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Below are articles that support specific interventions to advance MCH National Performance Measures (NPMs) and Standardized Measures (SMs). Most interventions contain multiple components as part of a coordinated strategy/approach.

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Displaying records 1 through 347 (347 total).

Madden N, Emeruwa UN, Friedman AM, Aubey JJ, Aziz A, Baptiste CD, Coletta JM, D'Alton ME, Fuchs KM, Goffman D, Gyamfi-Bannerman C, Kondragunta S, Krenitsky N, Miller RS, Nhan-Chang CL, Saint Jean AM, Shukla HP, Simpson LL, Spiegel ES, Yates HS, Zork N, Ona S. Telehealth Uptake into Prenatal Care and Provider Attitudes during the COVID-19 Pandemic in New York City: A Quantitative and Qualitative Analysis. Am J Perinatol. 2020 Aug;37(10):1005-1014. doi: 10.1055/s-0040-1712939. Epub 2020 Jun 9. PMID: 32516816; PMCID: PMC7416212.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Prenatal Care Access Access Provider Training/Education Telehealth/Virtual Care

Intervention Description: The intervention in the study on the transition of prenatal care to telehealth during the COVID-19 pandemic in New York City was the adoption and utilization of telehealth for prenatal care visits. The study aimed to evaluate the feasibility and effectiveness of telehealth for prenatal care during the COVID-19 pandemic, which necessitated a shift away from in-person visits to minimize the risk of viral transmission. The telehealth intervention involved the use of video conferencing technology to conduct prenatal care visits remotely. Patients were able to connect with their healthcare providers via video conferencing software, such as Zoom or Skype, to receive prenatal care services. The study analyzed the proportion of prenatal care visits that were conducted via telehealth compared to in-person visits over a 5-week period from March 9 to April 12, 2020, at Columbia University Irving Medical Center (CUIMC)-affiliated prenatal practices in New York City . The study also evaluated the challenges and successes associated with the adoption of telehealth for prenatal care, including provider attitudes towards telehealth, patient barriers to accessing telehealth, and operational considerations for clinics and healthcare systems . Overall, the intervention involved the rapid adoption and utilization of telehealth for prenatal care during the COVID-19 pandemic, with the aim of maintaining access to essential prenatal care services while minimizing the risk of viral transmission.

Intervention Results: The study on the transition of prenatal care to telehealth during the COVID-19 pandemic in New York City found that telehealth was rapidly adopted and utilized for prenatal care during the study period. The study analyzed 4,248 prenatal care visits over a 5-week period, of which approximately one-third were conducted via telehealth (n=1,352, 31.8%). By the fifth week, 56.1% of generalist visits, 61.5% of maternal-fetal medicine (MFM) visits, and 41.5% of clinic visits were conducted via telehealth . The study also found that providers generally had positive attitudes towards telehealth visits, and accessing technology and performing visits, documentation, and follow-up using the telehealth electronic medical record were all viewed favorably by providers . However, the study identified significant barriers to telehealth and in-person visits, including patient fear of COVID-19 infection, limited access to technology and connectivity, and language barriers . The study also found that the transition to virtual prenatal care was more challenging for patients with Medicaid insurance receiving care at health clinics than for women with commercial insurance in generalist and maternal-fetal medicine faculty practices. Factors related to differential care attendance included operational considerations such as requiring increased staffing in clinics and patient factors related to technological proficiency, language barriers, Wi-Fi and data access, child care, and fear of infection. Additional patient-level and operational supports were required to optimize access for patients with Medicaid . Overall, the study suggests that telehealth was feasible and associated with provider satisfaction for prenatal care during the COVID-19 pandemic. However, significant barriers to telehealth may be present for patients with Medicaid insurance, which may require additional support to resolve .

Conclusion: The conclusions drawn from the study on the transition of prenatal care to telehealth during the COVID-19 pandemic in New York City are as follows: 1. Rapid Transition Feasibility: The study demonstrated that a rapid transition to telehealth for prenatal care was feasible and associated with provider satisfaction. The adoption and utilization of telehealth for prenatal care were viewed favorably by healthcare providers . 2. Differential Uptake Based on Insurance: The study highlighted that telehealth uptake differed based on insurance, with patients with Medicaid insurance experiencing more challenges and barriers to accessing telehealth compared to those with commercial insurance. This finding underscores the need for additional patient-level and operational supports to optimize access for patients with Medicaid . 3. Operational Challenges: The transition to virtual prenatal care was more challenging for patients with Medicaid insurance receiving care at health clinics than for women with commercial insurance in generalist and maternal-fetal medicine faculty practices. Operational considerations, such as requiring increased staffing in clinics, were identified as significant barriers to the adoption of telehealth for prenatal care . 4. Patient Barriers: The study identified various patient-related barriers to telehealth, including technological proficiency, language barriers, Wi-Fi and data access, child care responsibilities, and fear of infection. These barriers need to be addressed to optimize access to telehealth for prenatal care, particularly for patients with Medicaid insurance . In summary, the study underscores the feasibility of rapid transition to telehealth for prenatal care and the need for additional support to address barriers faced by patients with Medicaid insurance. It emphasizes the importance of addressing operational challenges and patient-related barriers to ensure equitable access to telehealth for prenatal care during public health crises such as the COVID-19 pandemic .

Study Design: The study on the transition of prenatal care to telehealth during the COVID-19 pandemic in New York City utilized a mixed-methods approach, combining quantitative analysis and qualitative assessment. Quantitative Analysis: The study analyzed trends in whether prenatal care visits were conducted in-person or via telehealth over a 5-week period from March 9 to April 12 at Columbia University Irving Medical Center (CUIMC)-affiliated prenatal practices in New York City during the COVID-19 pandemic. The proportion of visits that were conducted via telehealth was analyzed by visit type by week . This quantitative analysis provided insights into the adoption and utilization of telehealth for prenatal care during the specified period. Qualitative Assessment: In addition to the quantitative analysis, the study conducted a survey and semistructured interviews of healthcare providers to evaluate resources and obstacles in the uptake of telehealth. The survey and interviews aimed to understand provider experiences, satisfaction, and challenges associated with the integration of telehealth into prenatal care. The qualitative assessment provided in-depth insights into the operational challenges and barriers faced by healthcare providers and clinics during the transition to telehealth for prenatal care . By employing both quantitative and qualitative methods, the study aimed to comprehensively assess the transition to telehealth for prenatal care during the COVID-19 pandemic, providing a multifaceted understanding of the challenges, successes, and provider attitudes related to this transition.

Setting: The setting for the study on the transition of prenatal care to telehealth during the COVID-19 pandemic is New York City. Specifically, the study focuses on the prenatal care facilities affiliated with the Columbia University Irving Medical Center (CUIMC) located in midtown Manhattan, Washington Heights in Upper Manhattan, Rockland County, and Westchester . These facilities provide care for patients with both Medicaid and commercial insurance, and the patients accessing prenatal care at these sites primarily deliver at NewYork Presbyterian Morgan Stanley Children’s Hospital of New York and NewYork Presbyterian/The Allen Hospital . The study provides insights into the adoption of telehealth for obstetric patients in a tertiary referral hospital and clinic system in New York City, offering valuable information on the implementation of telehealth in an urban setting during the COVID-19 pandemic.

Population of Focus: The target audience for the study on the transition of prenatal care to telehealth during the COVID-19 pandemic in New York City includes a wide range of stakeholders involved in maternal-fetal medicine, obstetrics and gynecology, public health, healthcare administration, and telehealth implementation. This may encompass: 1. Healthcare Providers: Obstetricians, gynecologists, maternal-fetal medicine specialists, and other healthcare professionals involved in prenatal care. 2. Healthcare Administrators: Hospital administrators, clinic managers, and healthcare system leaders responsible for implementing telehealth services and optimizing prenatal care delivery. 3. Public Health Officials: Professionals involved in public health policy, maternal and child health, and healthcare access initiatives. 4. Telehealth Practitioners: Individuals and organizations involved in the provision of telehealth services, including telemedicine companies and technology developers. 5. Researchers and Academics: Scholars and researchers interested in the impact of telehealth on prenatal care, healthcare delivery during crises, and healthcare disparities. 6. Policymakers: Government officials and policymakers involved in shaping healthcare regulations, reimbursement policies, and telehealth legislation. 7. Patient Advocacy Groups: Organizations advocating for improved access to prenatal care and maternal healthcare services. The study's findings are relevant to these stakeholders as they provide insights into the feasibility, challenges, and benefits of transitioning prenatal care to telehealth, particularly in an urban setting during a public health crisis. Additionally, the study's focus on provider attitudes and patient access issues makes it valuable for those interested in improving maternal healthcare delivery and access to early prenatal care.

Sample Size: Specifically, the study surveyed 36 healthcare providers and conducted interviews with 11 of them 8. While the exact sample size for the patient population is not provided, the study analyzed prenatal visits over a 5-week period from March 9, 2020, to April 12, 2020, during which time telehealth was adopted across clinical sites

Age Range: the study focused on prenatal care for pregnant individuals accessing care at the Columbia University Irving Medical Center (CUIMC)-affiliated obstetric ambulatory prenatal care facilities in New York City. As such, the patient population likely consisted of pregnant individuals of reproductive age, typically ranging from late teens to early 40s. Given the focus on prenatal care, the study's patient population would primarily include pregnant individuals seeking obstetric and gynecological care during the COVID-19 pandemic. The specific age range of these individuals was not explicitly stated in the available information.

Access Abstract

Accortt, E. E., Haque, L., Bamgbose, O., Buttle, R., & Kilpatrick, S. (2022). Implementing an inpatient postpartum depression screening, education, and referral program: a quality improvement initiative. American journal of obstetrics & gynecology MFM, 4(3), 100581.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education Quality Improvement EMR Reminder

Intervention Description: The interventions included nurse-champion training, standardized screening using the Patient Health Questionnaire-9 (PHQ-9), a reminder system for nurses to conduct screenings, and a video training program for nursing staff. These interventions align with a discernable strategy of implementing evidence-based screening tools and providing education and training to healthcare providers to improve their knowledge and comfort level in addressing perinatal mood and anxiety disorders. The study analyzes a multicomponent intervention that includes the four interventions mentioned above. The study aimed to determine if these interventions improved the PPD screening rate, PPD screening positive rate, and related social work referrals and consultation rates at Cedars-Sinai’s postpartum and maternal-fetal care units. The study found that all four interventions were successful in achieving the main outcomes, and the program has improved depression screening and increased social work referral rates at Cedars-Sinai.

Intervention Results: The four interventions increased nurse-champion screening comfort and perinatal mood and anxiety disorder knowledge, PHQ-9 screening rates from 10% to 99%, and screen-positive rates from 0.04% to 2.9%, and rates of social work consultation from 1.7% to 8.4% . Before training, 43% of surveyed nurses felt “very comfortable” screening patients for depression. After training, overall comfort increased to 73%. Nurse champions showed increased comfort discussing perinatal mental health, facilitating mental health referrals, and providing information to patients . After completion of 5 months of video training, the screening rate remained at 99%. Of those screened, 19% screened positive and as many as 39% of them consulted with social work . The SPC chart showed that screening rates had a sharp increase between March 2017 and June 2017 from 0.01% to 59.54% . The program sustained progress achieved by the first 4 interventions detailed in the report, and data from the next 4 interventions are currently being analyzed.

