC) to usual care. The study used a waitlist variation for randomizing patients from 12 complex care clinics in Ontario, Canada, over two years.

Setting: The study was conducted in Ontario, Canada, across 12 complex care clinics. The clinics were selected based on their capacity to provide care to children with medical complexity (CMC) and their families.

Population of Focus: The target audience for the study includes healthcare professionals, policymakers, and researchers involved in the care of children with medical complexity (CMC) and their families. The findings of the study are relevant to professionals working in complex care clinics, as well as those involved in developing and implementing care coordination programs for CMC. Additionally, the study may be of interest to healthcare policymakers and researchers focused on improving the quality of care and reducing healthcare utilization for this population.

Sample Size: The study initially assessed 451 participants for eligibility, of whom 207 met the preestablished inclusion criteria for randomization. Ultimately, 139 participants (77 in the intervention group and 62 in the waitlist control group) were included in the primary analysis. Of these, 117 participants completed the 12-month follow-up, and 108 completed the 24-month follow-up.

Age Range: The median age of the participants at enrollment was 29 months, with an interquartile range (IQR) of 9-102 months. This indicates that the age range of the participants in the study was from as young as a few months to over 8 years old.

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Nurse/Nurse Practitioner, Collaboratives,

Intervention Description: The intervention described in the study is a longitudinal care coordination program for infants with medical complexity. The program provides care coordination to infants in the NICU through their first year at home, with a focus on family-facing activities. The program aims to support families in navigating the complex healthcare system, accessing community resources, and coordinating care across inpatient and outpatient settings. The care coordination program involves the involvement of care coordinators, outpatient providers, and program organizers to provide comprehensive support to families.

Intervention Results: Parent-reported benefits included frequent communication and personalized support that met families’ and patients’ evolving needs. Care coordinators, who were trained as nurses and social workers, developed longitudinal relationships with parents. This seemed to facilitate individualized support throughout the first year of life. Providers reported that smaller caseloads were central to the success of the program.

Conclusion: As is true for all descriptive program evaluations, this study offers observations about this program without drawing definitive conclusions about impact.

Study Design: The study design is a descriptive program evaluation using the Centers for Disease Control and Prevention Framework for Program Evaluation. The study used a sequential exploratory mixed-methods approach to evaluate parental experiences, provider perspectives, and care coordinator perspectives. The study also developed a logic model to describe program structure and stated goals.

Setting: The study was conducted at a level IV NICU at a freestanding academic children's hospital, Ann & Robert H. Lurie Children's Hospital of Chicago.

Population of Focus: The target audience for the study includes healthcare providers, particularly those involved in the care of infants with medical complexity, such as neonatologists, nurses, therapists, chaplains, child life specialists, primary care physicians, surgeons, physician assistants, and nurse coordinators. Additionally, the study is relevant to care coordinators, program organizers, and researchers interested in longitudinal care coordination for infants with medical complexity.

Sample Size: 5 parents were interviewed, and 23 parents completed a survey; 8 providers were interviewed, and 26 providers participated in focus groups; 2 care coordinators were interviewed.

Age Range: The age range of the study participants is from birth to the first year of life, as the program provides care coordination to infants in the NICU through their first year at home.

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Motivational Interviewing/Counseling, Assessment (caregiver), PATIENT/CONSUMER, Educational Material, Online Material/Education/Blogging, Motivational Interviewing, PARENT/FAMILY, Consultation (Parent/Family), Notification/Information Materials (Online Resources, Information Guide)

Intervention Description: A study was undertaken to determine the effectiveness of two brief multi-strategic child health nurse delivered interventions in: decreasing the prevalence of infants exposed to SHS; decreasing the prevalence of smoking amongst parent/carers of infants and increasing the prevalence of household smoking bans.

Intervention Results: When compared to the Control group at 12 months, no significant differences in the prevalence of infant exposure to SHS were detected from baseline to follow-up for Treatment condition 1 or Treatment condition 2. Similarly, no significant differences were detected in the proportion of parent/care givers who reported that they were smokers, or in the proportion of households reported to have a complete smoking ban.

Conclusion: Further research is required to identify effective interventions that can be consistently provided by child health nurses if the potential of such settings to contribute to reductions in child SHS exposure is to be realised.

Study Design: Cluster randomized controlled trial

Setting: Community well-child health clinics

Population of Focus: s Infants exposed to second hand smoke

Data Source: Data was collected via computer during the visit, child health clinic records

Sample Size: 1424 parents of children aged 0 to 4 years attending well-child health checks

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Cost-Sharing Requirements,

Intervention Description: The intervention bundle included designating physician and nurse champions, pre-screening patients’ charts, empowering nurses to recommend immunization, providing no-cost vaccinations, placing prompts in clinic note templates, and eliminating the requirement for pre-vaccination pregnancy tests.

Intervention Results: The prevalence of women who had both completed and initiated the series was significantly higher, 20.3% and 29.7% respectively, in the last month, compared to their counterfactuals (p < 0.01). The bundled intervention had a significant attributable reduction among Spanish speakers and publicly insured and uninsured women.

Conclusion: The study demonstrates the impact of implementing an evidence-based multi-component interventions bundle that successfully reduced missed opportunities and increased HPV vaccine uptake in a low resource OB/GYN clinic serving predominantly low-income, black, and Hispanic women.

Study Design: Retrospective study with an interrupted time-series model using counterfactual comparison groups

Setting: Urban, hospital-based OB/GYN clinic

Population of Focus: Young adult women (non-pregnant, 11-26 years)

Sample Size: 6,463 vaccine-eligible visits during the study period

Age Range: 11-26 years

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Nurse/Nurse Practitioner, Planning for Transition, Pediatric to Adult Transfer Assistance, Care Coordination, Quality Improvement/Practice-Wide Intervention

Intervention Description: This quantitative descriptive study used a survey questionnaire to investigate nurses' role and responsibilities in health care transition planning (HCTP) for youth and young adults with chronic illness and/or disability. The survey looked at respondents' role in health care transition planning (HCTP), inclusion of HCTP in job description, levels of HCTP knowledge, and ratings of importance of HCTP elements.

Intervention Results: Over 64% of respondents performed HCTP activities related to complex chronic illness management. Only 18% reported specialized training in HCTP. The highest-ranking items in regard to perceived importance were educating and supporting disease self-management and speaking with families about complex needs. Predictors of perceived importance were role, inclusion of transition planning in a job description, percentage of time in direct care, caring for those aged 14 years and older, and level of knowledge about HCTP.

Conclusion: The findings highlight key aspects of the pediatric nurse role in HCTP and identify specific elements that can be addressed to support future HCTP role development.

Study Design: Quantitative descriptive methodology

Setting: Hospitals/Clinics

Population of Focus: Pediatric nurses

Sample Size: 1814

Age Range: Adults

Intervention Components (click on component to see a list of all articles that use that intervention): School-Based Health Centers, Nurse/Nurse Practitioner, Teacher/Staff Training,

Intervention Description: Male high school students are at particular risk of forgoing sexual health care. ABSTRACT: Purpose: Adolescent males are less likely to receive health care and have lower levels of sexual and reproductive health (SRH) knowledge than adolescent females. The purpose of this study was to determine if a school-based structural intervention focused on school nurses increases receipt of condoms and SRH information among male students. Methods: Interventions to improve student access to sexual and reproductive health care were implemented in six urban high schools with a matched set of comparison schools. Interventions included working with school nurses to improve access to sexual and reproductive health care, including the provision of condoms and information about pregnancy and sexually transmitted disease prevention and services. Intervention effects were assessed through five cross-sectional yearly surveys, and analyses include data from 13,740 male students.

Intervention Results: Nurses in intervention schools changed their interactions with male students who visited them for services, such that, among those who reported they went to the school nurse for any reason in the previous year, those in intervention schools reported significant increases in receipt of sexual health services over the course of the study compared with students in comparison schools. Further, these results translated into population-level effects. Among all male students surveyed, those in intervention schools were more likely than those in comparison schools to report increases in receipt of sexual health services from school nurses.

Conclusion: With a minimal investment of resources, school nurses can become important sources of SRH information and condoms for male high school students.

Study Design: Longitudinal quasi-experimental study

Setting: Urban high schools in a public school district in Los Angeles County, California

Population of Focus: Male high school students from urban high schools

Sample Size: Total of 13,740 male high school students (T1: 2,709 male students; T2: 2,636 male students; T3: 2,690 male students; T4: 2,910 male students; T5: 2,795 male students)

Age Range: Adolescents males ages 14 to 18 years

Intervention Components (click on component to see a list of all articles that use that intervention): Planning for Transition, Pediatric to Adult Transfer Assistance, Integration into Adult Care, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: A total of 65 teenagers with T1D were recruited for a structured program of transition. They attend transitional meetings involving both pediatric and adult team and were, when ready, welcomed in specialized consultations for adolescents with a special « passport ». Here we study their characteristics before and after structured transition and the benefit of this program.

Intervention Results: 9 transition meetings took place (September 2012-December 2017). Mean age was 16.5 years. Mean age at onset of T1D was 7.5 years with average pediatric follow-up of 9 years.72% of young adults felt satisfied. After the transition meeting, 74% of patients wished to join directly adult unit. They were followed there for 28.4 ± 16.2 months. The glycaemic control improved significantly with a decrease in HbA1C of 0.93 ± 1.69% the first year of follow-up and the number of young adults achieving a HbA1C < 7.5% increased by 8%.

Conclusion: This program was beneficial for 75% of patients who demonstrated an improvement in their metabolic control the year following transition to adult care service. To our knowledge, this study is the first one in North Africa to report on the outcome of a structured transition program from pediatric to adult diabetes care.

Study Design: Pre-post and prospective cohort

Setting: Clinic-based (Pediatric diabetes clinics)

Population of Focus: Patients treated by two pediatric endocrinologists in clinics from the center of Tunis

Data Source: Demographic and clinical data

Sample Size: 65 patients with type 1 diabetes

Age Range: 14 years and older (no maximum age limit) (range 14.5- 23.2 years)

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Planning for Transition, YOUTH, Peer-led Mentoring/Support Counseling, Nurse/Nurse Practitioner, PARENT/FAMILY, Counseling (Parent/Family)

Intervention Description: The aim of this study was to assess the impact of a transition clinic model on adolescent congenital heart disease (CHD) patients' health perception outcomes. The transition clinic model consists of multidisciplinary standardized interventions to educate and support CHD patients and represents a key element in the adequate delivery of care to these individuals during their transition from childhood to adulthood. Currently, empirical data regarding the impact of transition clinic models on the improvement of health perceptions in CHD adolescent patients are lacking. A quasi-experimental design was employed. Quality of life, satisfaction, health perceptions and knowledge were assessed at the time of enrolment (T0) and a year after enrolment (T1), respectively. During the follow-up period, the patients enrolled (aged 11-18 years) were involved in the CHD-specific transition clinic model (CHD-TC).

Intervention Results: A sample of 224 CHD adolescents was enrolled (60.7% boys; mean age: 14.84 ± 1.78 years). According to Warnes' classification, 22% of patients had simple heart defect, 56% showed moderate complexity and 22% demonstrated severe complexity. The overall results suggested a good impact of the CHD-TC on adolescents' outcomes, detailing in T1 the occurrence of a reduction of pain (P < 0.001) and anxiety (P < 0.001) and an improvement of knowledge (P < 0.001), life satisfaction (P < 0.001), perception of health status (P < 0.001) and quality of life (P < 0.001).

Conclusion: The CHD-TC seems to provide high-quality care to the patient by way of a multidisciplinary team. The results of the present study are encouraging and confirm the need to create multidisciplinary standardized interventions in order to educate and support the delivery of care for CHD adolescents and their families.

Study Design: Quasi- experimental, non-randomized, using a pre/ post-intervention approach

Setting: Clinic-based (Outpatient clinic of a facility for CHD)

Population of Focus: Adolescents with congenital heart disease (CHD)

Data Source: Self-report questionnaires and medical records

Sample Size: 224

Age Range: 11-18 years of age

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Motivational Interviewing, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Telephone Support, CAREGIVER, Home Visit (caregiver), Assessment (caregiver), Attestation (caregiver), Motivational Interviewing/Counseling

Intervention Description: This pilot study evaluated the effectiveness of a nurse-delivered home-visiting program during the postpartum period that included a low-intensity smoking relapse-prevention intervention.

Intervention Results: Although both groups showed significant relapse from being smoke free, the intervention group was twice as likely to be smoke free at 3 and 6 months, and three times as likely to be smoke free at both times. The cotinine verification revealed a misclassification rate of 37% at the 6-month follow-up (i.e., participants self-reported as abstinent but shown by cotinine not to be abstinent).

Conclusion: The effectiveness of this brief, low-cost, and potentially replicable intervention in improving the rate of persistent postpartum smoke-free status for women who quit smoking during pregnancy is encouraging. A randomized trial of the approach is warranted.

Study Design: Pilot study; Prospective two-group design

Setting: Birthing hospital plus home visit

Population of Focus: English-speaking women who delivered healthy babies, resided in Franklin County, Ohio, and reported quitting smoking during pregnancy and at least 7 days before delivery

Data Source: Questionnaire that included smoking history and attitudes and intent to stay smoke free administered at baseline. Saliva sample for maternal cotinine analysis collected at baseline and 3 and 6 months for all participants who self-reported abstinence (defined as no smoking for the previous 7 days)

Sample Size: 97 in the baseline group and 122 in the intervention group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Nurse/Nurse Practitioner,

Intervention Description: This project implemented an innovative care coordination model, involving one-on-one supports from a trained care coordinator who liaised with the broader intersectoral care team to improve joint care planning, integration of services, and the experience of both families and care providers.

Intervention Results: Over 2 years, this project provided care coordination to 84 children and their families, with an age range from 2 to 17 years. The care coordination intervention demonstrated positive impacts for children, families, and care teams and contributed to clinical efficiencies. Children had fewer visits to the emergency department and less frequent acute care use. Improvement in access to services, joint care planning and communication across providers, and better linkage with school supports were demonstrated.Families reported that the program decreased their stress around coordinating care for their child.

Conclusion: This work demonstrated that intersectoral care coordination is attainable through innovative and collaborative practice for children with complex neurodevelopmental and medical needs.

Study Design: The study design is a single-group interventional study using a repeated-measures framework. The study evaluated the impact of a care coordination intervention on children with concurrent neurodevelopmental disorders and chronic health conditions. The study used previously established outcome measures and conducted surveys at 0, 6, and 12 months to evaluate the impact of care coordination activities. The study did not include a control group receiving standard of care during the same period, and randomizing patients to care coordination or standard care was deemed a barrier to referral and recruitment. Therefore, the study design has limitations, but it provides valuable insights into the effectiveness of a care coordination intervention for children with neurodevelopmental disorders and complex medical needs.

Setting: The article does not provide a specific setting for the study. However, it does mention that the participants were identified and referred from a variety of sources, including subspecialty clinics at a regional Canadian children’s hospital, community pediatricians, nurses, allied health professionals, and pediatric mental health services.

Population of Focus: The target audience for the study is healthcare providers, policymakers, and researchers who are interested in improving care coordination for children with neurodevelopmental disorders and complex medical needs.

Sample Size: The study provided care coordination to 84 children and their families over a period of two years.

Age Range: 2 to 17 years

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, Home Visits, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, CAREGIVER, Home Visit (caregiver)

Intervention Description: We conducted a randomized controlled trial to determine whether a home-based intervention program could reduce infant passive smoking and lower respiratory illness.

Intervention Results: 1) A significant difference in the amount of exposure to tobacco smoke—5.9 fewer cigarettes per day at 12 months; (2) no difference in infant cotinine excretion; (3) lower prevalence of persistent lower respiratory symptoms among intervention-group infants of smoking mothers whose head of household had no education beyond high school (14.6% versus 34.0%).

Conclusion: The prevalence of persistent lower respiratory symptoms was lower among intervention-group infants of smoking mothers whose head of household had no education beyond high school: intervention group, 14.6%; and controls, 34.0%.

Study Design: RCT

Setting: In the home

Population of Focus: Infants weighing at least 2000 g at birth, free of significant postnatal medical problems, and residing in Alamance or Chatham County in central North Carolina

Data Source: Urine collection from the infants; self-report about smoking and smoke exposure from the mother and other questions designed to identify maternal and family characteristics that might modify the effect of the intervention and to identify risk factors for infant lower respiratory disease.

Sample Size: 933 total started the study, 659 completed it; 168 infants in the reduced data collection groups

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling, Motivational Interviewing, Patient Reminder/Invitation, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: To determine if mothers receiving a smoking cessation intervention emphasizing health risks of environmental tobacco smoke (ETS) for their children have a higher quit rate than 1) mothers receiving routine smoking cessation advice or 2) a control group.

Intervention Results: Complete data (baseline and both follow-ups) were available for 166 subjects. There was no impact of group assignment on the quit rate, cigarettes/day, or stage of change. The Child Health Group intervention had a sustained effect on location where smoking reportedly occurred (usually outside) and on improved knowledge of ETS effects.

Conclusion: Further research is needed to devise more effective methods of using the pediatric health care setting to influence adult smoking behaviors.

Study Design: RCT

Setting: Primary care center in a large urban children’s hospital

Population of Focus: Female caregivers (16 years and older) who accompanied a child (under 12 years) to the Primary Care Center of Columbus Children’s Hospital for a health care visit for any chief complaint or well-child examination

Data Source: Baseline data on demographics and smoking topics collected by questionnaire; and 1- and 6-month follow-ups.

Sample Size: 479 mothers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, CAREGIVER, Home Visit (caregiver), Motivational Interviewing/Counseling, PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: To evaluate the impact of the School-Based Asthma Therapy trial on asthma symptoms among urban children with persistent asthma.

Intervention Results: The primary outcome was the number of symptom-free days during 2 weeks averaged across the pea asthma season (November-February). Children in the treatment group experienced more symptom-free days and better results on several other asthma-related measures. Full-year outcomes also showed a significant treatment effect. When comparing outcomes separately for children without and with smoke exposure in the home, results suggest an effect of the intervention for both groups of children. Primary findings were independent of any change in the child’s cotinine level, suggesting that the school-based care component alone is effective in reducing symptoms.

Conclusion: The School-Based Asthma Therapy intervention significantly improved symptoms among urban children with persistent asthma. This program could serve as a model for improved asthma care in urban communities.

Study Design: Randomized trial, with children stratified by smoke exposure in the home and randomized to a school-base care group or a usual care group

Setting: School, with intervention in the home

Population of Focus: Children aged 3 to 10 years with persistent, physician-diagnosed asthma in the Rochester City School District, with consent of the child’s primary care provider to participate in the study

Data Source: All families were given diaries to track their child’s symptoms, and outcomes were assessed by monthly telephone interviews. Saliva samples were collected from the child at the beginning and end of the study to determine the child’s level of cotinine. Medical records were reviewed for 10% of the sample to confirm office and emergency department visits and hospitalizations.

Sample Size: 530 children from 67 schools and preschools

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Planning for Transition, Pediatric to Adult Transfer Assistance, PROVIDER/PRACTICE, EMR Reminder, Nurse/Nurse Practitioner, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide)

Intervention Description: An EMR-based transition planning tool (TPT) was introduced into the Pediatric CHD Clinic. Two nurses used the TPT with eligible patients. Independent of the intervention, two medicine-pediatric CHD physicians and one nurse practitioner were added to the ACHD Clinic to address growing capacity needs.

Intervention Results: Control patients waited 26 ± 19.2 months after their last pediatric clinic visit for their first adult visit. Intervention patients waited 13 ± 8.3 months (P = .019). Control and Intervention patients experienced a lapse in care greater than two (50% vs 13%, P = .017) and three (30% vs 0%, P = .011) years, respectively. The difference between the recommended number of months for follow-up and the first adult appointment (15.1 ± 17.3 Control and 4.4 ± 6.1 Intervention months) was significant (P = .025). NYHAFS deteriorated between the last Pediatric visit and the first ACHD visit for seven (23%) Control patients and no Intervention patients (P = .042). Four of seven Control patients whose NYHAFS declined had a lapse of care of more than two years.

Conclusion: There is a need for improved HCT planning for patients with moderate to severe CHD, otherwise, lapses of care and adverse outcomes can ensue.

Study Design: Prospective study

Setting: Clinic-based (Children’s hospital pediatric cardiology clinic)

Population of Focus: Adolescent patients with moderate to severe congenital heart disease (CHD)

Data Source: Electronic medical records; New York Heart Association Functional Assessment of Heart Failure instrument

Sample Size: 25 intervention, 30 control

Age Range: Intervention 16- 25 years, control 18 years or older

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Nurse/Nurse Practitioner, YOUTH, Adult-led Support/Counseling/Remediation, PARENT/FAMILY, Training (Parent/Family), Notification/Information Materials (Online Resources, Information Guide), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Home Visit (caregiver)

Intervention Description: A 2-year randomized, controlled trial involving 95 children measured the impact of a comprehensive home and ambulatory program for pediatric asthma management using objective outcome measures.

Intervention Results: There were no significant differences in medical visits, theophylline levels, or records of asthma symptomsOne year after discontinuing the intervention, a marked "washout" effect was observed.

Conclusion: Comprehensive ambulatory programs of childhood asthma management can improve objective measures of illness severity but must be sustained.

Study Design: RCT

Setting: Homes and well-child clinics

Population of Focus: Patients admitted to the Izaak Walton Killam Children’s Hospital with a diagnosis of asthma in the preceding 5 years

Data Source: Medical personnel

Sample Size: 95 children

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Referrals, Nurse/Nurse Practitioner, Multicomponent Approach,

Intervention Description: The intervention described in the article is an innovative program for the care of children with incontinence and dysfunctional elimination. This program is unique in that it combines subspecialty services (urology, gastroenterology, and psychiatry) in a single point of care for this population. It is also the first reported independent nurse practitioner (NP)-run specialty referral practice in a free-standing pediatric ambulatory subspecialty setting. The program involves the operation of a Continence Clinic, staffed by nurse practitioners, registered nurses, and medical assistants, and equipped with specialized clinical space and testing capabilities, including urodynamics and uroflow systems, anorectal manometry systems, and innovative treatment options such as animated pelvic floor biofeedback using a pediatric pelvic floor biofeedback system. The intervention aims to provide comprehensive care for children with incontinence and dysfunctional elimination, with the goal of achieving continence and improving the overall health and well-being of the affected children. The program also seeks to address the fragmentation of care that currently exists across traditional subspecialties and to demonstrate the effectiveness of non-physician provider reconfiguration of health care delivery in subspecialty practice. Overall, the intervention involves a multidisciplinary approach to the assessment, diagnosis, and management of incontinence and dysfunctional elimination in children, with a focus on integrating subspecialty services and utilizing nurse practitioners to deliver care in a specialized clinic setting.

Intervention Results: Analysis indicates that this model is fiscally sound, has similar or higher patient satisfaction scores when measured against physician-run subspecialty clinics, and has an extensive geographic referral base in the absence of marketing.

Conclusion: The article does not explicitly mention statistically significant findings in the context of hypothesis testing or inferential statistics. However, it reports on various outcome measures such as financial performance, patient/family satisfaction, and geographic referral base data. The study primarily utilizes descriptive statistics to measure and compare these outcomes. While the article provides data on revenue generation, cost per relative value unit, patient satisfaction scores, and geographic referral patterns, it does not explicitly state whether these findings were analyzed for statistical significance. Therefore, the presence of statistically significant findings is not clearly indicated in the article.

Study Design: The study design used in the article is not explicitly stated. However, the article mentions that retrospective data on financial, patient satisfaction, and patient referral base were compiled to assess the program. Additionally, the article discusses the use of descriptive statistics to measure and compare patient/family satisfaction and geographic referral base data. Furthermore, the article refers to the use of a Logic Model, which provides a pictorial representation of how a program is expected to achieve its results and corresponding process and outcome measures for determining the extent to which the intervention was implemented as planned. This suggests that the study may have utilized a program evaluation design based on a Logic Model, which is often used to evaluate the effectiveness and efficiency of unique programs.

Setting: The setting for the study was Nemours Children’s Specialty Care, an outpatient clinic in Jacksonville, Florida. The NP-run Continence Clinic is an independent program within Nemours, which offers 17 pediatric subspecialty services staffed by approximately 100 physicians and 20 NPs. The Continence Clinic is not embedded in any other division and is treated no differently from the physician-run divisions within the organization. It shares the same operations infrastructure as the rest of the subspecialty clinics, including the EPIC electronic medical record with associated registration, scheduling, and billing functions. Corporate services furnish materials and supplies, maintenance, housekeeping, legal, and risk management services.