Conclusion: Quality improvement results from the first 3 years of the program suggest that 4 interventions improved screening rates, screen-positive rates, and social work consultation rates. Future work will focus on method of screening, patients at highest risk of perinatal mood and anxiety disorders, and ongoing nurse training.

Study Design: The study design used the Standards for QUality Improvement Reporting Excellence 2.0 guidelines to report outcomes from the four interventions. The study aimed to evaluate the impact of the interventions on the postpartum depression screening, education, and referral program at Cedars-Sinai. The interventions included nurse-champion training, use of the 9-item Patient Health Questionnaire-9 in the postpartum unit, a series of brief in-service trainings, and a 10-minute video training. The study collected data including nurse feedback, screening rates, screen-positive rates, and social work consultation rates

Setting: The study was conducted at Cedars-Sinai, a nonprofit hospital located in Beverly Hills, California. The hospital has a postpartum and maternal-fetal care unit where the interventions were implemented to improve the screening, education, and referral program for postpartum depression. The study included a sample of 19,564 women who delivered their babies at Cedars-Sinai over the course of two years

Population of Focus: The target audience of this study appears to be healthcare professionals, specifically those working in the postpartum and maternal-fetal care units at Cedars-Sinai. The study aimed to improve the screening, education, and referral program for postpartum depression at Cedars-Sinai, and the interventions were targeted towards nursing staff and social workers. The study also reported on the outcomes of the interventions, including nurse feedback, screening rates, screen-positive rates, and social work consultation rates, which may be of interest to healthcare professionals working in similar settings.

Sample Size: The sample size for the study was 19,564 women who delivered their babies at Cedars-Sinai over the course of two years. This sample size was used to evaluate the outcomes of the interventions aimed at improving the screening, education, and referral program for postpartum depression at the hospital

Age Range: The study did not report a specific age range for the sample of women who delivered their babies at Cedars-Sinai. However, the study did report that the average patient age was 33.95 years old

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Adams S, Nicholas D, Mahant S, Weiser N, Kanani R, Boydell K, Cohen E. Care maps and care plans for children with medical complexity. Child Care Health Dev. 2019 Jan;45(1):104-110. doi: 10.1111/cch.12632. PMID: 30462842.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement/Practice-Wide Intervention Provider Training/Education Guideline Change and Implementation Provider Tools

Intervention Description: Parents were interviewed and instructed on creating a care map. That map was then shared with HCP. Both parents and HCP were intereviewed to learn what their thoughts were about implementing both care maps and care plans.

Intervention Results: Two themes reflected two primary categories: (a) the utility of care plans and care maps, and (b) the intersection of care plans and care maps. results indicated that care maps are useful and should be created and discussed with HCP prior to creating a care plan.

Conclusion: No Conclusion: Results: Data analysis exploring the relationship and utility of care plans and care maps revealed six primary themes related to using care plans and care maps that were grouped into two primary categories: (a) utility of care plans and maps; and (b) intersection of care plans and care maps. Discussion: Care plans and care maps were identified as valuable complementary documents. Their integration offers context about family experience and respects the parents' experiential wisdom in a standard patient care document, thus promoting improved understanding and integration of the family experience into care decision making

Study Design: A qualitative design with thematic analysis

Setting: CMC: Hospital/Clinic - tertiary pediatric academic health sciences center, The Hospital for Sick Children (SickKids), and at a community hospital, North York General Hospital (NYGH), both located in Ontario, Canada.

Population of Focus: CMC - healthcare providers, including pediatricians, pediatric subspecialists, pediatric nurse practitioners, social workers, occupational and physiotherapists, pharmacists, and community nurses, who provide care for children with medical complexity.

Sample Size: 15 parents, 30 HCP - 15 parents of children with medical complexity who created care maps, and 30 healthcare providers who provided care to children with medical complexity.

Age Range: 1/17/2024

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Addala, A., Filipp, S. L., Figg, L. E., Anez-Zabala, C., Lal, R. A., Gurka, M. J., Haller, M. J., Maahs, D. M., Walker, A. F., & Project ECHO Diabetes Research Team (2022). Tele-education model for primary care providers to advance diabetes equity: Findings from Project ECHO Diabetes. Frontiers in endocrinology, 13, 1066521. https://doi.org/10.3389/fendo.2022.1066521

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education Technology-Based Support

Intervention Description: In the US, many individuals with diabetes do not have consistent access to endocrinologists and therefore rely on primary care providers (PCPs) for their diabetes management. Project ECHO (Extension for Community Healthcare Outcomes) Diabetes, a tele-education model, was developed to empower PCPs to independently manage diabetes, including education on diabetes technology initiation and use, to bridge disparities in diabetes.

Intervention Results: PCPs reported improvement in all domains of diabetes education and management. From baseline, PCPs reported improvement in their confidence to serve as the T1D provider for their community (pre vs post: 43.8% vs 68.8%, p=0.005), manage insulin therapy (pre vs post: 62.8% vs 84.3%, p=0.002), and identify symptoms of diabetes distress (pre vs post: 62.8% vs 84.3%, p=0.002) post-intervention. Compared to pre-intervention, providers reported significant improvement in their confidence in all aspects of diabetes technology including prescribing technology (41.2% vs 68.6%, p=0.001), managing insulin pumps (41.2% vs 68.6%, p=0.001) and hybrid closed loop (10.2% vs 26.5%, p=0.033), and interpreting sensor data (41.2% vs 68.6%, p=0.001) post-intervention.

Conclusion: PCPs who participated in Project ECHO Diabetes reported increased confidence in diabetes management, with notable improvement in their ability to prescribe, manage, and troubleshoot diabetes technology. These data support the use of tele-education of PCPs to increase confidence in diabetes technology management as a feasible strategy to advance equity in diabetes management and outcomes.

Study Design: Pre-post study

Setting: Health centers in underserved areas of California and Florida

Population of Focus: Primary care providers (PCPs) who were recruited from federally qualifying health centers and community health centers in underserved areas of California and Florida. The participants included physicians and advanced practice providers, with a focus on those who were responsible for managing diabetes care in these settings

Sample Size: 116 providers

Age Range: Adult providers serving pediatric populations

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Agosta, L. J., & Johnson, C. (2017). Implementing Interventions Aimed at Reducing Rates of Cesarean Birth. Nursing for women's health, 21(4), 260–273. https://doi.org/10.1016/j.nwh.2017.06.006

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Provider, Education; Hospital, Chart audit and feedback, Elective induction policy, Guideline change and implementation, Quality improvement HEALTH_CARE_PROVIDER_PRACTICE Provider Training/Education HOSPITAL Chart Audit and Feedback Elective Induction Policy Guideline Change and Implementation Quality Improvement

Intervention Description: At a large Southern US women's hospital, new measures were made to reduce the rates of cesarian delivery at the facility. Endeavors were led by nurse / doctor leaders (VP & chief of staff). These included monitoring, benchmarking & disseminating information about CD at the facility; new protocols for oxytocin administration; Bishop's score assessment; elective CD performed only at 39 weeks; new protocols and intrapartum alternative positioning devices, the process of laboring down, and closed glottis pushing attempts in second-stage labor.

Intervention Results: Collectively, these interdisciplinary interventions have resulted in significant decreases in overall cesarean birth rates and comparable significant reductions in the NTSV cesarean rates.

Conclusion: Concerted efforts to reduce rates of nonmedically indicated cesarean birth have resulted in the development and implementation of comprehensive action plans aimed at effecting reductions and enhancing overall obstetric quality care.

Setting: One large obstetric hospital in the Southern USA

Population of Focus: NTSV births

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Ahlers-Schmidt, C. R., Schunn, C., Hervey, A. M., Torres, M., & Nelson, J. (2021). Promoting Safe Sleep, Tobacco Cessation, and Breastfeeding to Rural Women During the COVID-19 Pandemic: Quasi-Experimental Study. JMIR pediatrics and parenting, 4(4), e31908. https://doi.org/10.2196/31908

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): PROFESSIONAL_CAREGIVER Education/Training (caregiver) Provision of Safe Sleep Item COMMUNITY Presentation

Intervention Description: With the support of the Kansas Infant Death SIDS (KIDS) Network, safe sleep instructors in four rural counties (Geary, Cloud, Harvey, and Shawnee) held virtual Safe Sleep Community Baby Showers in 2020. Safe sleep, breastfeeding, and tobacco cessation/avoidance education was provided to participants regardless of education format. In-person events were interactive by nature, using presentation and demonstration, but also included video components. For virtual events, Geary and Cloud counties chose to provide educational videos and prerecorded presentations to participants (passive). Harvey and Shawnee counties held real-time interactive education over a virtual platform. Data was collected via pre- and postsurveys. Those who completed both surveys received a portable crib and wearable blanket.

Intervention Results: Based on data from 145 in-person and 74 virtual participants, virtual participants were more likely to be married (P<.001) and have private insurance (P<.001), and were less likely to report tobacco use (P<.001). Both event formats significantly increased knowledge and intentions regarding safe sleep and avoidance of secondhand smoke (all P≤.001). Breastfeeding intentions did not change. Differences were observed between in-person and virtual meetings regarding confidence in the ability to avoid secondhand smoke (in-person: 121/144, 84% vs virtual: 53/74, 72%; P=.03), intention to breastfeed ≥6 months (in-person: 79/128, 62% vs virtual: 52/66, 79%; P=.008), and confidence in the ability to breastfeed ≥6 months (in-person: 58/123, 47% vs virtual: 44/69, 64%; P=.02).

Conclusion: Although both event formats demonstrated increased knowledge/intentions to follow safe sleep recommendations, virtual events may further marginalize groups who are at high risk for poor birth outcomes. Strategies to increase technology access, recruit priority populations, and ensure disparities are not exacerbated will be critical for the implementation of future virtual events.

Setting: Four rural counties in Kansas

Population of Focus: Pregnant or postpartum women

Access Abstract

Ahlers-Schmidt, C. R., Schunn, C., Hervey, A. M., Torres, M., Sage, C., Henao, M., & Kuhlmann, S. (2021). Infant Safe Sleep Promotion: Increasing Capacity of Child Protective Services Employees. International journal of environmental research and public health, 18(8), 4227. https://doi.org/10.3390/ijerph18084227

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE Provider Training/Education PROFESSIONAL_CAREGIVER Education/Training (caregiver) COMMUNITY Presentation

Intervention Description: This study assessed the impact of the two-day Kansas Infant Death and SIDS (KIDS) Network Safe Sleep Instructor (SSI) train-the-trainer program on CPS staffs' knowledge of the American Academy of Pediatrics safe sleep recommendations. Training was attended by 43 participants, 27 (63%) of whom were employed by CPS. All participants completed a 10-item pre- and post-training knowledge assessment at the beginning of the training and immediately following the training, respectively. Following training, SSIs were certified to educate parents/caregivers, childcare providers, health care providers, and other members of their communities about safe sleep practices. SSIs were tasked with providing safe sleep training to at least 10 professionals and with hosting one Safe Sleep Community Baby Shower or Crib Clinic within 9 months of certification.