Population of Focus: The target audience for the study includes healthcare professionals, administrators, and policymakers involved in pediatric subspecialty care, particularly those with an interest in innovative models of care delivery and workforce configurations. Additionally, the study may be of interest to nurse practitioners, as the program described in the article is nurse practitioner-run and represents a novel approach to subspecialty care. Furthermore, the findings of the study may be relevant to researchers and professionals interested in pediatric incontinence and dysfunctional elimination, as well as those focused on improving access to care and patient/family satisfaction in pediatric subspecialty settings.

Sample Size: The article does not explicitly mention the sample size for the study. However, it describes the program as the first reported independent nurse practitioner–run specialty referral practice in a free-standing pediatric ambulatory subspecialty setting. The study reports retrospective data on financial, patient satisfaction, and patient referral base to assess the program. Therefore, the sample size may be related to the patient population served by the NP-run Continence Clinic at Nemours Children’s Specialty Care in Jacksonville, Florida.

Age Range: The age range of the study is not explicitly mentioned in the provided document. However, since the program focuses on providing care for children with incontinence and dysfunctional elimination, it can be inferred that the study likely includes pediatric patients, encompassing a wide age range from infancy to adolescence. For specific details on the age range of the study, it may be necessary to refer to additional sources or contact the authors of the study directly.

Intervention Components (click on component to see a list of all articles that use that intervention): PAYER, Expanded Insurance Coverage, HEALTH_CARE_PROVIDER_PRACTICE, Public Insurance (Health Care Provider/Practice), Provider Training/Education, Nurse/Nurse Practitioner, CLASSROOM_SCHOOL, Teacher/Staff Training, PROFESSIONAL_CAREGIVER, Outreach (caregiver), Outreach (School Staff)

Intervention Description: Healthy and Ready to Learn is a targeted, school-based CHIP and Medicaid outreach initiative for identifying and enrolling eligible and uninsured children entering kindergarten in North Carolina’s highest need counties. 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. Continuous community-based outreach (e.g., attending community events, providing outreach materials in various languages, contacting local organizations and leaders to help inform families about CHIP and Medicaid) is also utilized.

Intervention Results: With increased enrollment rates and well-child exam rates, findings demonstrate the potential benefits of using schools as a point of intervention in enrolling young children in public health insurance and as a source of trusted information for parents from low-income backgrounds. The initiative increased enrollment rates by 12.2% points and increased well-child exam rates by 8.6% points in the regression discontinuity design models, but not differences-in-differences, and did not significantly increase well-child visits. Findings demonstrate the potential benefits of using schools as a point of intervention in enrolling young children in public health insurance and as a source of trusted information for low-income parents.

Conclusion: Findings demonstrate the potential benefits of using schools as a point of intervention in enrolling young children in public health insurance and as a source of trusted information for low-income parents.

Study Design: Quasi-experimental difference-in-difference and regression discontinuity

Setting: Schools (Elementary schools in North Carolina)

Population of Focus: Uninsured kindergarten-aged children in high economic need counties in North Carolina

Data Source: Medicaid and CHIP administrative data, focus groups, key informant interviews

Sample Size: 300 children; 16 counties were selected as intervention sites that included 278 elementary schools in 22 districts; in the second year, expanded to 32 counties

Age Range: 4-6 years

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Patient Reminder/Invitation, Educational Material, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Financial Incentives, Nurse/Nurse Practitioner

Intervention Description: Before-and-after comparisons of the time-appropriate delivery rates of cervical and breast cancer screening using the automated and NP-augmented strategies of the P-PROMPT reminder and recall system.

Intervention Results: Before-and-after comparisons of time-appropriate delivery rates (< 30 months) of cancer screening showed the rates of Pap tests and mammograms for eligible women significantly increased over a 1-year period by 6.3% (P < .001) and 5.3% (P < .001), respectively. The NP-augmented strategy achieved comparable rate increases to the automated strategy alone in the delivery rates of both services.

Conclusion: The use of provider and patient reminders and pay-for-performance incentives resulted in increases in the uptake of Pap tests and mammograms among eligible primary care patients over a 1-year period in family practices in Ontario.

Setting: Eight primary care network practices and 16 family health network practices in southwestern Ontario

Population of Focus: Practicing physicians from the participating primary care network and family health network groups

Data Source: CytoBase (consortium of main laboratories in Ontario), combined with rosters of eligible patients

Sample Size: Total (N=246) Analysis (n=232) N=physicians

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Patient Reminder/Invitation, HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Quality Improvement/Practice-Wide Intervention, Nurse/Nurse Practitioner

Intervention Description: Improving cervical cancer screening rates was identified as a priority in a federally qualified health center when only 40% of eligible women were properly screened in 2016. Forty-five percent of the population the clinic serves is uninsured and 60% are Hispanic. The aim of this quality improvement project was to have 75% of the women 21 to 65 years of age who sought care at this clinic during the 60-day project period receive Pap test eligibility screening, enrollment in a state and federal screening program, and case management. Four rapid plan–do–study–act cycles were used. Tests of change included team engagement, patient engagement, eligibility screening, and case log management. Data were analyzed using run charts to evaluate the impact of interventions on outcomes. The interventions consisted of team meetings, a patient engagement tool, an eligibility screening tool, and case log management.

Intervention Results: Among the women who completed care at the clinic during the 60-day project period, 80% were uninsured and 86% were Hispanic. A total of 87% of women received effective care, which consisted of same-day Well Woman Health Care Program enrollment and a same-day Pap test or an appointment to return for a well-woman visit.

Conclusion: A multicomponent approach led to underserved women receiving equitable access to cervical cancer screening and timely enrollment in a cervical cancer screening program.

Setting: Federally qualified health center (FQHC) in Tucson, Arizona,

Population of Focus: Uninsured and underserved women ages 21-65

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Planning for Transition, Pediatric to Adult Transfer Assistance, Care Coordination, PROVIDER/PRACTICE

Intervention Description: Adolescents and young adults with special health care needs were enrolled in a randomized HCT CC intervention. Intervention participants received HCT CC as outlined in the 2011 clinical report. Perceptions of chronic illness care quality and CC were assessed at 0, 6, and 12 months.

Intervention Results: Intervention participants had a Patient Assessment of Chronic Illness Care score at 12 months of 3.6 vs 3.3 compared with participants in the control group (P = .01). Intervention participants had higher average scores for patient activation (3.7 vs 3.4; P = .01), problem solving (3.8 vs 3.4; P = .02), and coordination/follow-up (3.0 vs 2.5; P < .01). The Client Perceptions of Coordination Questionnaire revealed that intervention participants had 2.5 times increased odds to endorse mostly or always receiving the services they thought they needed and had 2.4 times increased odds to have talked to their provider about future care (P < .01).

Conclusion: Implementing recommended HCT CC practices improved patient or patient caregiver perception of quality of chronic illness care and CC especially among the most complex patients.

Study Design: Randomized controlled trial

Setting: Hospital/clinicbased

Population of Focus: SSI Medicaid MCO recipients with chronic conditions who spoke English and could complete surveys

Data Source: Patient Assessment of Chronic Illness Care (PACIC)15 and the Client Perceptions of Coordination Questionnaire (CPCQ)

Sample Size: 209 (105 intervention, 104 control)

Age Range: 16-22 years

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Nurse/Nurse Practitioner, Group Education,

Intervention Description: A continuing education program for perinatal nursing staff working in the labor and delivery unit, postpartum unit, and nursery was developed. The program was based on a review of literature and consisted of the incidence and prevalence of PPD and issues surrounding stigma associated with PPD. It also included a discussion of the symptoms, risk factors, diagnosis, and treatment of PPD, guidelines for screening, and resources for referral. The role of the nurse in the provision of PPD patient education related to patient teaching and anticipatory guidance was also included.

Intervention Results: For this study, a 10-question PPD knowledge-based pre- and posttest was administered. A paired-samples t test was calculated to compare the mean pretest score to the mean final exam score. The mean score on the pretest was 68.88 (SD = 10.25), and the mean score on the posttest was 94.14 (SD = 8.68). Nurses had a significant increase in PPD knowledge from pretest to posttest, t(24) = −9.690, p < .001.One hundred nine postpartum patients were discharged during the 4-week time prior to the intervention; 0.9% (P1) received postpartum depression (PPD) education prior to discharge. One hundred twenty-nine postpartum patients were discharged over the course of 4 weeks postintervention; 93.8% (P2) received PPD education.

Conclusion: Patient education is an essential component of nursing practice. This study found that perinatal nurses are more likely to provide PPD education to patients when they are more knowledgeable about the condition. It highlights the importance of a needs assessment and continuing education and professional development for nursing staff. Results support the use of continuing education to improve nurses’ confidence in their ability to provide patient education and to increase their knowledge of PPD. The outcomes of this study support research by providing strategies to increase nurses’ ability to educate patients on PPD.

Study Design: Quasi-experimental study

Setting: 150-bed regional hospital with 1,600 annual births

Sample Size: 26 nurses; 49% survey response

Age Range: 24-66

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Nurse/Nurse Practitioner,

Intervention Description: Children known to child welfare are more likely to have poor health compared to the general population. Most children served by child welfare are served in their own homes. New Jersey implemented the Child and Family Nurse Program (CFNP) to provide nurse care coordination to address the health needs of children who remain in-home.

Intervention Results: Families served by CFNP experienced improvements in family protective factors and health-related quality of life from baseline to follow-up.

Conclusion: The study concluded that the Child and Family Nurse Program (CFNP) in New Jersey showed positive outcomes for families of children with medical needs known to child welfare. Families served by CFNP demonstrated improvements in family protective factors and health-related quality of life (HRQL) from baseline to follow-up. The findings indicated that the program had a positive impact on family well-being, as evidenced by the significant improvements in Family Functioning/Resiliency, Child Development/Knowledge of Parenting, and all three indicators of health-related quality of life. The study also highlighted the strengths and weaknesses of the research design and data collection methods, acknowledging the limitations of using parent self-report to measure outcomes. Despite these limitations, the study provided evidence of the potential effectiveness of CFNP in improving outcomes for families of children with medical needs known to child welfare. Overall, the study's conclusions supported the positive impact of CFNP on family well-being outcomes, emphasizing the potential benefits derived by the families served by the program.

Study Design: The study design is a retrospective cohort study that used data from the Child and Family Nurse Program (CFNP) in New Jersey from 2016 to 2017. The study aimed to describe the families served by CFNP and the services provided to them. The study also evaluated the impact of CFNP on family protective factors and health-related quality of life (HRQL) using a pre-post design. The study collected baseline and follow-up data from caregivers of children served by CFNP using surveys. The study design allowed for the identification of trends and patterns in the data and provided insights into the effectiveness of CFNP in improving outcomes for families of children with medical needs known to child welfare.

Setting: The setting for the study was New Jersey, where the Child and Family Nurse Program (CFNP) was implemented to improve health outcomes for children with significant health challenges who remain in-home. The study focused on the families served by CFNP in New Jersey from 2016 to 2017.

Population of Focus: The target audience for the study is policymakers and child welfare agency leaders who are interested in improving the health and well-being of children served by child welfare who remain in-home. The study provides evidence-based recommendations for improving care coordination for these children, specifically through the implementation of nurse care coordination programs like the Child and Family Nurse Program (CFNP). The study also provides insights into the strengths and weaknesses of the CFNP and the study design, which may be useful for policymakers and child welfare agency leaders who are considering implementing similar programs or conducting similar evaluations. Additionally, the study may be of interest to healthcare providers and researchers who are interested in improving the health outcomes of vulnerable populations.

Sample Size: The study included a sample of 304 families referred to the Child and Family Nurse Program (CFNP) during the study period. Of these, 297 families were eligible for the study.

Age Range: The study did not focus on a specific age range, but rather on families of children with medical needs known to child welfare who remain in-home. The index child in the study was on average 5.2 years of age, but the study did not exclude families based on the age of the child. Therefore, the age range of the children in the study is likely to be broad, ranging from infants to adolescents.

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Nurse/Nurse Practitioner, Educational Material (Provider),

Intervention Description: The intervention was an online educational program that included information on PD screening and treatment, interviewing skills, screening tools, and treatment options. The intervention was designed based on the Theory of Planned Behavior (TPB) constructs, which include attitudes toward behavior, perceived behavioral control, subjective norms, perceived behavioral intention, and behavioral outcome. The study analyzed the impact of this specific intervention on participants' PD-related perceptions and intentions. Therefore, the intervention described aligns with a discernable strategy based on the TPB constructs.

Intervention Results: The results of the study showed positive gains in several key areas related to perinatal depression (PD) screening and treatment. Specifically, the intervention resulted in positive gains in PD-related perceived behavioral control (PBC), attitudes, subjective norms, knowledge, intention to screen and treat PD, and perceived importance of screening and treating PD from pre- to post-intervention . The findings indicated improvements in PD-related attitudes, knowledge, and the perceived importance of PD screening and treatment after the intervention . Additionally, the Theory of Planned Behavior Scale (TPBS) scores showed significant improvements from pre- to post-intervention, indicating a positive impact of the educational intervention on participants' perceptions and intentions related to PD screening and treatment . Overall, the results suggested that the PD online educational intervention was effective in improving participants’ PD-related PBC, attitudes, subjective norms, knowledge, and intention to screen and treat PD

Conclusion: PBC demonstrated a small-to-moderate positive association with perceived importance of screening and treating PD at post-intervention. Results from the current study suggest that the PD online educational intervention is effective in improving participants’ PD-related PBC, attitudes, subjective norms, knowledge, and intention to screen and treat PD.

Study Design: The study utilized a quasi-experimental, repeated-measures design. The study included a single group of participants, and data were collected at two time points: pre-intervention and post-intervention. The pre-intervention assessments occurred online directly prior to the participants engaging in the training, while the post-intervention assessments occurred online directly after the participants engaged in the training . This design allowed for the evaluation of changes in participants' perceptions and intentions related to perinatal depression (PD) screening and treatment before and after the educational intervention. The use of pre-post measures enabled the researchers to assess the impact of the intervention on participants' PD-related knowledge, attitudes, and intention to screen and treat PD, as well as their perceived importance of screening and treating PD. While the study did not include a control group, the use of a repeated-measures design allowed for the evaluation of changes within the same group of participants, which can provide valuable information about the impact of the intervention on participants' perceptions and intentions related to PD screening and treatment.

Setting: The study setting was not explicitly mentioned in the provided excerpts. However, the study was conducted with graduate nursing students, and the intervention was implemented and assessed online via Qualtrics . Therefore, it can be inferred that the study setting for the educational intervention and data collection was an online platform, likely associated with the academic institution where the graduate nursing program was located.

Population of Focus: The target audience of the study was graduate nursing students. The researchers chose nursing students as the participant population for several reasons. First, educational interventions for healthcare profession students have been well received and effective in improving student comfort with addressing postpartum depression. Second, nursing is the largest of the healthcare professions, with almost 3 million nurses practicing in the United States, indicating their potential impact on patient care. Third, the nursing profession has shifted to providing evidence-based care to patients; as such, this study aimed to improve perinatal depression-related evidence-based care

Sample Size: The study included a sample of 59 graduate nursing students

Age Range: The study did not provide a specific age range for the participants. However, the study included graduate nursing students, and the average age of the participants was 33.83 years (SD = 7.35)

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Nurse/Nurse Practitioner, Technology-Based Support,

Intervention Description: The purpose of this study was to explore health-related quality of life (HRQL) and family impact in the context of an advanced practice registered nurse-delivered telehealth care coordination intervention for children with medical complexity (CMC). This was a secondary outcomes analysis of a randomized controlled trial with 163 families of CMC in an existing medical home. HRQL and family impact were measured using the PedsQL measurement model.

Intervention Results: Significant predictors of Year 2 child HRQL were baseline HRQL and the presence of both neurologic impairment and technology dependence. There was no significant intervention effect on child HRQL or family impact after 24 months.

Conclusion: Care coordination interventions for CMC may need to incorporate family system interventions for optimal outcomes in a range of quality of life domains.

Study Design: 163 children and their parental caregivers

Setting: A Special Needs Program certified in the Minnesota Health Care Homes Program (medical home for children with medical complexity)

Population of Focus: Children with medical complexity and their parental caregivers. To be eligible for the study, the identified child had to meet at least four of five Children with Special Health Care Needs (CSHCN) Screener criteria, which include the need or use of prescription medications, above routine use of health care services, a functional limitation, need or use of specialized therapies or services, and treatment or counseling for a developmental or behavioral problem.

Age Range: Children aged 2-15 years and their parental caregivers

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Nurse/Nurse Practitioner, Shared Plans of Care

Intervention Description: To address the problem and alleviate burden for families, the Comprehensive Cerebral Palsy Program implemented a nurse‐led comprehensive interdisciplinary team approach to provide optimal care coordination to patients and families, using an Integrative Holistic Care Plan (IHCP). During an annual 3–4 hour Comprehensive CP Clinic appointment, a team of specialists meets with the family, and a holistic, evidence‐based plan of care is developed. The family‐centered care plan includes summaries of each discipline's plan of care with individualized goals, recommendations, and evidence‐based outcomes. After the visit, the plan of care is communicated with the family, primary care provider, and other community provi- ders to ensure continuity of care.

Intervention Results: Early in the program and electronic IHCP development stage, clinical, and financial outcomes were improved. In addition to significant cost savings, family satisfaction surveys showed continuous improvement in the areas of access, com- munication, and coordination of care.

Conclusion: Overall, the quality, effectiveness, and efficiency of care in the Comprehensive Cerebral Palsy Program, using the Integrative Holistic Care Plan, has resulted in improving health outcomes, decreasing cost, and increasing satisfaction of our CP patient population with complex needs. The data on reduced healthcare utilization, and improved family satisfaction support this conclusion. Based on the program success, additional state level funding to further enhance care coordination services and to formalize collaborations with Public Health Nurses from our catchment area was awarded and the program achieved NCQA Patient Centered Specialty Care Recognition.

Study Design: The article does not describe a specific research study with a traditional study design. Instead, it presents an original article detailing the development and implementation of an intervention, the Integrative Holistic Care Plan (IHCP), in the context of the Comprehensive Cerebral Palsy Program. The article discusses the implementation of the nurse-led comprehensive interdisciplinary team approach to provide optimal care coordination to patients and families, using the IHCP. Therefore, the article focuses on the description and outcomes of the implemented intervention rather than a traditional research study design.

Setting: Comprehensive Cerebral Palsy Program, Nationwide Children's Hospital, Columbus, Ohio

Population of Focus: The target audience for the study includes healthcare professionals, particularly those working in interdisciplinary clinics and caring for children and adults with cerebral palsy. This may include nurses, physicians, therapists, social workers, and other providers involved in the care of individuals with cerebral palsy. Additionally, the study may be of interest to healthcare administrators and policymakers involved in the development and implementation of care coordination programs for individuals with complex healthcare needs.

Sample Size: We have previously reported on the initial experience of 131 patients who received care in the Comprehensive CP Program during the first year of operation.

Age Range: The article does not describe a specific study with a defined age range but does appear to be child focused.

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Planning for Transition, Pediatric to Adult Transfer Assistance, Integration into Adult Care, YOUTH, Education on Disease/Condition, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: A cluster randomized clinical trial was conducted of a nurse-led transition intervention for 16- to 17-year-olds with moderate or complex CHD versus usual care. The intervention group received two 1-h individualized sessions targeting CHD education and self-management skills. The primary outcome was excess time to adult CHD care, defined as the interval between the final pediatric and first adult cardiology appointments, minus the recommended time interval, analyzed by using Cox proportional hazards regression accounting for clustering. Secondary outcomes included scores on the MyHeart CHD knowledge survey and the Transition Readiness Assessment Questionnaire.

Intervention Results: A total of 121 participants were randomized to receive the intervention (n = 58) or usual care (n = 63). At the recommended time of first adult appointment (excess time = 0), intervention participants were 1.8 times more likely to have their appointment within 1 month (95% confidence interval: 1.1 to 2.9; Cox regression, p = 0.018). This hazard increased with time; at an excess time of 6 months, intervention participants were 3.0 times more likely to have an appointment within 1 month (95% confidence interval: 1.1 to 8.3). The intervention group had higher scores at 1, 6, 12, and 18 months on the MyHeart knowledge survey (mixed models, p < 0.001) and the Transition Readiness Assessment Questionnaire self-management index (mixed models, p = 0.032).

Conclusion: A nurse-led intervention reduced the likelihood of a delay in adult CHD care and improved CHD knowledge and self-management skills.

Study Design: Cluster randomizedclinical trial

Setting: Clinic-based (Outpatient clinic)

Population of Focus: Adolescents attending outpatient clinics in 1 of 2 tertiary care pediatric cardiology programs in Canada

Data Source: Questionnaires

Sample Size: 121 (58 intervention, 63 control)

Age Range: 16-17 years

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Education on Disease/Condition, Planning for Transition, HEALTH_CARE_PROVIDER_PRACTICE, YOUTH

Intervention Description: To evaluate the impact of a novel nurse-led transition intervention program designed for young adolescents (age 13-14 years) with congenital heart disease (CHD). We hypothesized that the intervention would result in improved self-management skills and CHD knowledge.

Intervention Results: We randomized 60 participants to intervention (n = 30) or usual care (n = 30). TRANSITION-Q score (range 0-100) increased from 49 ± 10 at baseline to 54 ± 9.0 at 6 months (intervention) vs 47 ± 14 to 44 ± 14 (usual care). Adjusted for baseline score, TRANSITION-Q scores at 1 and 6 months were greater in the intervention group (mean difference 5.9, 95% CI 1.3-10.5, P = .01). MyHeart score (range 0-100) increased from 48 ± 24 at baseline to 71 ± 16 at 6 months (intervention) vs 54 ± 24 to 57 ± 22 (usual care). Adjusted for baseline score, MyHeart scores at 1 and 6 months were greater in the intervention group (mean difference 19, 95% CI 12-26, P < .0001). Participants aged 14 years had a greater increase in TRANSITION-Q score at 6 months compared with 13-year-old participants (P < .05).

Conclusion: A nurse-led program improved transition readiness and CHD knowledge among young adolescents. This simple intervention can be readily adopted in other healthcare settings.

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Nurse/Nurse Practitioner,

Intervention Description: The intervention described in the article to increase care coordination for children is the key worker role in children's cancer care. The key worker is a designated healthcare professional who acts as a consistent point of contact for families throughout the cancer trajectory, providing support, information, and coordination of care. The key worker is responsible for facilitating communication between healthcare professionals and families, coordinating care across different healthcare settings, and providing emotional support to families.

Intervention Results: Participants included: 22 nurse specialist key workers, 103 parents, 85 professionals and 10 children/young people. Qualitative and quantitative data were woven together, to best illuminate key worker services. Four main models of care were described as well as the context of care and process of care. Key working effectiveness centred around three pillars: care coordination; expert knowledge, experience and expertise; relationship. These were essential to improved family experience, emotional wellbeing, and delivery of individualized care closer to home.

Conclusion: Our findings support the notion that key working effectiveness was dependent upon three pillars: coor- dination; knowledge, expertise and experience; and relationship. But in certain conditions, such as a varia- tion in context, this placed limits on enacting the three pillars, and the positive experience of the family was diminished. When they worked well, key worker roles reduced the fragmented nature of services, families placed a great value on their role, wanting to retain the same key worker from diagnosis, beyond treatment into long-term care. Retaining these roles, where they are already in place, or including, if not, we would highly recommend, factoring into budgets to sustain such roles. Service need influenced the type of key worker model in place, our findings enrich these models, and evidence the importance of clinical teams describing what is needed for their patients, in terms of coordination, consistency and continuity in care. Variations in model delivery should be wel- comed, but need to be evaluated, to ensure patient outcomes, patient experience, and equity of access to services remains.

Study Design: This project carried out an evaluation using case studies: specifically, an “intrinsic” case study, where the case itself was the key worker role. Other participants (parents, children, young people, and professionals) were linked to each case and their practice. Case study research takes a holistic approach (it considers the case within its context) and is characterized by a convergence of diverse sources of data, which provide a means of considering the multiple elements likely to shape and influence the case, in this context the key worker role. To understand and reveal complexities of the case, we collected multiple sources of data that centre on the key workers’ role. Reporting of findings followed the Good Reporting of a Mixed-methods Study (GRAMMS) guidelines. The GRAMMS checklist is available as a supplementary file.

Setting: The study was conducted across principal treatment centers for children with cancer in England, Wales, and Scotland.

Population of Focus: The target audience for the study includes healthcare professionals, policymakers, and researchers involved in the treatment and care of children with cancer.

Sample Size: The sample size for this study included 103 parents, 10 children/young people, 22 key workers, and 85 professionals from various healthcare roles who worked closely with the key worker and families across different sites. Additionally, 31 individual interviews and 12 focus group interviews were conducted as part of the data collection process.

Age Range: young people under the age 16 years.

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Patient-Centered Medical Home, Notification/Information Materials (Online Resources, Information Guide), PARENT_FAMILY, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: We aimed to integrate nurse care managers to coordinate care for such patients, and then evaluate, if this improved health care utilization.