Intervention Results: Following SSI certification, CPS SSIs provided more safe sleep training to professionals than other SSIs (1051 vs. 165, respectively), and both groups of SSIs were able to significantly increase the knowledge of their trainees.

Conclusion: Overall, the KIDS Network SSI training was successful. The innovative partnership with CPS allowed for provision of training to a group not historically targeted for safe sleep education.

Setting: Kansas Department of Children and Families Child Protective Services (CPS)

Population of Focus: Child Protective Services staff

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Aita M, Héon M, Savanh P, De Clifford-Faugère G, Charbonneau L. Promoting Family and Siblings' Adaptation Following a Preterm Birth: A Quality Improvement Project of a Family-Centered Care Nursing Educational Intervention. J Pediatr Nurs. 2021 May-Jun;58:21-27. doi: 10.1016/j.pedn.2020.11.006. Epub 2020 Dec 5. PMID: 33285437.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education Patient-Centered Medical Home Quality Improvement/Practice-Wide Intervention

Intervention Description: pre-test, training intervention and tool guide, post test

Intervention Results: After completing the educational intervention to promote family and sibling adaptation in the NICU, the nurses' knowledge and perceptions were more favorable, and they implemented more nursing practices.

Conclusion: Based on the findings of our quality improvement project, the educational intervention could be offered to all NICU nurses working with families, as the positive attitudes of nurses are central to the implementation of FCC (Maree & Downes, 2016). FCC should be encouraged in NICUs as parental presence, educational sessions and participating actively in the care of preterm infants have been recently reported to improve both infant and parental outcomes (O'Brien et al., 2018), as well as the infants' medical outcomes (Lv et al., 2019). Visitors' programs in hospital centers to support FCC have reported significant results for parents (Lee et al., 2014). Policies in the NICU should encourage the parents' presence and participation in care and also include siblings and extended families, such as grandparents (Craig et al., 2015; Lee et al., 2014). If necessary, the visitation policy could be modified to promote parental presence, participation and partnership in FCC (Griffin, 2013). The design of the NICU can also support FCC (Maree & Downes, 2016). With the goal of expanding the reach of our training intervention, this quality improvement project is currently being turned into an online training program in order to be offered to all NICU nurses across the province. This project should be replicated with a larger sample of NICU nurses. Future research could also evaluate the parents' satisfaction with the FCC in the NICU using an instrument that includes all FCC principles (Dall'Oglio et al., 2018). Using FCC guidelines, the effect of training or educational programs on the family members' psychological and wellness outcomes should be evaluated (Davidson et al., 2017). Comparing the effect of FCC on the adaptation of different sibling age groups (i.e., 3 to 8 years old vs. 12 to 16 years old), as well as grandparents or even others deemed to be significant others by families during NICU hospitalization, would also contribute to the body of knowledge about FCC. Finally, nurses' perceptions of the benefits of implementing FCC in their practice could be further explored through a qualitative study. The findings of our project reinforce the importance of offering NICU nurses educational training programs to support them in their practice, as part of quality improvement processes. Our results support the main objective of the educational intervention, which was to develop the nurses' competencies in intervening with siblings and families in the NICU. This FCC educational intervention can significantly contribute to the quality of care offered to family members, including siblings, who have a preterm infant hospitalized at the NICU

Study Design: quality improvement project

Setting: NICU: a level III NICU in Montreal, Canada, with a capacity of 40 beds designed in pods - a level III NICU in Montreal, Canada, with a capacity of 40 beds designed in pods (intermediate and intensive care) and single-family rooms, where approximately 110 nurses work

Population of Focus: NICU Nurses - the nurses working in the NICU. A convenience sample of 20 nurses initially participated in the project, and 13 completed the post-intervention evaluation .

Sample Size: 20 nurses

Age Range: 23-44

Access Abstract

Allen KP. A bullying intervention system in high school: A two-year school-wide follow-up. Studies in Educational Evaluation. 2010;36(3):83-92.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH Adult-led Support/Counseling/Remediation PARENT/FAMILY Presentation/Meeting/Information Session/Event CLASSROOM Adult-led Curricular Activities/Training SCHOOL Assembly Reporting & Response System

Intervention Description: This study is an evaluation of a systemic, two-year, whole-school bullying intervention initiative that was implemented in a US public high school.

Intervention Results: Except for a reduction in victimization, all goals were achieved in some measure. Self-reported bullying decreased 50% or more. Students' reporting that peers intervened in bullying increased. Staff-reported reductions in student aggression, and staff's belief that the school's efforts to address bullying were adequate increased.

Conclusion: This evaluation points to the possible success of a whole-school, systemic approach to managing bullying at the high school level. (Contains 1 figure and 2 tables.)

Study Design: QE: pretest-posttest

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Victimization: Pretest (n=874); Posttest (n=817) Perpetration: Pretest (n=870); Posttest (n=818)

Age Range: 14-18

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Allen SG, Berry AD, Brewster JA, Chalasani RK, Mack PK. Enhancing developmentally oriented primary care: an Illinois initiative to increase developmental screening in medical homes. Pediatrics. 2010;126 Suppl 3:S160-164.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE Provider Training/Education Educational Material (Provider) Expert Support (Provider)

Intervention Description: To increase primary care providers' use of validated tools for developmental, social/emotional, maternal depression, and domestic violence screening and to increase early awareness of autism symptoms during pediatric well-child visits in children aged 0 to 3 years.

Intervention Results: Percentage of sites screening 85% of children by 12-month well-child visit increased from 0% at baseline to 68.8% at follow-up. Sites not reaching 85% screening screened 48-83% of children at follow-up. Percentage of sites conducting social/emotional screening for 85% of children by 18-month well-child visit increased from 6% at baseline to 46.7% at follow-up. Sites not reaching 85% screening screened 5-81% of children at follow-up. Percentage of sites screening 85% of children by 24-month well-child visit increased from 0% at baseline to 68.8% at follow-up. Sites not reaching 85% screening screened 18-84% of children at follow-up.

Conclusion: The Enhancing Developmentally Oriented Primary Care (EDOPC) project enhanced confidence and intent to screen among a large group of Illinois primary health care providers. Among a sample of primary care sites at which chart reviews were conducted, the EDOPC project increased developmental screening rates to the target of 85% of patients at most sites and increased social/emotional screening rates to the same target rate in nearly half of the participating practices.

Study Design: QE: pretest-posttest

Setting: Primary care medical homes (federally qualified health centers, residency training programs, private practices) primarily in Chicago, Illinois, metropolitan area

Population of Focus: Children ages 4 to 24 months

Data Source: Child medical record

Sample Size: Chart audits at 16 sites (n=25 per site)

Age Range: Not specified

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Allende-Richter, S. H., Johnson, S. T., Maloyan, M., Glidden, P., Rice, K., & Epee-Bounya, A. (2018). A previsit screening checklist improves teamwork and access to preventive services in a medical home serving low-income adolescent and young adult patients. Clinical Pediatrics, 57(7), 835-843.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Education/Training (caregiver) Enabling Services PROFESSIONAL_CAREGIVER PATIENT_CONSUMER

Intervention Description: The goal of this project was to optimize team work and access to primary care services among publicly insured adolescents and young adults attending an urban primary care clinic, using a previsit screening checklist to identify patient needs and delegate tasks within a care team to coordinate access to health services at the time of the visit.

Intervention Results: The majority of patients were receptive to the previsit screening checklist; 85% of services requested were provided; nonclinician staff felt more involved in patient care; and providers’ satisfaction increased.

Conclusion: We conducted an interventional quality improvement initiative in a PDSA (Plan-Do-Study-Act) cycle format; 291 patients, 13 to 25 years old were included in the study over an 8-months period. The majority of patients were receptive to the previsit screening checklist; 85% of services requested were provided; nonclinician staff felt more involved in patient care; and providers’ satisfaction increased.

Access Abstract

An official position statement of the Association of Women’s Health, Obstetric and Neonatal Nurses. Racism and Bias in Maternity Care Settings. J Obstet Gynecol Neonatal Nurs. 2021 Sep;50(5):e6-e8. doi: 10.1016/j.jogn.2021.06.004. Epub 2021 Jul 26. PMID: 34325955.

Evidence Rating: Expert Opinion

Intervention Components (click on component to see a list of all articles that use that intervention): Education/Training (caregiver)

Intervention Description: None

Intervention Results: None

Conclusion: Nurses should seek to ensure that women from varied backgrounds, races, and ethnicities receive quality health care that is free from racism and bias. • Knowledge matters. Ideally, all nurses would learn about the role and impact of racism and ways to overcome its effects on the provision of care. Health care providers should demonstrate cultural competency in listening and communicating effectively with patients. • Language matters. The way nurses communicate with patients, their families and communities, other health care professionals, and each other is important. All written materials, toolkits and bundles, and educational documents should be evaluated to ensure that they reflect the patient population served. • Action matters. Nurses should advocate for change in didactic education, clinical training, and maternity and perinatal care settings to achieve non-discriminatory, quality health services for all patients. Nurses need to challenge themselves, their colleagues, and nurse leaders to promote clear and directive actions with built-in accountability measures.

Study Design: n/a

Setting: n/a

Population of Focus: Nurses

Age Range: n/a

Access Abstract

Arlinghaus, K. R., Ledoux, T. A., & Johnston, C. A. (2021). Randomized controlled trial to increase physical activity among Hispanic‐American middle school students. Journal of School Health, 91(4), 307-317.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): PE Enhancements Adult-led Curricular Activities/Training CLASSROOM_SCHOOL

Intervention Description: In this randomized control trial, we examined Moderate-to-vigorous physical activity (MVPA) in a physical activity intervention compared to physical education (PE) class as usual (TAU), stratified by sex and weight classification. Standardized BMI (zBMI) overtime was also examined.

Intervention Results: Participants were 12.10 ± 0.63 years old and 53% were girls. Overall those in intervention increased weekday MVPA more than TAU (F(1,190) = 7.03, p < .01). Intervention girls increased weekday MVPA; whereas TAU girls decreased weekday MVPA (F(1,99) = 7.36, p < .01). Among those with obesity, there was no difference in MVPA between conditions (F(1, 56) = 0.33, p = .57), but Intervention decreased zBMI significantly more than TAU (F(1, 56) = 6.16, p < .05).

Conclusion: Structured PE classes grounded in behavioral theory may be an important strategy to prevent typical decreases in MVPA during adolescence, particularly among girls and for youth with obesity.