Intervention Results: Three medical home-based nurse care managers were integrated into four pediatric hospital affiliated practices in a large, urban center. The number of ED visits and inpatient admissions were statistically significantly decreased post-intervention (p < 0.05).There was also a decrease in the number of subspecialty visits, but it was close to the threshold of significance (p = 0.054). There was no impact noted on primary care visits.

Conclusion: This quality improvement project demonstrates that nurse care managers who are integrated into the medical home of CSHCN can potentially decrease the utilization of ED visits and hospital admissions as well as subspecialty visits. Practice implications Nurse care managers can play a pivotal role in medical home redesign for the care of CSHCN.

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Nurse/Nurse Practitioner,

Intervention Description: The intervention described in this study is the integration of nurse care managers into the medical home setting for children with special health care needs (CSHCN) . The nurse care managers were responsible for coordinating care for CSHCN, including providing education and support to families, facilitating communication between healthcare providers, and ensuring that patients received appropriate and timely care. The nurse care managers worked closely with pediatric house staff and attending faculty to provide comprehensive care for CSHCN.

Intervention Results: Three medical home-based nurse care managers were integrated into four pediatric hospital affiliated practices in a large, urban center. The number of ED visits and inpatient admissions were statistically significantly decreased post-intervention (p < 0.05).There was also a decrease in the number of subspecialty visits, but it was close to the threshold of significance (p = 0.054). There was no impact noted on primary care visits.

Conclusion: This quality improvement project demonstrates that nurse care managers who are integrated into the medical home of CSHCN can potentially decrease the utilization of ED visits and hospital admissions as well as subspecialty visits.

Study Design: The study utilized a quality improvement project design to evaluate the impact of integrating nurse care managers into the pediatric medical home for children with special health care needs (CSHCN) . The project evaluated the health care utilization for primary care, subspecialty care, emergency department visits, and inpatient care using a pre- and post-intervention design. The study compared the number of visits before and after the integration of nurse care managers to assess the impact on healthcare utilization.

Setting: The setting for the study was the Ambulatory Care Network at NewYork-Presbyterian Hospital.

Population of Focus: The target audience for the study is healthcare providers, policymakers, and researchers who are interested in improving care coordination for children with special health care needs (CSHCN) in the medical home setting. The study's findings may be of particular interest to healthcare providers and policymakers who are involved in the care of CSHCN and are looking for strategies to improve care coordination and reduce healthcare costs. Additionally, researchers interested in quality improvement projects and interventions to improve care for CSHCN may find the study's methodology and results informative.

Sample Size: The study involved 673 children who received longitudinal care coordination support from nurse care managers in the pediatric medical home.

Age Range: The study did not specify a specific age range for the children with special health care needs (CSHCN) who received care coordination support from nurse care managers in the pediatric medical home. However, the study did report the mean age of the population subsets for inpatient, ED, outpatient medical home, and outpatient subspecialty visits, which was 8 years.

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement/Practice-Wide Intervention, Care Coordination, Nurse/Nurse Practitioner,

Intervention Description: There is a rising number of children with special health care needs (CSHCN) in the pediatric medical home anThis quality improvement project evaluated the impact on CSHCN of the integration of nurse care managers in the pediatric medical home. From October 2015 through February 2019, 673 children received longitudinal care coordination support from a care manager. Health care utilization for primary, subspecialty, emergency department (ED) and inpatient care was reviewed using pre and post design.d their care coordination is complicated and challenging. We aimed to integrate nurse care managers to coordinate care for such patients, and then evaluate, if this improved health care utilization.

Intervention Results: Three medical home-based nurse care managers were integrated into four pediatric hospital affiliated practices in a large, urban center. The number of ED visits and inpatient admissions were statistically significantly decreased post-intervention (p < 0.05).There was also a decrease in the number of subspecialty visits, but it was close to the threshold of significance (p = 0.054). There was no impact noted on primary care visits.

Conclusion: This quality improvement project demonstrates that nurse care managers who are integrated into the medical home of CSHCN can potentially decrease the utilization of ED visits and hospital admissions as well as subspecialty visits.

Study Design: Pre-post study

Setting: Four pediatric hospital-affiliated practices in a large, urban center in the United States

Population of Focus: Children with special health care needs who were enrolled in the four pediatric hospital-affiliated practices in a large, urban center in the United States

Sample Size: 673 patients who received the nurse care manager intervention across the four medical homes

Age Range: CYSHCN 0-18 years

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Nurse/Nurse Practitioner, Technology-Based Support,

Intervention Description: A quality improvement project assessed the gaps in care, identified high-risk patients, and developed a novel pediatric trauma care coordinator (PTCC) nursing position to bridge the gap.

Intervention Results: In the 12-month preimplementation period, 14 patients had a costly return to health care (CRH) rate of 14%, compared with the 12-month postimplementation period in which 18 patients had a CRH rate of 0%. Patients received a mean of 21.2 communication events and 14.1 intervention events from the PTCC in the postimplementation period.

Conclusion: The novel PTCC nursing position has addressed a critical gap in the recovery of severely injured children at this pediatric trauma center. A nurse seems to be the ideal type of provider for this position due to the trust relationship with families linked to the medical knowledge to communicate efficiently and effectively with the other providers. The utilization of the existing trauma registry provides a cost-effective tool to collect enhanced outcome data for ongoing quality assessment. The general application of the program to other centers is difficult to determine as local resources vary between pediatric trauma centers. Value assessment and durability of the impact on CRH warrant further investigation.

Study Design: The study is described as a quality improvement project, which indicates that it focuses on implementing and evaluating changes in a healthcare setting to improve patient care and outcomes.

Setting: The setting for the study was a pediatric trauma center. The study was conducted in a single institution, and the pediatric trauma program was developed within this institution.

Population of Focus: The target audience for the study includes healthcare professionals involved in pediatric trauma care, such as trauma nurses, trauma coordinators, pediatric surgeons, and other healthcare providers working in pediatric trauma centers. Additionally, the study may be of interest to hospital administrators, quality improvement professionals, and researchers in the field of pediatric trauma care.

Sample Size: In the 12-month preimplementation period, 14 patients had a CRH rate of 14%, compared with the 12-month postimplementation period in which 18 patients had a CRH rate of 0%.

Age Range: The study does not specify an age range for the pediatric trauma patients included in the program.

Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Education/Training (caregiver), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Quality Improvement/Practice-Wide Intervention

Intervention Description: To assess the effectiveness of 2 interventions separately and combined to promote infant safe sleep practices compared with control interventions.

Intervention Results: The primary outcome was maternal self-reported adherence to 4 infant safe sleep practices of sleep position (supine), sleep location (room sharing without bed sharing), soft bedding use (none), and pacifier use (any); data were collected by maternal survey when the infant was aged 60 to 240 days. The independent effect of the nursing quality improvement intervention was not significant for all outcomes. Interactions between the 2 interventions were only significant for the supine sleep position.

Conclusion: Among mothers of healthy term newborns, a mobile health intervention, but not a nursing quality improvement intervention, improved adherence to infant safe sleep practices compared with control interventions. Whether widespread implementation is feasible or if it reduces sudden and unexpected infant death rates remains to be studied.

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Quality Improvement/Practice-Wide Intervention, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: The purpose of this study was to develop and implement a transition process planning and communication tool to facilitate transition planning among multiple, pediatric subspecialties within a system-wide transition program.

Intervention Results: Implementation of the tool was feasible and corresponded with increased transition planning documentation post-implementation. Nurses represented 33% of the sample that utilized the tool. Survey results revealed barriers to documentation and utilization of the tool, along with strategies for improvement.

Conclusion: This study demonstrates that health professionals, especially pediatric nurses and nurse practitioners, are willing to adopt new, electronic documentation tools to enhance multidisciplinary transition planning consistent with best practices. Future studies should address identified barriers, assess the effectiveness of the tool on improving transition outcomes, and consider implications for integration into global health care models. System-wide implementation of such tools may improve multidisciplinary communication and coordination of care for youth with special health care needs.

Intervention Components (click on component to see a list of all articles that use that intervention): Patient-Centered Medical Home, Nurse/Nurse Practitioner, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: To examine the workforce transformation occurring in community health centers that have achieved PCMH status, and to assess the relationship of those changes to utilization, as measured by the number of visits.

Intervention Results: We found that adopting a PCMH model was significantly associated with a growth in use of advanced practice staff (nurse practitioners and physician assistants) [0.53 full-time equivalent (FTE), 8.77%; P<0.001], other medical staff (medical assistants, nurse aides, and quality assurance staff) (1.23 FTE, 7.46%; P=0.001), mental health/substance abuse staff (0.73 FTE, 17.63%; P=0.005), and enabling service staff (case managers and health educators) (0.36 FTE, 6.14%; P=0.079), but not primary care physicians or nurses. We did not observe a significant increase in utilization, as measured in total number of visits per year. However, the visits marginally attributed to advanced practice staff (539 FTE, 0.89%; P=0.037) and mental health/substance abuse staff (353 FTE, 0.59%; P=0.051) significantly increased.

Conclusion: Our findings suggest that the implementation of PCMH actively reengineers staff composition and this, in turn, results in changes in marginal utilization by each staff type.

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Training (Parent/Family), Nurse/Nurse Practitioner,

Intervention Description: Hospital discharge offers an opportunity to initiate coordination of follow-up care, preventing readmissions or emergency department (ED) recidivism. We evaluated how revisits and costs of care varied in a 12-month period between children in a care coordination program at our center (enrolled after hospital discharge with a tracheostomy or on a ventilator) and children with complex chronic condition discharges who were not enrolled.

Intervention Results: Seventy patients in the program were compared with 56 patients in the control group. On bivariate analysis, the median combined number of hospitalizations and ED visits in 2018 was lower among program participants (0 vs 1; P 5 .033), and program participation was associated with lower median total costs of care in 2018 ($700 vs $3200; P 5 .024). On multivariable analysis, care coordination program participation was associated with 59% fewer hospitalizations in 2018 (incidence rate ratio: 0.41; 95% confidence interval: 0.23 to 0.75; P 5 .004) but was not significantly associated with reduced ED visits or costs.

Conclusion: The care coordination program is a robust service spanning the continuum of patient care. We found program participation to be associated with reduced rehospitalization, which is an important driver of costs for children with medical complexity.

Study Design: The study design is a retrospective cohort study. The study aimed to compare the outcomes of children with complex chronic conditions who were enrolled in the C5 program with a similar group of children who were not enrolled in the program. The study used electronic medical records to assess hospital revisits and total costs of care for both groups over a 12-month period. The study also analyzed patient characteristics, including age, gender, race, and insurance status, to compare the two groups.

Setting: The study was conducted at a rural tertiary-care academic medical center in the southeastern United States. The Center for Children with Complex and Chronic Conditions (C5) program was established at this university-affiliated medical center to provide care coordination for children with complex chronic conditions.

Population of Focus: The target audience for the study is healthcare professionals and policymakers who are involved in the care of children with complex chronic conditions. The study provides evidence regarding the effectiveness of a care coordination program for children with complex chronic conditions, which can inform the development of similar programs in other healthcare settings. The study's findings can also be used to guide healthcare policies aimed at improving care coordination for children with complex chronic conditions, particularly in rural areas where access to care may be limited.

Sample Size: The sample size for the study consisted of 70 patients in the C5 program and 56 patients in the control group.

Age Range: The study included children aged under 1-17 years.

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Nurse/Nurse Practitioner, PROFESSIONAL_CAREGIVER, Education/Training (caregiver), HOSPITAL, Quality Improvement, Crib card, Audit/Attestation

Intervention Description: A multidisciplinary team developed a quality improvement initiative to create a hospital-based safe sleep environment for all newborns and infants prior to discharge. The safe sleep initiative included two key elements: (1) parent education about safe infant sleep that included verifying their understanding of safe sleep, and (2) modeling of safe infant sleep environment by hospital staff. To monitor compliance, documentation of parent education, caregiver surveys, and hospital crib check audits were tracked monthly. A visual safe sleep “crib ticket”—a checklist of safe sleep guidelines-- was placed at the bedside of newborns who were ready for supine positioning. Investigators used Plan-Do-Study-Act (PDSA) cycles to evaluate the impact of the initiative from October 2015 through February 2018.