Access Abstract

Arora, B. K., Klein, M. J., Yousif, C., Khacheryan, A., & Walter, H. J. (2023). Virtual Collaborative Behavioral Health Model in a Community Pediatric Network: Two-Year Outcomes. Clinical pediatrics, 62(11), 1414–1425. https://doi.org/10.1177/00099228231164478

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement/Practice-Wide Intervention Provider Training/Education Referrals

Intervention Description: Due to the pervasive shortage of behavioral health (BH) specialists, collaborative partnerships between pediatric primary care practitioners (PPCPs) and BH specialists can enhance provision of BH services by PPCPs. We aimed to create a new model of collaborative care that was mostly virtual, affordable, and scalable. The pilot program was implemented in 18 practices (48 PPCPs serving approximately 150 000 patients) in 2 consecutive cohorts. Outcomes were assessed by administering pre-program and post-program surveys.

Intervention Results: Across the 18 practices, PPCPs reported significantly increased confidence in their BH knowledge and skills, and significantly increased their provision of target BH services. Barriers to BH service provision (resources, time, and staff) were unchanged.

Conclusion: This compact, mostly virtual model of BH collaboration appears to be beneficial to PPCPs while also offering convenience to patients and affordability and scalability to the practice network.

Study Design: Pre-post observational study

Setting: 18 clinical practices (48 PPCPs serving approximately 150000 patients) in CA.

Population of Focus: Pediatric primary care provicers in clinic-based practices. The eligible population comprises approximately 200 PPCPs in 65 practices in a pediatric network affiliated with an academic medical center in Southern California. This report presents the findings from the first 2 groups of practices to enroll (cohorts 1 [7 practices, 23 PPCPs] and 2 [11 practices, 25 PPCPs]).

Sample Size: 18 practices, 48 pediatric primary care providers

Age Range: Providers seeing pediatric patients 0-17 years

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Ashby, B. D., Ehmer, A. C., & Scott, S. M. (2019). Trauma-informed care in a patient-centered medical home for adolescent mothers and their children. Psychological services, 16(1), 67.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Enabling Services Provider Training/Education Patient-Centered Medical Home PATIENT_CONSUMER HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: The Colorado Adolescent Maternity Program (CAMP) is an obstetric and pediatric medical home for pregnant and parenting adolescent girls through age 22 and their children located within Children’s Hospital Colorado. With the integration of behavioral health into CAMP, and given the prevalence of trauma histories among adolescent mothers reported in the literature, programmatic and operational changes to clinical care were made using the Substance Abuse and Mental Health Services Administration’s six key principles of a trauma-informed approach.

Intervention Results: Data showed that nearly 30% of participants reported a history of trauma. Following the inclusion of trauma-informed principles, patients had significantly higher rates of attendance at prenatal appointments (p < .001) and significantly lower rates of low birthweight babies (p = .02).

Conclusion: Future programmatic changes and long-term assessment outcomes of this trauma-informed approach in a PCMH are also discussed.

Access Abstract

Assibey-Mensah, V., Suter, B., Thevenet-Morrison, K., Widanka, H., Edmunds, L., Sekhobo, J., & Dozier, A. (2019). Effectiveness of peer counselor support on breastfeeding outcomes in WIC-enrolled women. Journal of nutrition education and behavior, 51(6), 650-657.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER Peer Counselor Educational Material Telephone Support PROFESSIONAL_CAREGIVER Education/Training (caregiver)

Intervention Description: In efforts to improve breeastfeeding rates, WIC established the Breastfeeding peer Counselor program (BFPC) model to improve breastfeeding rates among participants. The Upstate New York WIC BFPC program (UNYWIC BFPC) began with volunteers who provided support to WIC participants referred to BFPC services. The BFPCs completed Loving Support training. BFPC contacts included telephone, in-person (WIC clinic or home), and mailings.

Intervention Results: Mothers who accepted BFPC referrals and had at least 1 phone conversation or in-person contact had a significant 35% to 164% increased odds of positive BF outcomes. Mailings did not significantly improve outcomes.

Conclusion: The Special Supplemental Nutrition Program for Women, Infants, and Children may need to identify barriers to BF duration and implement interventions in communities with low BF rates. Future studies may benefit from evaluating the impact of combined in-person support and phone contacts during the prenatal and postpartum periods on BF outcomes.

Study Design: Secondary data analysis

Setting: The Upstate New York WIC Breastfeeding Peer Counselor program

Population of Focus: WIC-enrolled mothers with live singleton births who accepted a Breastfeeding Peer Counselor program referral

Sample Size: 2,149 mothers

Age Range: 5 day old infants (prenatal and postnatal contact with mothers)

Access Abstract

Association of Maternal & Child Health Programs, National Institute for Children's Health Quality. Early Childhood Developmental Screening and Title V: Building Better Systems. 2017. http://www.amchp.org/programsandtopics/CYSHCN/projects/spharc/LearningModule/Documents/Issue %20Brief%20FINAL%209-11.pdf.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation Training Assessment Policy/Guideline (National)

Intervention Description: In an effort to document state and jurisdiction activity in National Performance Measure 6 (NPM 6), AMCHP conducted an environmental scan of Title V program developmental screening activities. AMCHP obtained information through the Title V Information System (TVIS) by filtering Title V programs that chose NPM 6 and reviewing the narrative and action plans to ascertain their NPM 6 strategies, their accompanying evidence-based/informed strategy measures (ESMs), and related challenges. Information included in this issue brief does not represent an exhaustive list of each state’s and jurisdiction’s developmental screening activity, nor is every state or jurisdiction that is implementing the strategies mentioned. However, the range of strategies presented and the states and jurisdictions referenced here provide a snapshot of Title V program approaches, strategies, and techniques being used to increase developmental screening rates.

Intervention Results: The environmental scan of TVIS revealed that 41 states and jurisdictions chose NPM 6. As previously mentioned, Title V programs also have the option to select a State Performance Measure (SPM) based on results from their state’s needs assessment. Ten of the 41 states and jurisdictions that chose NPM 6 also selected an SPM related to developmental screening. The scan also found four states that did not choose NPM 6, but did select an SPM related to developmental screening. The environmental scan revealed a wide range of NPM 6 strategies and activities, under the following categories: • Policy Research, Development and Implementation • Systems Coordination 3 • Data Collection, Measurement and Existing Landscape • Technical Assistance and Training • Education, Engagement and Resource Development • Other Title V Program Strategies

Conclusion: information on Title V program activities related to NPM 6. These data provide insight into identified needs in policy, systems coordination, training, data integration, as well as strategies to address these needs. The selected examples highlighted within each category may prove useful to other Title V programs as they implement developmental screening-related strategies and measures to build or improve systems of care for children. In coming years, NPM 6 data can be analyzed more in-depth to develop resources such as reports, toolkits, or guides to assist Title V programs with developmental screening and early identification system challenges. These data will also guide AMCHP’s efforts to create meaningful technical assistance opportunities including webinars, learning modules, conference sessions, and other in-person trainings, to help states in advancing NPM 6. These resources will expand the repository of promising policies and practices featured on the State Public Health Autism Resource Center website (http://www.amchp.org/SPHARC), which is accessible to all Title V programs and their state and national partners.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Access Abstract

Association of Maternal & Child Health Programs. Standards for Systems of Care for Children and Youth with Special Health Care Needs. A Product of the National Consensus Framework for Systems of Care for Children and Youth with Special Health Care Needs Project. 2014. http://www.amchp.org/AboutTitleV/Resources/Documents/Standards%20Charts%20FINAL.pdf

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (National) Educational Material Screening Tool Implementation Training

Intervention Description: The document outlines national consensus standards for developing comprehensive, quality systems of care for children and youth with special health care needs (CYSHCN). The standards cover 10 core domains including screening/assessment, eligibility/enrollment, access to care, the medical home model, community-based services, family partnerships, transition to adulthood, health IT, quality assurance, and insurance/financing. Specific structural and process standards are provided for each domain, synthesized from existing frameworks, federal requirements, and input from a national workgroup of experts and stakeholders. The standards are intended for use by state programs, health plans, providers, and others serving CYSHCN.

Intervention Results: The document does not present results per se, but rather provides the full set of consensus-based system standards across the 10 core domains. Detailed standards are outlined related to components like screening processes, care coordination, access to pediatric specialty care, respite care, transition planning, health IT capabilities, quality measurement, and adequate insurance coverage and financing for needed services. Relevant existing national principles, frameworks, federal laws, and quality measures are cited for each domain.

Conclusion: The standards presented are designed to guide national, state and local stakeholders in achieving comprehensive, quality systems of care to improve health outcomes for the CYSHCN population. They are intended to supplement and align with existing federal requirements, evidence-based principles, and quality metrics. The document concludes that consensus around these core system standards is essential as states extend insurance coverage, design benefits, and implement quality initiatives affecting CYSHCN under the Affordable Care Act and other reforms. Widespread application of the standards across systems serving CYSHCN is recommended.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Access Abstract

Athanasiades C, Kamariotis H, Psalti A, Baldry AC, Sorrentino A. Internet use and cyberbullying among adolescent students in greece: The 'tabby' project. Hellenic Journal of Psychology. 2015;12(1):14-39.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM Adult-led Curricular Activities/Training

Intervention Description: The main objective of the article is to present the implementation of a European project in Greece for the safe use of the internet.

Intervention Results: Results showed that even though adolescent students in Greece report a number of risky online behaviors, exhibit lower rates of cyberbullying compared to students from other European countries. Additionally, students' estimate of their involvement in cyberbullying incidents in the future was significantly correlated with their risky and unsafe use of the internet.

Conclusion: Results regarding the effect of the school-based intervention on students' online behavior are inconclusive, pointing to the need for an extended implementation over a long period of time and parental involvement in all prevention initiatives.

Study Design: RCT: pretest-posttest

Setting: Greece

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=314) Intervention (n=123); Control (n=140)

Age Range: 13-14

Access Abstract

Baldry AC, Farrington DP. Evaluation of an intervention program for the reduction of bullying and victimization in schools. Aggress Behav. 2004;30(1):1-15.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM Adult-led Curricular Activities/Training

Intervention Description: The present study evaluates the effect of an intervention program on the reduction of bullying and victimization in schools with a sample of 239 students aged 10–16 years old in Rome, Italy.

Intervention Results: Results showed that the program worked best for older students, but not for younger ones who in some cases reported an increased level of victimization after the intervention. For older students there was a decrease in victimization according to the sum of types of behavior for the experimental group, but an increase for the control group. The same result was found for direct victimization, having belongings stolen, and being called nasty names.

Conclusion: Therefore, the program seemed to be beneficial for older students but possibly damaging for younger students. It is suggested that the program could have worked better with older students because of the cognitive skills it required. Younger students could have reported higher levels of bullying after the intervention because they became more sensitized to the topic of bullying.

Study Design: Cluster RCT: pretest-posttest

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=239) Intervention (n=131): Pretest (n=128) Control (n=106): Pretest (n=105)

Age Range: 11/15/2022

Access Abstract

Ballou, J., Wiseman, C., Jackson, L., Godfrey, R., & Cagle, D. (2017). Lactation skills workshop: a collaboration of the City of Dallas WIC and local hospitals. Journal of nutrition education and behavior, 49(7), S202-S206.

Evidence Rating: Emerging Evidence

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

Intervention Description: The City of Dallas, TA, WIC program collaborated with 3 urban hospitals and developed a training of practical techniques and information for staff to use while working with breastfeeding patients. It recognizes the powerful role that health care workers have in successful BF and the need for competent, hands-on skills to support lactation. The goals of the new collaboration with WIC were to provide staff a supervised clinical experience in a workshop format and provide a venue to practice the information they gained from the didactic education.

Intervention Results: Since implementation, 1,600 workers were trained, 1 hospital achieved Baby-Friendly designation, and all have increased BF rates by 10%.

Conclusion: The City of Dallas, TX, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program collaborated with 3 urban hospitals and developed a training of practical techniques and information for staff to use while working with BF patients. Since implementation, 1,600 workers were trained, 1 hospital achieved Baby-Friendly designation, and all have increased BF rates by 10%.

Study Design: Evaluation data

Setting: Three hospitals in Dallas, TX, and the City of Dallas WIC program

Population of Focus: Physicians, midwives, dietitians, and staff from area hospitals and clinics

Sample Size: 1600 people over three years

Age Range: Adults

Access Abstract

Banerjee J, Aloysius A, Mitchell K, Silva I, Rallis D, Godambe SV, Deierl A. Improving infant outcomes through implementation of a family integrated care bundle including a parent supporting mobile application. Arch Dis Child Fetal Neonatal Ed. 2020 Mar;105(2):172-177. doi: 10.1136/archdischild-2018-316435. Epub 2019 Jun 21. PMID: 31227521.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Training (Parent/Family) Family-Based Interventions Patient-Centered Medical Home

Intervention Description: In collaboration with veteran parents’ focus groups, we created an experienced co-designed care bundle including IFDC mobile application, which together with staff training programme comprised the IFDC programme. Infant outcomes were compared with retrospective controls in a prepost intervention analysis.

Intervention Results: Infants in the IFDC group were discharged earlier: median corrected GA (36+0 (IQR 35+0–38+0) vs 37+1 (IQR 36+3–38+4) weeks; p=0.003), with shorter median LOS (41 (32–63) vs 55 (41–73) days; p=0.022)

Conclusion: This is the first reported study from a UK tertiary neonatal unit demonstrating significant benefits of family integrated care programme. The IFDC programme has significantly reduced LOS, resulted in the earlier achievement of full enteral and suck feeds

Study Design: Implemented the Integrated Family Delivered Care (IFDC) program to a subset of infants while also having a control group. Compared infant outcomes.

Setting: NICU - London

Population of Focus: Families of NICU patients - healthcare providers and professionals working in neonatal intensive care units, as well as parents of preterm infants who are receiving care in these units.

Sample Size: 89 families - 89 infants who were admitted to the neonatal units of the participating healthcare facility. However, for the purpose of the outcome analysis, infants were included if they were less than 34 weeks gestational age, admitted for at least 14 days, and received the entire period of care in the neonatal units. This resulted in a sample size of 37 infants .

Age Range: Parents of infants

Access Abstract

Barbosa Filho VC, Bandeira ADS, Minatto G, et al. Effect of a Multicomponent Intervention on Lifestyle Factors among Brazilian Adolescents from Low Human Development Index Areas: A Cluster-Randomized Controlled Trial. Int J Environ Res Public Health. 2019;16(2):267. Published 2019 Jan 18. doi:10.3390/ijerph16020267

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL Teacher/Staff Training Comprehensive School-Based PA Program

Intervention Description: The four-month intervention included strategies focused on training teachers, new opportunities for physical activity in the school environment, and health education strategies for the school community (including parents). Moderate- to-vigorous physical activity level (≥420 min/week), TV watching and computer use/gaming (<2 h/day), daily consumption of fruit juice, fruit, vegetables, soft drinks, savory foods and sweets, and current alcohol and tobacco use were measured before and after intervention.

Intervention Results: McNemar's test and logistic regression (odds ratio [OR] and a 95% confidence interval [95% CI]) were used, considering p < 0.05. In the intervention schools, a significant increase occurred in the number of adolescents who met physical activity guidelines (5.3%; 95% CI = 0.8; 9.8) and who reported using computer for <2 h a day (8.6%; 95% CI = 3.8; 13.4) after intervention. No changes were observed in the control schools. At the end of the intervention, adolescents from intervention schools were more likely to practice physical activity at recommended levels (OR = 1.44; 95% CI = 1.00; 2.08) than adolescents from control schools. No significant change was observed for the other lifestyle factors.

Conclusion: In conclusion, this multicomponent intervention was effective in promoting physical activity among adolescents from vulnerable areas. However, other lifestyle factors showed no significant change after intervention.

Study Design: Cluster RCT

Setting: 6 schools in the public education system

Population of Focus: Adolescents in grades 7-9

Data Source: Physical activity list and Youth Risk Behavior Survey Questionnaire

Sample Size: 548 adolescents in intervention group; 537 in the control group

Age Range: Ages 11-18

Access Abstract

Bardos, J., Loudon, H., Rekawek, P., Friedman, F., Brodman, M., & Fox, N. S. (2017). Association Between Senior Obstetrician Supervision of Resident Deliveries and Mode of Delivery. Obstetrics and gynecology, 129(3), 486–490. https://doi.org/10.1097/AOG.0000000000001910

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education Residents/Medical Students HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: Six obstetricians with significant experience in operative deliveries supervised and taught residents on labor and delivery, including the use of forceps

Intervention Results: There were 5,201 live, term, singleton, vertex deliveries under the care of residents, 1,919 (36.9%) before December 2012 and 3,282 (63.1%) December 2012 or later. The rate of forceps deliveries significantly increased from 0.6% to 2.6% (adjusted odds ratio [OR] 8.44, 95% confidence interval [CI] 3.1–23.1), and the rate of cesarean deliveries significantly decreased from 27.3% to 24.5% (adjusted OR 0.68, 95% CI 0.55–0.83). There were no statistically significant differences in the rates of third- or fourth-degree lacerations or 5-minute Apgar scores less than 7. Among nulliparous women, the forceps rate increased from 1.0% to 3.4% (adjusted OR 4.87, 95% CI 1.74–13.63) and the cesarean delivery rate decreased from 25.6% to 22.7% (adjusted OR 0.69, 95% CI 0.53–0.89). The increase in forceps deliveries

Conclusion: Having senior obstetricians supervise resident deliveries is significantly associated with an increased rate of forceps deliveries and a decreased rate of cesarean deliveries.

Setting: Mt. Sinai Hospital

Population of Focus: All patients with term singleton vertex gestrations

Access Abstract

Barry S, Paul K, Aakre K, Drake-Buhr S, Willis R. Final Report: Developmental and Autism Screening in Primary Care. Burlington, VT: Vermont Child Health Improvement Program; 2012.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE Provider Training/Education Educational Material (Provider) Participation Incentives Quality Improvement/Practice-Wide Intervention Expert Support (Provider) Modified Billing Practices Data Collection Training for Staff Screening Tool Implementation Training Office Systems Assessments and Implementation Training Expert Feedback Using the Plan-Do-Study-Act-Tool Collaboration with Local Agencies (State) Collaboration with Local Agencies (Health Care Provider/Practice) Engagement with Payers STATE POPULATION-BASED SYSTEMS Audit/Attestation HEALTH_CARE_PROVIDER_PRACTICE Audit/Attestation (Provider)

Intervention Description: The Vermont Child Health Improvement Program (VCHIP) at the University of Vermont collaborated with state agencies and professional societies to conduct a survey of Vermont pediatric and family medicine practices regarding their developmental screening and autism screening processes, referral patterns, and barriers. The survey was administered in 2009 to 103 primary care practices, with a 65% response rate (89% for pediatric practices, 53% for family medicine practices).

Intervention Results: The survey results revealed that while 88% of practices have a specific approach to developmental surveillance and 87% perform developmental screening, only 1 in 4 use structured tools with good psychometric properties. Autism screening was performed by 59% of practices, with most using the M-CHAT or CHAT tool and screening most commonly at the 18-month visit. When concerns were identified, 72% referred to a developmental pediatrician and over 50% to early intervention. Key barriers to both developmental and autism screening were lack of time, staff, and training. Over 80% of practices used a note in the patient chart to track at-risk children, and most commonly referred to child development clinics, audiology, early intervention, and pediatric specialists.

Conclusion: The survey conducted by VCHIP revealed wide variation in developmental and autism screening practices among Vermont pediatric and family medicine practices. While most practices conduct some form of screening, there is room for improvement in the use of validated tools, adherence to recommended screening ages, and implementation of office systems for tracking at-risk children. The survey identified knowledge gaps and barriers that can be addressed through quality improvement initiatives, which most respondents expressed interest in participating in.

Study Design: QE: pretest-posttest

Setting: Pediatric and family medicine practices in Vermont

Population of Focus: Children up to age 3

Data Source: Child medical record; ProPHDS Survey

Sample Size: Chart audits at 37 baseline and 35 follow-up sites (n=30 per site) Baseline charts (n=1381) - Children 19-23 months (n=697) - Children 31-35 months (n=684) Follow-up charts (n=1301) - Children 19-23 months (n=646) - Children 31-35 months (n=655)

Age Range: Not specified

Access Abstract

Bastani, R., Glenn, B. A., Singhal, R., Crespi, C. M., Nonzee, N. J., Tsui, J., ... Taylor, V. M. (2022). Increasing HPV Vaccination among Low-Income, Ethnic Minority Adolescents: Effects of a Multicomponent System Intervention through a County Health Department Hotline. Cancer Epidemiology, Biomarkers & Prevention, 31(1), 175–182. https://doi.org/10.1158/1055-9965.EPI-20-1578 [HPV Vaccination SM]

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Telephone Support Education/Training (caregiver)

Intervention Description: The intervention included telephone education, mailed brochures tailored to the caregiver's preferred language, insurance status, sex of child, and race/ethnicity, as well as HPV provider referral. The control group received a brief in-language CDC fact sheet about HPV and the vaccine

Intervention Results: The study reported a higher than expected increase in vaccine initiation rates in the control group and equivalency in outcome rates in both study groups

Conclusion: The study reported a higher than expected increase in vaccine initiation rates in both the intervention and control groups, with no statistically significant difference between the two groups 7. Therefore, there was an increase in uptake, but it was not significantly different between the intervention and control groups.

Study Design: The study utilized a multicomponent system intervention through a County Health Department Hotline

Setting: The study was conducted through a County Health Department Hotline

Population of Focus: The target audience comprised low-income, ethnic minority adolescents and their caregivers

Sample Size: A total of 238 participants were enrolled in the study, with 225 providing some follow-up data

Age Range: The age range of the adolescents involved in the study was not explicitly mentioned in the provided text.