Intervention Results: Safe sleep education was documented for all randomly checked records (n = 440). A survey (n = 348) revealed that almost all caregivers (95.4%) reported receiving information on safe infant sleep. Initial compliance with all criteria in WBN (n = 281), NICU (n = 285), and general pediatric inpatient units (n = 121) was 0%, 0%, and 8.3%, respectively. At 29 months, WBN and NICU compliance with all criteria was 90% and 100%, respectively. At 7 months, general pediatric inpatient units' compliance with all criteria was 20%.

Conclusion: WBN, NICU and general pediatric inpatient unit collaboration with content experts led to unit-specific strategies that improved safe sleep practices.

Setting: Well-baby nursery (WBN) and NICU in an academic, quaternary care, regional referral center

Population of Focus: Hospital staff

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Nurse/Nurse Practitioner, HOSPITAL, Quality Improvement

Intervention Description: The primary goals of the initiative were to improve nurses' adherence to the 2016 AAP safe sleep recommendations, including the supine infant sleep position, and to increase role modeling of a safe infant sleep environment. The initiative included a slide-show presentation on SUID, the AAP 2016 recommendations for infant safe sleep, rationale behind the recommendations, and common barriers to following the safe sleep guidance. The post-intervention evaluation included testing of nurses' knowledge, infant crib audits, and nurses' evaluation of the intervention.

Intervention Results: A significant improvement was found in overall nurse education scores. Crib audits demonstrated a significant improvement in the following elements: use of multiple blankets, swaddling of the infant, and parent teaching. Nursing surveys reported an increase in confidence to practice safe sleep recommendations and educate and redirect parents.

Conclusion: Implementing a safe sleep initiative can increase nurses' knowledge, improve adherence to recommendations with modeling safe sleep practices, and increase parent awareness of safe sleep recommendations, potentially positively affecting adherence after discharge.

Setting: Community hospital in a women's services unit

Population of Focus: Full-time nurses and infant care technicians

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Nurse/Nurse Practitioner

Intervention Description: The purpose of this quality improvement initiative was to increase the percentage of eligible infants being placed in safe sleep environments by registered nurses in a NICU. An evidence-based safe sleep bundle was developed and implemented in a level IV NICU at an academic medical center in the Southeastern United States. Data were subsequently collected for 5 months via biweekly crib audits.

Intervention Results: Of the 744 infants audited in the QI period, 604 were observed in a safe sleep environment. From the pre- to postintervention period, SSPs increased by 68% (preintervention: 13%, postintervention: 81%, P value < .001). Adherence to the varying components of SSPs also reflected statistically significant improvements.

Conclusion: SSPs should be endorsed and modeled in all NICUs. Introducing proper SSPs in the hospital setting may lead to better compliance at home by the infants' caregivers.

Setting: Academic medical institution in Southeast U.S.

Population of Focus: Registered nurses in NICU

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Educational Material, Other Education, Other Person-to-Person Education

Intervention Description: Nurse-delivered telephone support, relapse prevention training, and information about the adverse effects of smoking and ETS.

Intervention Results: At 6 months postpartum, 36% remained abstinent; 26% smoking; and 38% smoking daily. At 12 months postpartum, 78.5% reported no difficulties in making homes smoke- free. By 12 months this % increased to 86.9%.

Conclusion: While regional legislative activity has been effective in reducing ETS in many public places,12 private homes cannot be easily regulated. Public health education remains the most effective means to protect children from ETS in their homes. While there is growing appreciation for the importance of smoke-free homes,133 there remain significant misperceptions about effective ways to enact this protection.

Study Design: RCT

Setting: Hospital (time of birth) and Community (telephone)

Population of Focus: Mothers who had quit smoking during pregnancy

Data Source: Interview data collection at birth and at 6 and 12 months postpartum.

Sample Size: 251 mothers

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): SCHOOL, School-Based Health Centers, PROVIDER/PRACTICE, Patient-Centered Medical Home, Nurse/Nurse Practitioner, PATIENT/CONSUMER, Referrals, Peer Counselor

Intervention Description: We describe the implementation of an "expanded medical home" partnering a primary care practice (the Ypsilanti Health Center [YHC]) with local school-based health centers (the Regional Alliance for Healthy Schools [RAHS]), and to assess whether this model improves access to and quality of care for shared patients.

Intervention Results: At baseline, patients seen at YHC/RAHS had higher compliance with most quality metrics compared with those seen at YHC only. The proportion of shared patients significantly increased because of the intervention (P < .001). Overall, patients seen in the expanded medical home had a higher likelihood of receiving quality metric services than patients in YHC only (odds ratio, 1.8; 95% confidence interval, 1.57-2.05) across all measures.

Conclusion: Thoughtful and intentional implementation of an expanded medical home partnership between primary care physicians and school-based health centers increases the number of shared high-risk adolescent patients. Shared patients have improved compliance with quality measures, which may lead to long-term improved health equity.

Study Design: Quasi-experimental: Nonequivalent control group; Qualitative

Setting: Michigan primary care and consortium of school-based health centers

Population of Focus: Adolescents

Data Source: • Record review of preventive health measures • University of Michigan Health System Quality Management Program quality measures • Qualitative data

Sample Size: n=2200 adolescents; 9338 visits

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): , Care Coordination, Nurse/Nurse Practitioner, Non-Traditional Providers

Intervention Description: Approximately 20% of school-age children have a vision problem. Screening is an effective way to detect visual impairments, although only if adequate follow-up is available. Here, we evaluate the impact of hiring full-time nurses in four underserved schools on the likelihood of increasing follow-up for treatment after vision screening. First, we compared descriptive screening follow-up data from the intervention schools with that of five matched schools with part-time nurses in San Jose, California, from 2008 to 2012. The intervention schools had around 2800 low-income, minority children each year, and the five comparison schools had around 3445. Secondly, we conducted a qualitative analysis of open-ended survey responses from 129 teachers in the nine participating schools.

Intervention Results: In the final year, 96% of the students screened and referred for possible vision problems in schools with full-time nurses were followed up and examined by a health care provider. Yet, only 67% of students screened in comparison schools were examined.

Conclusion: Teachers in schools with full-time nurses reported that follow-up of vision problems and getting glasses for students was the most beneficial activity performed by the nurses. School nurses can effectively increase medical care coordination and follow-up of vision screening in low-income communities.

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs, Nurse/Nurse Practitioner,

Intervention Description: A brief parent-based sexual health intervention delivered by student nurses, which included a manual, booster calls, and coordination with a local pediatric mobile vaccination clinic to offer free vaccinations

Intervention Results: The intervention group had significantly higher rates of HPV vaccination and lower rates of sexual activity initiation compared to the control group at 6-month follow-up

Conclusion: Student nurses can be effective facilitators of prevention interventions for adolescent sexual health, and investing in their training and utilization can serve hard-to-reach communities

Study Design: Randomized controlled trial

Setting: Schools and after-school programs

Population of Focus: Parents and youth

Sample Size: 530 adolescent-parent dyads

Age Range: Not specified, but the study involved youth in middle school

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Quality Improvement/Practice-Wide Intervention, Motivational Interviewing,

Intervention Description: The American Academy of Pediatrics (AAP) recommends primary care-based health promotion for obesity prevention at all visits, focusing on nutrition and activity. In this quality improvement project, a primary care innovation was developed to support parents in promoting healthy habits in their children ages 2 to 5 years old. Nurse-led telephone support using motivational interviewing was implemented during two follow-up phone calls aimed at helping parent-child dyads reach self-created activity or nutrition goals.

Intervention Results: Parent-rated confidence and motivation related to meeting these goals showed significant increases. During the second call, 80% self-reported goal completion and high satisfaction with the visits. Registered nurses reported a significant increase in their self-efficacy of communication with parents.

Conclusion: This project showed the feasibility of using nurse telephone visits in an urban low-income primary care setting to improve parental recognition and understanding of healthy habits that align with American Academy of Pediatrics recommendations for obesity prevention.

Study Design: Program evaluation

Setting: An urban pediatric primary care clinic within a large academic institution in the U.S. Midwest. The clinic served as the medical home for approximately 7,000 children, with a predominantly low-income and diverse patient population. The healthcare team consisted of registered nurses, medical assistants, attending physicians, and pediatric residents.

Population of Focus: Parent-child dyads with children who were identified as overweight, obese, or at risk for overweight/obesity based on their body mass index (BMI) or parent-identified nutrition or physical activity habits.

Sample Size: 50 parent-child dyads

Age Range: Children aged 24 to 67 months

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Educational Material

Intervention Description: As asthma is the most common chronic disease in childhood, much attention is directed towards primary prevention. Here, the clinical effectiveness of a multifaceted educational prevention was studied.

Intervention Results: The results of this study indicate that the intervention was able to reduce exposure to mite, pet and food allergens, but not to passive smoking. Despite this reduction, there was no effect on either parentally reported or GP-observed symptoms during first 2 yrs of life, nor on total and specific IgE at 2 yrs. However, asthma-like symptoms at the end of the 2nd yr were less frequently reported in the intervention group.

Conclusion: In conclusion, the intervention used in this study was not effective in reducing asthma-like symptoms in high-risk children during the first 2 yrs of life, although it was modestly effective at 2 yrs. Follow-up is necessary to confirm whether the intervention can actually prevent the development of asthma.

Study Design: RCT

Setting: Community

Population of Focus: Pregnant moms whose child would be high-risk for developing asthma

Data Source: Parental and GP report of asthma-like symptoms using questionnaires Measurement of mite, cat and dog allergen levels at baseline and 1 year.

Sample Size: 476 randomized to intervention and control groups

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Integration into Adult Care, Pediatric to Adult Transfer Assistance, Planning for Transition, Nurse/Nurse Practitioner, YOUTH, Education on Disease/Condition, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: We compared the clinical long-term course of 24 patients with and 11 patients without structured transition care within 24 months before and 24 months after transfer from paediatric to adult health care. Socio-economic parameters and quality of life were assessed by IBD Questionnaire (IBDQ-32) and additional items. Treatment costs were calculated for medication, surgery and hospitalisation.

Intervention Results: The percentage of transfer group patients with an IBD-related intestinal complication was higher compared to the transition group (64% vs. 21%, p = 0.022). We also found a tendency towards a higher number of IBD-related surgery in the transfer group compared to the transition group (46% vs. 13%, p = 0.077). Transfer group patients received higher mean cumulated doses of radiation compared with the transition group (4.2 ± 5.3 mSv vs. 0.01 ± 0.01 mSv, p = 0.036). Delayed puberty was only noted in the transfer group (27%, p = 0.025). Mean expenditures for surgeries and hospitalisation tended to be lower in the transition group compared to transfer group patients (744 ± 630€ vs. 2,691 ± 4,150€, p = 0.050). Sexual life satisfaction was significantly higher (p = 0.023) and rates of loose bowel movements tended to be lower (p = 0.053) in the transition group.

Conclusion: Structured transition of adolescents with IBD from paediatric into adult health care can lead to important clinical and economic benefits.

Study Design: Retrospective study design

Setting: Clinic-based (Pediatric department of a health clinic)

Population of Focus: Patients with IBD transferring to adult care

Data Source: Medical records, patient questionnaires

Sample Size: 24 patients with transition care

Age Range: 17-22 years of age

Intervention Components (click on component to see a list of all articles that use that intervention): PROFESSIONAL_CAREGIVER, Educational Material (caregiver), Provision of Safe Sleep Item, HOSPITAL, Quality Improvement, Crib Card, Policy/Guideline (Hospital), HEALTH_CARE_PROVIDER_PRACTICE, Educational Material (Provider), Nurse/Nurse Practitioner, Audit/Attestation, Audit/Attestation (Provider)

Intervention Description: This hospital quality improvement initiative performed a series of Plan-Do-Study-Act cycles designed to increase the proportion of infants placed in a “perfect sleep” environment that met all of the American Academy of Pediatrics’ infant safe sleep guidelines. The initiative took place while the hospital was preparing for Baby Friendly certification, with increased emphasis on rooming in and skin to skin at the same time. Initial cycles targeted nurse and parental education, while later cycles focused on providing sleep sacks/wearable blankets for the infants. The goal was to achieve 70% “perfect sleep” compliance among infants cared for in the hospital.

Intervention Results: While we did not meet our goal, the percentage of infants with 'perfect sleep' increased from a baseline of 41.9% to 67.3%, and we also saw improvement in each of the individual components that contribute to this composite measure. Improvements were sustained over 12 months later, suggesting that QI interventions targeting infant safe sleep in this inpatient setting can have long-lasting results.

Conclusion: This project also suggests that infant safe sleep QI initiatives and preparation towards Baby Friendly Hospital Certification can be complementary.

Population of Focus: Hospital healthcare providers

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner,

Intervention Description: The intervention inclues a Nurse Practitioner-led service that provides comprehensive health assessments and care for Aboriginal children and families experiencing homelessness or high housing mobility. The intervention involves the collection of data on attendance levels, referrals to other organizations, demographic information, health service use or needs, and de-identified client information. This aligns with a discernable strategy of providing holistic and individualized care to address the complex health and social needs of vulnerable children and families. The study does not explicitly mention a multicomponent intervention, but it does involve a comprehensive approach to addressing the health and social needs of Aboriginal children and families. The Nurse Practitioner-led service encompasses various components such as health assessments, referrals, and data collection to provide tailored care and support. Therefore, while not explicitly labeled as a multicomponent intervention, the approach described in the study involves multiple interconnected elements to address the complex needs of the target population.

Intervention Results: The study reported several key findings: 1. Health Status: The study found that First Nations children had lower severity levels of health problems compared to non-First Nations children, suggesting stronger extended family support and the positive impact of cultural norms of reciprocity , , . 2. Immunization Rates: Both First Nations and non-First Nations children had low immunization rates, with no First Nations child being immunized and only 9% of non-First Nations children being immunized . 3. Service Utilization: The Nurse Practitioner-led service provided holistic and assertive care for children living in housing insecurity, addressing their health and social needs before they became difficult to resolve. The model led to enhanced access to health care and increased uptake of referrals, resulting in improved health outcomes for homeless/housing insecure children . 4. Comparison of First Nations and non-First Nations Children: The study aimed to compare the health and welfare outcomes of First Nations and non-First Nations children living in housing instability who presented to the Nurse Practitioner-led primary service. The outcomes suggested that First Nations children had better health status than non-First Nations children, partly explained by the strong focus on extended family support and the cultural norm of reciprocity . These results highlight the importance of tailored, culturally sensitive interventions and the need for improved access to health care and immunization for vulnerable Aboriginal children and families experiencing housing instability.

Conclusion: The conclusions drawn from the study are as follows: 1. Importance of Nurse Practitioner-led Intervention: The study emphasizes the importance of Nurse Practitioner-led interventions in homeless services, highlighting the Nurse Practitioner's ability to provide targeted and in-depth health care to complex families and vulnerable populations. Without such interventions, children would remain disconnected from health and well-being services, including education . 2. Need for Further Research: The study underscores the need for further research in the area of childhood outcomes for First Nations children and non-First Nations children living in housing instability. The lack of health service interest and government focus on children living in housing instability is concerning, and more research is required to understand the extent of deficits in service delivery and their ongoing implications for children across their lifespan . 3. Support for Innovative Services: The study supports the need for innovative services that directly support First Nations children and their families to navigate health and social systems. The Nurse Practitioner-led clinic addressed many of the gaps in existing health access for children, leading to improved health outcomes for homeless/housing insecure children who might otherwise miss out on urgent acute care and medical interventions . 4. Recommendations for Future Practice: The study recommends the employment of First Nations staff in the service to enhance cultural safety, as well as the need for sustainability and funding from state health. Additionally, the study suggests the involvement of First Nations researchers and community organizations in future phases to provide room for the voices of First Nations families on the service and the Nurse Practitioner. These conclusions highlight the significance of tailored, culturally safe interventions and the necessity for ongoing research, support, and collaboration to address the health and social needs of vulnerable Aboriginal children and families experiencing housing instability.

Study Design: The study utilized a proof of concept design to assess the effectiveness of a Nurse Practitioner-led service for children living in housing instability, particularly focusing on First Nations and non-First Nations children. The proof of concept study aimed to provide initial evidence of the feasibility and potential outcomes of the Nurse Practitioner-led service within the context of homeless services. The study implemented an innovative model of extended health care delivery by embedding a Nurse Practitioner in a homeless service to work with families, providing health assessments and referrals using clinically validated assessment tools . The study design involved the collection of data on attendance levels, referrals, demographic information, health assessments, and other relevant factors to evaluate the impact of the Nurse Practitioner-led service on the health and well-being of the children and families accessing the service , . The study's design focused on providing comprehensive health assessments and referrals for children living in housing insecurity, with a specific emphasis on comparing the health and welfare outcomes of First Nations and non-First Nations children. The study aimed to address the lack of consultation with First Nations communities in addressing complex issues such as family homelessness and to provide culturally safe community care that leads to increased access and trust in services . Overall, the study design aimed to assess the potential benefits and outcomes of the Nurse Practitioner-led service within the context of homeless services, particularly focusing on the unique needs of First Nations children and families living in housing instability.

Setting: The study was conducted in the Southern suburbs of Adelaide, South Australia, within a homeless service provided by Uniting Care Wesley Bowden (UCWB) organization. The Nurse Practitioner-led service was embedded within the homeless service and provided health assessments, treatment, and referrals for children of families living in housing insecurity . The study's focus on the health and social needs of First Nations children and families suggests that the findings are particularly relevant to those working within Indigenous health and community services in South Australia. However, the study's findings may also have broader implications for healthcare and support services for homeless populations in other regions and countries.

Population of Focus: The target audience for this study includes healthcare professionals, policymakers, and organizations involved in providing healthcare and support services to homeless populations, particularly children and families experiencing housing instability. Additionally, the findings of this study may be of interest to researchers and practitioners working in the fields of public health, social work, and Indigenous health. The study's focus on the health and social needs of First Nations children and families suggests that the findings are particularly relevant to those working within Indigenous health and community services.

Sample Size: The study involved 43 families and their children over a 6-month period, between December 2019 and August 2020. Within this sample, nine of the children were identified as First Nations children . The small sample size of the study should be taken into consideration when interpreting the findings, as it may limit the generalizability of the results.

Age Range: The study did not specify a specific age range for the children accessing the Nurse Practitioner-led service. However, the study reported that the average age of attendees was 7 years old, with the youngest child who attended the service being 7 weeks old and the oldest being 16 years old . The study also reported that most homeless families referred to the Nurse Practitioner-led service had numerous siblings, with only four of the 43 children having no siblings . Overall, the study's findings suggest that the Nurse Practitioner-led service provided health assessments and referrals for a wide range of children, from infants to adolescents, who were experiencing housing instability.

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Educational Material (Provider), Nurse/Nurse Practitioner,

Intervention Description: The article describes an evidence-based educational intervention aimed at increasing the screening of immigrant mothers for postpartum depression in the Baby Well Clinic. The intervention consisted of a 2-hour educational session for Child Health Services (CHS) nurses, which included information on postpartum depression, screening tools, and cultural aspects of depression in immigrant mothers. The nurses were also provided with a screening tool and a guideline for screening and referral. The intervention was followed by a 6-month implementation period during which the nurses were expected to screen all immigrant mothers attending the Baby Well Clinic for postpartum depression.

Intervention Results: The study found that the educational intervention was feasible and acceptable to CHS nurses. The nurses reported increased knowledge and confidence in screening for postpartum depression, and the majority of them (97%) stated that the training had a positive impact on their ability to screen immigrant mothers for postpartum depression. However, the study also found that the implementation of the intervention was challenging due to factors such as language barriers, limited time, and competing demands. The study suggests that further research is needed to evaluate the effectiveness and cost-effectiveness of the intervention

Conclusion: The intervention was found feasible but require adjustment in the design of the practical training sessions. The use of the provided material, a comic strip on parental support and interpreter information needs further evaluation.

Study Design: The study design used in this research is a feasibility study with a one-group pretest-posttest experimental design

Setting: However, it is mentioned that the study was conducted by researchers from Lund University in Sweden . The study focused on screening immigrant mothers for postpartum depression in the context of the Baby Well Clinic, which is a primary healthcare center that provides care for families with children aged 0-6 years

Population of Focus: The target audience for this study is Child Health Services (CHS) nurses who work with non-native-speaking immigrant mothers in the Baby Well Clinic in Sweden . The aim of the study was to test the feasibility of an evidence-based educational intervention for CHS nurses in screening non-native-speaking immigrant mothers for postpartum depression

Sample Size: The sample size for this study was 34 Child Health Services (CHS) nurses representing 17 clinics

Age Range: However, the study focused on screening immigrant mothers for postpartum depression in the context of the Baby Well Clinic, which is a primary healthcare center that provides care for families with children aged 0-6 years . Therefore, it can be inferred that the age group of the participants is mothers with newborns and infants aged 0-6 years.

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Nurse/Nurse Practitioner,

Intervention Description: A shared care model was implemented in 2006 in Queensland to fa- cilitate paediatric oncology, haematology and palliative care patients receiving care as close to home as possible. Following initial diagnosis, care planning and treatment at the tertiary children's hospital, appropriate local care was coordi- nated by Regional Case Managers (RCMs) established at each of 10 Shared Care Units (SCUs). This enabled safe and quality regional care supported by a state- wide network providing clinical governance and education. This paper examines learnings from 15 years of this shared care.

Intervention Results: The paper reviews the attributes, knowledge and experience required for RCMs. Standards of care were supported through education workshops, clinical placements, chemotherapy credentialing, guidelines and standards. RCMs facilitated communication and information sharing with the tertiary centre, advocated for their cohort of patients locally and streamlined and supported the family's experience of care.

Conclusion: The RCM role provided invaluable clinical leadership for the care of paediatric oncology, haematology and palliative patients across Queensland. As new treatments evolve, the expertise and coordination provided by the RCMs will be even more critical. Achieving high-quality shared care outcomes is underpinned by the RCMs drive to achieve statewide safety and support for this cohort of children.

Study Design: The study design involves a mixed-methods approach, incorporating both quantitative and qualitative methods to evaluate the implementation of a statewide model of shared care for paediatric oncology, haematology, and palliative care patients across Queensland. The study includes a survey of staff from Shared Care Units (SCUs) and focus group interviews with Regional Case Managers (RCMs) to assess the attributes, knowledge, and experience required for RCMs, as well as the standards of care supported through education workshops, clinical placements, chemotherapy credentialing, guidelines, and standards. This mixed-methods approach allows for a comprehensive evaluation of the role of RCMs and the implementation of shared care for paediatric oncology, haematology, and palliative care patients, providing a more holistic understanding of the challenges and successes of the statewide model.

Setting: Ten hospitals throughout Queensland facilitated a statewide model of shared care for paediatric oncology, haematology and palliative care patients, supported by a tertiary hub in Brisbane.

Population of Focus: The target audience for the study is healthcare professionals, policymakers, and researchers interested in improving the care of paediatric oncology, haematology, and palliative care patients across Queensland. The study's findings and recommendations may be of interest to healthcare professionals and policymakers involved in the planning, implementation, and evaluation of shared care models for paediatric oncology, haematology, and palliative care patients in other regions or countries.

Sample Size: The online survey was distributed to regional care managers (RCMs) with 12 responses, including all of the 10 current RCMs and 2 past incumbents. Two focus groups were conducted consisting of a total of 10 RCMs and 6 Clinical or Registered Nurses supporting RCMs.

Age Range: While the specific age range is not explicitly mentioned, the study addresses the care of patients in the paediatric age group, which typically includes individuals from birth to 18 years of age

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement, Nurse/Nurse Practitioner, HOSPITAL, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: To facilitate implementation, clinical nurses were educated as Subject Matter Experts (SMEs) to empower them to transform and sustain outcomes-driven QI for infant safe sleep nursing practice.

Intervention Results: Immediate posteducation surveys completed by SMEs indicated that over 98% of respondents strongly agreed or agreed they were able to effectively demonstrate communication strategies, identify SME role components, provide environment surveillance, and demonstrate best practices in infant safe sleep. To allow time for assimilation of the of SME role, a survey was initiated at 6 months to capture progress made. Seventy-eight SMEs responded to the survey and reported exceptional or substantial progress in 10 areas for SME responsibilities.

Conclusion: Use of the SME role for program implementation led to highly favorable SME-reported outcomes in leading a hospital-based QI program.

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Nurse/Nurse Practitioner, Hospital, Quality Improvement, Audit/Attestation

Intervention Description: This descriptive study examined outcomes from 268 clinical nurses who received comprehensive education on infant safe sleep and their role as subject matter experts (SMEs). SME nurses completed two interactive learning modules addressing safe sleep guidelines and teaching strategies and attended a workshop to acquire skills for program implementation. Key competencies included data collection and dissemination, policy development, and communication techniques. Likert-type scale surveys measured knowledge gained and progress made in practice following education.