Access Abstract

Batra, E. K., Lewis, M., Saravana, D., Corr, T. E., Daymont, C., Miller, J. R., Hackman, N. M., Mikula, M., Ostrov, B. E., & Fogel, B. N. (2021). Improving Hospital Infant Safe Sleep Compliance by Using Safety Prevention Bundle Methodology. Pediatrics, 148(6), e2020033704. https://doi.org/10.1542/peds.2020-033704

Evidence Rating: Emerging

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

Intervention Description: A hospital-wide safe sleep bundle, based on a hospital-acquired conditions (HAC) model, was implemented in September 2017. Interventions were chosen by team members during multidisciplinary team meetings. Four key time points and/or interventions across the study period were (1) nursing education on the safe sleep bundle; 2) policy update and implementation; (3) collection and sharing of audit data; and (4) peer-to-peer bundle checklist reviews during registered nurse shift handoffs and electronic medical record (EMR) input. Other notable education interventions included subject matter expert training by guest speakers from the University of Pennsylvania and education to parents through updating newborn video instruction and increased exposure to appropriate safe sleep modeling.

Intervention Results: Overall compliance improved from 9% to 72%. Head of bed flat increased from 62% to 93%, sleep space free of extra items increased from 52% to 81%, and caregiver education completed increased from 10% to 84%. The centerline for infant in supine position remained stable at 81%.

Conclusion: Using an HAC bundle safety prevention model to improve adherence to infant safe sleep guidelines is a feasible and effective method to improve the sleep environment for infants in all areas of a children's hospital.

Setting: Penn State Children's Hospital

Population of Focus: Hospital healthcare providers

Access Abstract

Bauer NS, Lozano P, Rivara FP. The effectiveness of the Olweus Bullying Prevention Program in public middle schools: A controlled trial. J Adolesc Health. 2007;40(3):266-274.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH Adult-led Support/Counseling/Remediation PARENT/FAMILY Presentation/Meeting/Information Session/Event Notification/Information Materials (Online Resources, Information Guide) CLASSROOM Adult-led Curricular Activities/Training Enforcement of School Rules SCHOOL Assembly Reporting & Response System Bullying Committee Teacher/Staff Meeting Teacher/Staff Training School Rules Identification and Monitoring of/Increased Supervision in Targeted Areas POPULATION-BASED SYSTEMS COMMUNITY Media Campaign (Print Materials, Radio, TV)

Intervention Description: To examine the effectiveness of a widely disseminated bullying prevention program.

Intervention Results: Regression analyses controlling for baseline prevalence and school characteristics showed no overall effect on student victimization. However, when stratified by ethnicity/race, reports of relational and physical victimization decreased by 28% (RR = .72, 95% CI: .53-.98) and 37% (RR = .63, 95% CI: .42-.97), respectively, among white students relative to those in comparison schools. No similar effect was found for students of other races/ethnicities; there were no differences by gender or by grade. Students in intervention schools were more likely to perceive other students as actively intervening in bullying incidents, and 6th graders were more likely to feel sorry and want to help victims.

Conclusion: The program had some mixed positive effects varying by gender, ethnicity/race, and grade but no overall effect. Schools implementing the program, especially with a heterogeneous student body, should monitor outcomes and pay particular attention to the impact of culture, race and family influences on student behavior. Future studies of large-scale bullying prevention programs in the community must be rigorously evaluated to ensure they are effective.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Intervention (n=4959) Relational Victimization: Pretest (n=4607); Posttest (n=4480) Physical Victimization: Pretest (n=4531); Posttest (n=4419) Control (n=1559) Relational Victimization: Pretest (n=1408); Posttest (n=1456) Physical Victimization: Pretest (n=1373); Posttest (n=1448)

Age Range: NR

Access Abstract

Bauer SC, Smith PJ, Chien AT, Berry AD, Msall ME. Educating pediatric residents about development and social-emotional health. Infants Young Child. 2009;22(4):309-320.

Evidence Rating: Emerging Evidence

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

Intervention Description: We modified the Enhancing Developmentally Oriented Primary Care (EDOPC) program to provide a formal curriculum to pediatric residents serving children in distressed neighborhoods.

Intervention Results: Percentage of ASQ screening at 12-month well-child visits increased from 11% at baseline to 100% at follow-up. Percentage of ASQ:SE screening at 18-month well-child visits increased from 0% at baseline to 95% in June 2008 and declined to 58% at last follow-up in Jan 2009. Percentage of ASQ screening at 24-month well-child visits increased from 0% at baseline to 88% at follow-up.

Conclusion: Chart audits 1 year after the intervention demonstrated increased use of screening tools and more referrals to community services. This article will discuss lessons about facilitators and barriers to teaching residents about vulnerable preschool children.

Study Design: QE: pretest-posttest

Setting: University of Chicago Pediatric Residency Program in Chicago, Illinois

Population of Focus: Children ages 6 to 24 months

Data Source: Child medical record

Sample Size: Chart audits - Baseline (n=27 of 50 selected) - Follow-up 1: (n=61 of 100 selected) - Follow-up 2: (n=82 of 100 selected) - Follow-up 3: (n=94 of 100 selected) - Follow-up 4: (n=74 of 100 selected)

Age Range: Not specified

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Bauer, K. E., Agruss, J. C., & Mayefsky, J. H. (2021). Partnering with parents to remove barriers and improve influenza immunization rates for young children. Journal of the American Association of Nurse Practitioners, 33(6), 470-475. DOI: 10.1097/JXX.0000000000000381 [Flu Vaccination SM]

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Reminder/Recall Systems Education/Training (caregiver) Social Media

Intervention Description: Based on the concerns parents expressed through the survey, a program was designed and implemented that included reminder calls, parent education, proactive appointment scheduling, and social media reminders.

Intervention Results: After implementing a parent-driven quality-improvement program for 6 months during influenza season, the health center's pediatric influenza immunization rates rose to 57% compared with 44% during the year before.

Conclusion: Childhood immunization is a critical priority to protect the health and wellness of children. Increasing parent engagement in discussions about increasing immunization rates not only promotes awareness surrounding vaccines but also allows primary care providers to learn from parents to create a patient-centered immunization program. Programs that specifically target immunization efforts toward parental concerns have the potential for increased vaccine acceptance and improved health outcomes.

Study Design: The study utilized a randomized sampling method and conducted open-ended telephone surveys with parents of young children to identify key barriers to influenza immunization

Setting: a diverse, urban family health center

Population of Focus: The target audience for the study is parents of children aged 6 through 24 months at the urban family health center

Sample Size: The sample size is not explicitly mentioned in the provided text

Age Range: The age range of the children involved in the study is 6 through 24 months

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Bearman SK, Jamison JM, Lopez MA, Baker NM, Sanchez JE. Testing the Impact of a Peer-Delivered Family Support Program: A Randomized Clinical Effectiveness Trial. Psychiatric Services. 2022 Jan 18:appips202100278.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Parent Mentors Training (Parent/Family) Education on Disease/Condition

Intervention Description: NAMI Basics is a six-class manualized curriculum offered in English and Spanish. Classes occur weekly and are approximately 2.5 hours long. The curriculum covers the following content: an introduction to mental disorders and how they affect families, information about treatment of mental illness, communication skills, managing difficult child behaviors, crisis management, information about systems of care, and self-care and advocacy. NAMI-trained peer parents describe their own experiences parenting a child with mental health concerns to frame content and foster sharing of personal stories (see online supplement for more details). NAMI Basics peer parents are caregivers of a child who experienced mental health symptoms before age 13. NAMI relies on a referral process for identifying peer parents, and those who are trained to lead the course have typically taken a course previously. Training to become a peer parent takes approximately 15 hours. Training is led by NAMI state trainers, who have undergone this training previously, have experience observing and leading NAMI Basics classes, and have been recommended by their local affiliate. This study included 33 separate NAMI Basics courses across the five study sites. Nine of these courses occurred at affiliate 1, five at affiliate 2, six at affiliate 3, nine at affiliate 4, and four at affiliate 5. NAMI Basics courses were considered part of the study if at least one study participant attended any of the six classes. Classes were led by one or two peer parents; most were female (79%); half were Caucasian (50%), followed by Hispanic/Latinx (34%), and African American (16%). Fidelity was assessed by NAMI Basics–trained individuals who attended one randomly selected class for each study course and completed an adherence checklist indicating presence or absence of prescribed content (see online supplement). Class 3 was excluded from fidelity monitoring, because this session has a focus on sharing personal experiences. Fidelity to the intervention ranged from 79% to 100% (mean±SD=94.27±6.13).

Intervention Results: Compared with caregivers in the waitlist condition, NAMI Basics participants reported significant increases in parent engagement and activation, as well as intentions to engage with mental health services. NAMI Basics participants also reported significant decreases in their child’s intrapersonal and interpersonal distress, compared with those in the waitlist group. No significant differences were noted on measures of parenting stress, attitudes toward mental health services, or stigma.

Conclusion: NAMI Basics is a peer-parent support program that is readily available to support caregivers of children with mental health concerns, particularly those who experience barriers to service engagement. NAMI Basics significantly increased caregiver activation and engagement, as well as intentions to engage in services, and the children of participants showed decreases in some symptoms. Future research should examine the effects of NAMI Basics on outcomes over a longer duration and assess pathways that may result in child-level changes. Given well-documented barriers to mental health services engagement (1–3, 7–9), peer-parent support is an important resource to be leveraged.

Study Design: Randomized controlled trial

Setting: 5 NAMI affiliate locations in a southwestern U.S. state

Population of Focus: Caregivers of children under age 22 with mental health concerns

Sample Size: 111 caregivers

Age Range: Children were ages 3-22

Access Abstract

Beasley, D. R. (2021). An online educational intervention to influence medical and nurse practitioner students’ knowledge, self-efficacy, and motivation for antepartum depression screening and education. Nursing for Women's Health, 25(1), 43-53.

Evidence Rating: Emerging

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

Intervention Description: The intervention described by the article to increase postpartum screening was a 15-minute slide presentation with essential topics, including content on antepartum and postpartum depression focusing on signs, symptoms, screening, and treatment as well as antepartum maternal depression education highlighting the importance of understanding health literacy

Intervention Results: The results of the study showed that there was an increase in mean change over time for knowledge, self-efficacy, and motivation among medical and nurse practitioner students. The second null hypothesis was rejected, indicating that there was a significant increase in motivation levels from before to after the intervention. However, there was no significant difference between medical and nurse practitioner students, and student profession did not moderate the outcome effect

Conclusion: An intervention to influence health care students' knowledge, self-efficacy, and motivation for antepartum depression screening can be included in medical and nursing curricula and can also be used with currently practicing health care providers. Doing so could possibly benefit pregnant women by enhancing the antepartum care that they receive.

Study Design: The study design/type is a quasi-experimental study design

Setting: University of South Florida, College of Nursing and College of Medicine

Population of Focus: he target audience for the study was medical and nurse practitioner students who had completed the women's health/obstetric course within the curriculum, had self-identified ability to use the online technology platform/intervention, had access to an Internet-enabled device capable of accessing the online intervention, and were fluent in the English language

Sample Size: The sample size of this study was 71 participants, including 19 medical students and 52 nurse practitioner students

Age Range: The age group of the participants is not explicitly mentioned in the given texts. However, it is stated that medical students tended to be younger than nurse practitioner students

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Beemer LR, Ajibewa TA, DellaVecchia G, Hasson RE. A pilot intervention using gamification to enhance student participation in classroom activity breaks. International Journal of Environmental Research and Public Health. 2019;16(21):4082.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Curricular Activities/Training Physically Active Classrooms CLASSROOM_SCHOOL

Intervention Description: Nine third- through sixth-grade classrooms (n = 292 students) in one elementary-middle school in Detroit, Michigan (49% female, 95% nonwhite; 80% qualified for free/reduced lunch) participated in this 20-week intervention where teachers implemented 5 × 4 min moderate-to-vigorous activity breaks per day. Gamification of activity breaks occurred during weeks 13-20 of the intervention and included the use of game design elements and classroom goals for activity break intensity. Moderate-to-vigorous physical activity (MVPA) during activity breaks was measured via direct observation.

Intervention Results: There was a significant effect of intervention with a 27% increase in student MVPA participation during the gamified intervention weeks compared with the standard intervention weeks (p = 0.03). Gamification of activity breaks resulted in 55% (compared with 25% during the standard intervention) of students accumulating approximately 20 min of health-enhancing physical activity per day in their classroom.

Conclusion: These findings provide preliminary evidence that gamifying activity breaks may be an important strategy for increasing student participation in classroom activity breaks.

Study Design: Cohort design

Setting: One elementary-middle school in Detroit, MI, where at least 40% of students qualified for free/reduced priced lunch

Population of Focus: Students who were able to participate in physical education classes from 9 3rd through 6th grade classrooms

Data Source: System for Observing Play and Leisure Activity in Youth (SOPLAY)

Sample Size: 292 students

Age Range: Ages 8-13

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Bell R, Glinianaia SV, van der Waal Z, Close A, Moloney E, Jones S et al. Evaluation of a complex healthcare intervention to increase smoking cessation in pregnant women: Interrupted time series analysis with economic evaluation. Tobacco Control: An International Journal 2018;27:90-8.

Evidence Rating: Moderate Evidence

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

Intervention Description: To evaluate the effectiveness of a complex intervention to improve referral and treatment of pregnant smokers in routine practice, and to assess the incremental costs to the National Health Service (NHS) per additional woman quitting smoking.

Intervention Results: After introduction of the intervention, the referral rate increased more than twofold (incidence rate ratio=2.47, 95% CI 2.16 to 2.81) and the probability of quitting by delivery increased (adjusted OR=1.81, 95% CI 1.54 to 2.12). The additional cost per delivery was £31 and the incremental cost per additional quit was £952; 31 pregnant women needed to be treated for each additional quitter.

Conclusion: The implementation of a system-wide complex healthcare intervention was associated with significant increase in rates of quitting by delivery.

Study Design: Quasi experimental Crosssectional and Cost-benefit analysis

Setting: National Health Service(NHS) antenatal clinics

Population of Focus: Health records of singleton births to mothers who smoked and did not smoke

Data Source: Electronic health records

Sample Size: 37726

Age Range: Not specified

Access Abstract

Bell, A. D., Joy, S., Gullo, S., Higgins, R., & Stevenson, E. (2017). Implementing a Systematic Approach to Reduce Cesarean Birth Rates in Nulliparous Women. Obstetrics and gynecology, 130(5), 1082–1089. https://doi.org/10.1097/AOG.0000000000002263

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE Provider Training/Education HOSPITAL Guideline Change and Implementation Quality Improvement

Intervention Description: This quality improvement initiative used a systematic approach to reduce nulliparous cesarean birth rates, aligning with recommendations developed by the Council on Patient Safety in Women's Health Care: Patient Safety Bundle on the Safe Reduction of Primary Cesarean Births. Health care providers and nurses received education on contemporary labor management guidelines developed by the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine Obstetric Care Consensus regarding safe prevention of primary cesarean deliveries and nurses were instructed on labor support techniques. The preguideline implementation period was January 1, 2015, to June 30, 2015. The postguideline implementation period was July 1, 2016, to December 31, 2016. The primary outcome measured was the nulliparous, term, singleton, vertex cesarean birth rate.

Intervention Results: There were 434 women identified in the preguideline period and 401 women in the postguideline period. The nulliparous, term, singleton, vertex cesarean birth rate decreased from 27.9% to 19.7% [odds ratio (OR) 0.63, CI 0.46-0.88]. There were improvements in health care provider compliance with following the labor management guidelines from 86.2% to 91.5% (OR 1.73, 95% CI 1.11-2.70), the use of maternal position changes from 78.7% to 87.5% (OR 1.86, 95% CI 1.29-2.68), and use of the peanut birthing ball from 16.8% to 45.2% (OR 3.83, 95% CI 2.84-5.16) as provisions for labor support.

Conclusion: Implementing a systematic approach for care of nulliparous women is associated with a decrease in term, singleton, vertex cesarean birth rates.

Setting: Two rural community hospitals and one urban community hospital in North Carolina

Population of Focus: Nulliparous women with term singleton vertex gestations

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Berger-Jenkins, E., Monk, C., D’Onfro, K., Sultana, M., Brandt, L., Ankam, J., ... & Meyer, D. (2019). Screening for both child behavior and social determinants of health in pediatric primary care. Journal of developmental and behavioral pediatrics: JDBP, 40(6), 415.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement/Practice-Wide Intervention HEALTH_CARE_PROVIDER_PRACTICE Data Collection Training for Staff Provider Training/Education Audit/Attestation (Provider)

Intervention Description: Quality improvement (QI) methodology was used to implement routine screening using an adapted version of the Survey of Well Being of Young Children (SWYC), a child behavior and social screen, for all children ages 6 months to 10 years. Rates of screen administration and documentation were assessed for 18 months. Medical records of a convenience sample (N=349) were reviewed to track referrals and follow-up for positive screens.

Intervention Results: Over 18 months, 2028 screens were administered. Screening rates reached 90% after introducing a tablet for screening. Provider documentation of screens averaged 62%. In the convenience sample, 28% scored positive for a behavioral problem, and 25% reported at least 1 social stressor. Of those with positive child behavior or social stressor screens, approximately 80% followed up with their primary medical doctor, and approximately 50% completed referrals to the clinic social worker. Further analysis indicated that referral and follow-up rates varied depending on whether the family identified child behavior or social issues. Logistic regression revealed that parental concern was independently associated with child behavior symptoms (p = 0.001) and social stressors (p = 0.002).

Conclusion: Implementing a comprehensive psychosocial screen is feasible in pediatric primary care and may help target referrals to address psychosocial health needs.

Setting: Community health center

Population of Focus: Primary care peditricians

Access Abstract

Berns, H. M., & Drake, D. (2021). Postpartum depression screening for mothers of babies in the neonatal intensive care unit. MCN: The American Journal of Maternal/Child Nursing, 46(6), 323-329.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement/Practice-Wide Intervention Provider Training/Education Screening Tool Implementation

Intervention Description: The intervention is the implementation of a screening protocol for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) and referral to a licensed professional clinical counselor for mothers who score 10 or higher on the EPDS . The intervention aligns with a discernable strategy of using the Institute for Healthcare Improvement’s (IHI) Plan-Do-Study-Act cycle as a guiding framework to plan, implement, evaluate, and modify changes to achieve outcome objectives .

Intervention Results: The study found that the implementation of the PPD screening and referral process resulted in a 24% detection rate for postpartum depression, which is approximately double that of the general population . The project reduced common barriers to PPD treatment, such as cost, transportation, and childcare issues . The RNs who participated in the project reported that the educational content provided them with the necessary information to successfully implement the PPD screening and referral process . The study also found that 80% of RNs reviewed the slide presentation by the project start date .

Conclusion: This project recognizes the importance of an interdisciplinary care approach and highlights the need for early identification and treatment for PPD among mothers with babies in the NICU. The project can guide future initiatives to increase the use of screening in the inpatient setting, to detect PPD during its early and more treatable stages.

Study Design: The study design used in the research is not explicitly stated, but it appears to be a quality improvement project aimed at implementing a routine postpartum depression (PPD) screening protocol in the Neonatal Intensive Care Unit (NICU) . The study used a one-group, posttest-only design to evaluate outcome objectives

Setting: The setting for the study is not explicitly stated in any of the given texts. However, it is mentioned that IRB review and waiver were obtained from both the academic institution and the hospital site . Additionally, the study focuses on screening mothers of babies in the Neonatal Intensive Care Unit (NICU)

Population of Focus: The target audience for the study appears to be healthcare providers who work with mothers of babies in the Neonatal Intensive Care Unit (NICU) and are interested in implementing a routine postpartum depression (PPD) screening protocol. The study provides information on the use of the Edinburgh Postnatal Depression Scale (EPDS) for identifying mothers at risk for PPD, as well as recommendations for education and referral to licensed professional clinical counselors

Sample Size: The sample size for the study is 25 mothers who received the screening

Age Range: The age group of the mothers who received the screening is not mentioned in the given texts

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Bernstein, K., Gonrong, P., Shallat, S., Seidel, B., & Leider, J. (2022). Creating a Culture of Breastfeeding Support and Continuity of Care in Central Illinois. Health Promotion Practice, 23(1_suppl), 108S-117S.

Evidence Rating: Emerging

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

Intervention Description: This case study describes an innovative practice model informed by the Collective Impact Model (CIM) designed to promote breastfeeding continuity of care and community support in Central Illinois.

Intervention Results: Numerous breastfeeding support improvements were made at and between CIBPN sites. Breastfeeding rates at the birthing hospital and health center were stable, including during the COVID-19 pandemic.

Conclusion: This article contributes to the practice-based evidence for breastfeeding support by strengthening continuity of care through a successful application of the CIM by public health practitioners.

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Bick D, Murrells T, Weavers A, Rose V, Wray J, Beake S. Revising acute care systems and processes to improve breastfeeding and maternal postnatal health: a pre and post intervention study in one English maternity unit. BMC Pregnancy Childbirth. 2012;12(1):41-41.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE Hospital Policies Provider Training/Education

Intervention Description: Despite policy and guideline recommendations to support planned, effective postnatal care, national surveys of women's views of maternity care have consistently found in-patient postnatal care, including support for breastfeeding, is poorly rated.

Intervention Results: Post intervention there were statistically significant differences in the initiation (p = 0.050), duration of any breastfeeding (p = 0.020) and duration of exclusive breastfeeding to 10 days (p = 0.038) and duration of any breastfeeding to three months (p = 0.016). Post intervention, women were less likely to report physical morbidity within the first 10 days of birth, and were more positive about their in-patient care.