Intervention Results: Immediate posteducation surveys completed by SMEs indicated that over 98% of respondents strongly agreed or agreed they were able to effectively demonstrate communication strategies, identify SME role components, provide environment surveillance, and demonstrate best practices in infant safe sleep. To allow time for assimilation of the of SME role, a survey was initiated at 6 months to capture progress made. Seventy-eight SMEs responded to the survey and reported exceptional or substantial progress in 10 areas for SME responsibilities.

Conclusion: Use of the SME role for program implementation led to highly favorable SME-reported outcomes in leading a hospital-based QI program.

Setting: 25 birthing hospitals in Pennsylvania

Population of Focus: Nurses trained as subject matter experts (SMEs)

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Assessment (provider), Provider Training/Education, Nurse/Nurse Practitioner, PARENT/FAMILY, Education/Training (caregiver), Provision of Safe Sleep Item, HOSPITAL, Quality Improvement

Intervention Description: The purpose of our safe sleep initiative was to improve parental and staff knowledge of safe sleep practices and to achieve increased compliance with infant safe sleep in the hospital setting. A multidisciplinary team of health professionals was created to address poor compliance with safe sleep guidelines, investigate barriers, and identify primary drivers for improvement. Subsequent interventions included parent education, staff education, and improvements in system processes. Members of the hospitals nurse residency program conducted multidisciplinary surveys before and after the quality improvement initiative to assess staff knowledge of safe sleep practices. The data were collected prospectively.

Intervention Results: Compliance with safe sleep improved to >80% in both units. Tracking of process measures revealed NICU parents received safe sleep education 98-100% of the time. No change was observed in the balancing measures. Transfers from the NN to the NICU for temperature instability did not increase. Parent satisfaction with discharge preparedness did not change (98.2% prior to and 99.6% after).

Conclusion: We achieved improved compliance with safe sleep practices in our NN and NICU through education of staff and parents and improved system processes. We believe this will translate to improved safe sleep practices used by parents at home.

Setting: Truman Medical Center in Kansas City

Population of Focus: Infants admitted to newborn nursery and NICU

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Nurse/Nurse Practitioner, HOSPITAL, Quality Improvement, Sleep Environment Modification, Crib Card, Visual Display, Audit/Attestation

Intervention Description: A quality improvement (QI) model was developed to introduce the AAP guidelines on safe sleep (SS) practices into the NICU nursing practice in a consistent and sustainable method. The project team included the NICU hospitalist, a neonatologist, the Director of Newborn Services at the Wakefield Division, the nurse manager, two nurses, and a nurse practitioner. The team members met at monthly QI meetings to discuss progress for the duration of the project. Key drivers were identified, and the team used PDSA cycles to target interventions, which included a crib check tool and presentations by SS experts. One of the team’s main concerns during the initial deliberation sessions was the suboptimal temperature control in the NICU, and after meeting with the engineering staff, more sensors were placed in the NICU to eliminate the wide variations of temperatures throughout the day. The primary aim of the project was a 20% improvement in the SS compliance rates (from 7% to 27%) by December, 2017.

Intervention Results: Approximately 600 crib checks (CC) were performed over the duration of this project. At baseline, 7% of infants were placed in a SS position in the NICU. Following the QI project, SS position increased to 96% of infants.

Conclusion: Multifactorial interventions significantly improved SS compliance among NICU nurses. Cultivating personal motivation among nurses, consistent empowerment and dedication to culture change by the entire team was crucial for the sustainability of the project.

Setting: Wakefield neonatal service, Montefiore Medical Center

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Counseling (Parent/Family), Care Coordination, Integration into Adult Care, Pediatric to Adult Transfer Assistance, Planning for Transition, PARENT_FAMILY, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: Reaching a certain age, juvenile idiopathic arthritis (JIA) patients in paediatric care are transferred to adult care. An increased disease activity after transfer and increased dropout has been suggested, however, evidence is scarce. Our aim is to determine whether the process of transition is associated with increased disease-activity and dropout, and to identify associated factors. During a 3-year prospective transition cohort study, paediatric patients (14-17yrs) were transferred to adult care. Paediatric (10-13yrs) and adult JIA patients (18-27yrs) were used as control groups. Demographic and disease-related items were obtained yearly. Non-parametric tests were used to compare differences between the groups and mixed models to evaluate disease activity over time, measured by JADAS27 and DAS28. Dropout was defined as not attending the clinic for 2 consecutive visits.

Intervention Results: Groups did not differ regarding baseline variables of subtype, gender, uveitis, ANA-, RF- or HLA B27-positivity and current or past DMARD use. Median disease activity was not different between groups during follow-up. Transfer was not associated with disease activity. Dropout rate was 12%, and was significantly higher in patients under transition (22%) compared with paediatric (3%) and adult care (10%). Patients who dropped out had significantly lower disease activity at baseline and were using less MTX, but did not differ regarding subtype, ANA, RF and HLA-B27.

Conclusion: The process of transition in JIA is not associated with an increase in disease activity, however, this period carries a risk for drop out especially in patients with low disease activity.

Study Design: e Longitudinal transition cohort study

Setting: Clinic-based (Out-patient clinics of university hospitals)

Population of Focus: Juvenile idiopathic diabetes 1 patients transferring to adult care

Data Source: Medical records

Sample Size: 64 patients

Age Range: 14-17 years of age

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: All women delivering babies at six participating hospitals received an in-hospital screening and were deemed eligible for the study if they reported smoking during the 30 days before the pregnancy and quitting during pregnancy, and are willing to speak with a Visiting Nurse Association nurse about having quit smoking. At the 2-week, and 2- and 4-month well-baby visits with the pediatric provider they received reinforcement and a plan to try to quit again.

Intervention Results: Women in the experimental group were more likely to report that a doctor or nurse talked with them about smoking at least once since delivery (71% vs. 20% of control group). A significant and strong association emerged between experimental assignment and total number of times the women reported a provider talked about staying quit. Women in the intervention group were also more likely to report receiving written materials about how to stay quit (47% vs. 3% of control group). There was no difference in the relapse rate between women in the intervention (41%) and control (37%) groups.

Conclusion: Women in this study had quit smoking during pregnancy but had a high postpartum relapse rate, indicating the need for eVective relapse prevention interventions to protect new mothers and babies against the ill effects of smoking. Our results show that paediatric providers will deliver relapse prevention messages to infants’ mothers if they are informed that the mothers quit smoking during pregnancy. Despite our success in getting providers to deliver the relapse prevention intervention, the intervention itself was insuffcient to reduce relapse.

Study Design: RCT

Setting: Well-child healthcare setting (hospitals and well-baby visits)

Population of Focus: Postpartum women/new mothers with a history of smoking who reported smoking cigarettes 30 days before pregnancy and reported to have quit smoking during their pregnancy or within 30 days of becoming pregnant

Data Source: Baseline face-to-face interview at enrollment and follow-up telephone interview 6 months post-partum.

Sample Size: 287 women were enrolled with 141 in the experimental group and 146 in the control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Nurse/Nurse Practitioner, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), PATIENT/CONSUMER, Educational Material, CAREGIVER, Educational Material (caregiver), Motivational Interviewing/Counseling, Motivational Interviewing, Peer Counselor

Intervention Description: We conducted a population-based trial to evaluate the efficacy of an intervention aimed at preventing exposure of young children to parental tobacco smoke.

Intervention Results: A strong association was found between social class and smoking behavior, in particular smoking during meals at home. The intervention itself had limited effectiveness in decreasing the number of smokers. The effect was stronger in mothers and in higher social groups. Among the "white-collar" families belonging to the intervention group, the proportion of mothers who stopped smoking was 3 times higher than in the control group (not statistically significant).

Conclusion: Educational interventions against smoking should be planned taking into account the difference in efficacy according to social class.

Study Design: Control trial with nonrandom assignment

Setting: Community (population based survey) and well-child health care visit

Population of Focus: Parents of newborn babies living in the town of Rivoli before 3 month compulsory vaccination

Data Source: Baseline (pre-intervention) and followup (2 and 4 years post-intervention) questionnaires

Sample Size: 1015 parents with 402 in the intervention group and 613 in the control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Access, Collaboration with Local Agencies (State),

Intervention Description: There is increasing demand for primary care nationally, and advanced practice registered nurses are uniquely suited to meet this demand. Academic nursing programs are responding to this challenge by expanding graduate nurse practitioner (NP) programs, but they are limited by availability of student clinical placement sites and dedicated preceptors. We addressed these limitations by developing an academic-practice partnership between a College of Nursing pediatric nurse practitioner (PNP) program and a primary care clinic within an academic pediatric hospital. A novel PNP faculty role was developed with teaching, patient care, and clinical precepting responsibilities.

Intervention Results: This partnership increased access to pediatric primary care services within the local underserved community, increased the number of teaching faculty members and clinical preceptors, and expanded clinical education opportunities for PNP students.

Conclusion: This partnership increased access to pediatric primary care services within the local underserved community, increased the number of teaching faculty members and clinical preceptors, and expanded clinical education opportunities for PNP students.

Study Design: Program evaluation

Setting: A primary care pediatric clinic within an academic pediatric hospital in Colorado

Population of Focus: College of Nursing pediatric nurse practitioner (PNP) students, clinical preceptors, and teaching faculty members who participated in the academic-practice partnership with the primary care Child Health Clinic at Children's Hospital Colorado (CHCO)

Sample Size: 30 students

Age Range: Adult providers

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Counseling (Parent/Family), CAREGIVER, Motivational Interviewing/Counseling, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Notification/Information Materials (Online Resources, Information Guide), Educational Material (caregiver), Education/Training (caregiver)

Intervention Description: To determine the effectiveness of a cotinine-feedback, behaviorally based education intervention in reducing environmental tobacco smoke (ETS) exposure and health-care utilization of children with asthma.

Intervention Results: The intervention was associated with a significantly lower odds ratio (OR) for more than one acute asthma medical visit in the follow-up year, after adjusting for baseline visits (total visits, 87; OR, 0.32; p = 0.03), and a comparably sized but nonsignificant OR for one or more hospitalization (OR, 0.34; p = 0.14). The follow-up CCR measurement and the determination of whether smoking was prohibited inside the home strongly favored the intervention group (n = 51) (mean difference in CCR adjusted for baseline, −0.38; p = 0.26; n = 51) (60; OR [for proportion of subjects prohibiting smoking], 0.24; p = 0.11; n = 60).

Conclusion: This intervention significantly reduced asthma health-care utilization in ETS-exposed, low-income, minority children. Effects sizes for urine cotinine and proportion prohibiting smoking were moderate to large but not statistically significant, possibly the result of reduced precision due to the loss of patients to active follow-up. Improving ETS reduction interventions and understanding their mechanism of action on asthma outcomes requires further controlled trials that measure ETS exposure and behavioral and disease outcomes concurrently.

Study Design: RCT

Setting: Community (pediatric pulmonary service of a pediatric hospital)

Population of Focus: Parents of children 3 to 12 years of age with asthma who were ETS exposed

Data Source: Interview data, pulmonary function, urine cotinine, asthma medications, health care utilization.

Sample Size: 87 parents

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Counseling (Parent/Family), PROVIDER/PRACTICE, Nurse/Nurse Practitioner

Intervention Description: To determine if mothers receiving a smoking cessation intervention emphasizing health risks of environmental tobacco smoke (ETS) for their children have a higher quit rate than mothers who received routine smoking cessation advice, which focused on their own health, or a control group of mothers.

Intervention Results: Provision to mother of both groups of health risks of tobacco smoke resulted in significantly higher rate of cessation of smoking and smoking location change than those of the control group, with child intervention group having significantly higher rate of cessation of smoking and smoking location change than those of the maternal intervention group. Post-intervention knowledge scores differed significantly for all groups; however, child intervention group was the only significantly better group than the others. As such, an intervention including a detailed discussion with mothers and supplemented by a written document provides a substantial quit rates.

Conclusion: Discussion during short paediatric visits on effects of smoking on child's or maternal health may result in a significant smoking cessation, smoking location change rate or knowledge change. Those who cannot give up smoking usually change their location of smoking. Provision of information on effects of smoking on child's health, rather than maternal, may result in more significant changes in behaviour or knowledge. Maternal education on smoking should include information on effects of smoking on both child's and maternal health, but should be especially focused on child's health.

Study Design: RCT

Setting: Well-child healthcare setting (clinic in a children’s hospital)

Population of Focus: Mothers with children attending well-child clinic or with any primary complaint

Data Source: Questionnaires at baseline and 6 months.

Sample Size: 363 mothers with 111 in intervention 1, 131 in intervention 2, and 121 in control

Age Range: Not specified