Conclusion: It is possible to improve outcomes of routine in-patient care within current resources through continuous quality improvement.

Study Design: QE: pretest-posttest

Setting: Large maternity unit in the south of England

Population of Focus: Women on the postnatal ward who were >16 years old, able to speak and read English, and who had not experienced a stillbirth or neonatal death

Data Source: Mother self-report

Sample Size: Pretest (n=751/741)3 Posttest (n=725/725)

Age Range: Not specified

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Binkley C, Garrett B, Johnson K. Increasing dental care utilization by Medicaid-eligible children: a dental care coordinator intervention. J Public Health Dent. 2010;70(1):76-84.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER Home Visit (caregiver) Educational Material (caregiver) Oral Health Product Patient Navigation (Assistance) PROVIDER/PRACTICE Outreach (Provider) Education/Training (caregiver)

Intervention Description: The aim of this study was to determine the effect of a dental care coordinator intervention on increasing dental utilization by Medicaid-eligible children compared with a control group.

Intervention Results: Dental utilization during the study period was significantly higher in the intervention group (43 percent) than in the control group (26 percent). The effect was even more significant among children living in households well below the Federal Poverty Level. The intervention was effective regardless of whether the coordinator was able to provide services in person or via telephone and mail.

Conclusion: The dental care coordinator intervention significantly increased dental utilization compared with similar children who received routine Medicaid member services. Public health programs and communities endeavoring to reduce oral health disparities may want to consider incorporating a dental care coordinator along with other initiatives to increase dental utilization by disadvantaged children.

Study Design: RCT

Setting: Jefferson County in Louisville, KY

Population of Focus: Children aged 4-15 years who currently or for 2 years prior had Medicaid insurance but have not had Medicaid dental claims filed for the previous 2 years

Data Source: Medicaid claims

Sample Size: Intervention (n=68) Control (n=68)

Age Range: not specified

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Bogetz JF, Revette A, DeCourcey DD. Clinical Care Strategies That Support Parents of Children With Complex Chronic Conditions. Pediatr Crit Care Med. 2021 Jul 1;22(7):595-602. doi: 10.1097/PCC.0000000000002726. PMID: 33813549.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Patient-Centered Medical Home Provider Training/Education Quality Improvement/Practice-Wide Intervention

Intervention Description: The survey instrument, “Caring for Children with Complex Chronic Conditions,” was adapted from a previously validated instrument (20). The survey consisted of 183-items, including 21 open-ended response items

Intervention Results: Informational themes included providing clear communication, with subthemes of: 1) be honest and open and 2) coordinate interdisciplinary care and provide consistent messaging with other clinicians working with our family. Relational themes were as follows: 1) include parents’ experiences and recognize their expertise about their children, with subthemes of: a) be caring and sensitive toward parents and b) be accommodating and flexible to demonstrate respect and provide comfort and 2) maintain relationships with families throughout their child’s medical journey and into bereavement.

Conclusion: Clinical care strategies that support parents of children with complex chronic conditions reflect the unique needs of this group of children. Relational strategies such as including parents as experts in their child’s care were paramount to parents of children with complex chronic conditions throughout their child’s medical journey and at end of life.

Study Design: This study reports findings from a cross-sectional survey of bereaved parents of children with CCCs.

Setting: CMC: Hospital - a single children's hospital

Population of Focus: CMC - bereaved parents of children with complex chronic conditions (CCCs) who had received care at Boston Children's Hospital (BCH) and had passed away between January 2006 and December 2015.

Sample Size: 110 - The study had a total of 211 eligible participants, and 110 of those eligible parents completed the survey and at least one open-response item, yielding a 52% participation rate.

Age Range: 1.9–20.3 - children

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Bonville, C. A., Domachowske, J. B., & Suryadevara, M. (2019). A quality improvement education initiative to increase adolescent human papillomavirus (HPV) vaccine completion rates. Hum Vaccin Immunother. 2019; 15(7-8): 1570–1576. Published online 2019 Jun 26. doi: 10.1080/21645515.2019.1627822 [HPV Vaccination SM]

Evidence Rating: Moderate

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

Intervention Description: The intervention involved a QI program that included teaching essential QI principles, providing strategies to deliver a strong provider vaccine recommendation, reviewing system changes to facilitate vaccination, and engaging all office staff in the effort

Intervention Results: The QI program resulted in increases in HPV vaccine series initiation and completion rates among children aged 11–12 years, well above the goal of 10%, even when replicated with a second group of practices

Conclusion: The conclusion highlighted the success of the QI program in optimizing patient care and workflow efficiency in busy primary care practices, emphasizing the importance of basic quality improvement education and strategies to deliver a strong provider vaccine recommendation

Study Design: The study design involved a Quality Improvement (QI) program that included teaching essential QI principles and providing examples of workflow-focused strategies to improve HPV vaccination rates among children aged 11–12 years

Setting: The setting for the Quality Improvement (QI) initiative was pediatric practices in AAP NY Chapter 1, mostly large, private practices serving suburban communities

Population of Focus: The target audience included pediatric providers and staff from the participating practices in AAP NY Chapter 1

Sample Size: The article does not explicitly mention the sample size. However, it states that eight different pediatric practices from AAP NY Chapter 1, each employing between 1 and 10 providers, were recruited for participation in the QI initiative

Age Range: The age range targeted by the QI initiative was 11–12 years old

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Boulton MJ, Flemington I. The effects of a short video intervention on secondary school pupils' involvement in definitions of and attitudes towards bullying. Sch Psychol Int. 1996;17(4):331-345.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM Adult-led Curricular Activities/Training

Intervention Description: The aim of this study was to examine the effects of a single viewing of an anti-bullying video on secondary school pupils' views of, and involvement in, bullying.

Intervention Results: Participants who watched the video did not report less bullying of other pupils than those who did not watch it, nor was there evidence that the video led to more negative attitudes towards bullying in general. However, more of the participants who watched the video than did not watch it extended their definition of bullying to include three specific types of behaviour-'name-calling', 'telling nasty stories about some one' and 'forcing people to do things they don't want to do'.

Conclusion: The implication of these results for schools' anti-bullying initatives are discussed.

Study Design: Cluster RCT: pretest-posttest

Setting: UK

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=170)

Age Range: 11/14/2022

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Boulton, M. J., & Boulton, L. (2017). Modifying self-blame, self-esteem, and disclosure through a cooperative cross-age teaching intervention for bullying among adolescents. Violence and victims, 32(4), 609-626.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH Peer-led Mentoring/Support Counseling CLASSROOM Peer-led Curricular Activities/Training

Intervention Description: Bullying is common among school students, and some victims hold self-blaming attributions, exhibit low self-esteem, and do not seek social support. A cross-age teaching of social issues intervention was utilized to combat the latter three variables. In small cooperative groups of classmates, participants designed and delivered a lesson to younger students that informed them that bullies not victims are in the wrong, victims have no reason to feel bad about themselves, and that seeking help can be beneficial.

Intervention Results: CATS led to a significant improvement on all 3 dependent variables and changes in self-blame, and separately changes in self-esteem, mediated the positive effect of the intervention on help-seeking.

Conclusion: The theoretical and practical implications of these results were discussed, especially in terms of supporting a highly vulnerable subgroup of adolescents.

Access Abstract

Bowllan NM. Implementation and evaluation of a comprehensive, school‐wide bullying prevention program in an urban/suburban middle school. J Sch Health. 2011;81(4):167-173.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH Adult-led Support/Counseling/Remediation PARENT/FAMILY Notification/Information Materials (Online Resources, Information Guide) Presentation/Meeting/Information Session/Event CLASSROOM Enforcement of School Rules SCHOOL Bullying Committee Assembly Reporting & Response System Teacher/Staff Meeting Teacher/Staff Training School Rules Identification and Monitoring of/Increased Supervision in Targeted Areas POPULATION-BASED SYSTEMS COMMUNITY Media Campaign (Print Materials, Radio, TV)

Intervention Description: This intervention study examined the prevalence of bullying in an urban/suburban middle school and the impact of the Olweus Bullying Prevention Program (OBPP).

Intervention Results: Statistically significant findings were found for 7th grade female students who received 1 year of the OBPP on reports of prevalence of bullying (p = .022) and exclusion by peers (p = .009). In contrast, variability in statistical findings was obtained for 8th grade females and no statistical findings were found for males. Following 1 year of the OBPP, teachers reported statistically significant improvements in their capacity to identify bullying (p = .016), talk to students who bully (p = .024), and talk with students who are bullied (p = .051). Other substantial percentile changes were also noted.

Conclusion: Findings suggest a significant positive impact of the OBPP on 7th grade females and teachers. Other grade and gender findings were inconsistent with previous literature. Recommendations for further research are provided along with implications for school health prevention programming.

Study Design: QE: time-lagged age-equivalent control group

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Intervention (n=112); Control (n=158)

Age Range: NR

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Bradley, C., Day, C., Penney, C., & Michelson, D. (2020). ‘Every day is hard, being outside, but you have to do it for your child’: Mixed-methods formative evaluation of a peer-led parenting intervention for homeless families. Clinical child psychology and psychiatry, 25(4), 860-876.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Peer-led Curricular Activities/Training Family-Based Interventions

Intervention Description: Adapting the evidence base program 'Empowering Parents, Empowering Communities'

Intervention Results: Thirteen parents completed the programme (including one parent who required two attempts). We found improvements in child behavioural difficulties, parenting knowledge and practices, while parental well-being and social support were unchanged. Participants were highly satisfied overall, with indications that the peer-led model mitigated negative expectancies of services and normalized experiences of parenting in challenging conditions.

Conclusion: Parental self-care and ‘the good enough parent’ were strongly endorsed topics, although some content (e.g. timeout) was deemed impractical. These promising findings warrant further testing under controlled conditions.

Study Design: mixed-methods, formative evaluation

Setting: London, UK

Population of Focus: social workers, public health practitioners

Sample Size: N= 15; Parents living in temporary housing with children aged 2-11years old

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Brashears, K. A., & Erdlitz, K. (2020). Screening and Support for Infant Safe Sleep: A Quality Improvement Project. Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners, 34(6), 591–600. https://doi.org/10.1016/j.pedhc.2020.07.002

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER Training/Education PROFESSIONAL_CAREGIVER Education/Training (caregiver) Educational Material (caregiver)

Intervention Description: A quality improvement project was implemented at a pediatric primary care practice to improve screening for infant safe sleep practices. The screening form was updated to include questions from the Pregnancy Risk Assessment Monitoring System (PRAMS) that better capture actual sleeping practices and allow for a more targeted response from providers. Based on individual survey responses, the providers offered and documented their specific educational feedback. Any changes/improvements reported during a 2-week callback were also documented. Study participation was encouraged by offering a chance to win a $50 Amazon gift card and a free board book, Sleep Baby, Safe and Snug, covering the basics of safe sleep in a format that can be read to the child (Charlie's Kids Foundation, 2017).

Intervention Results: This updated screening better captured actual sleeping practices, allowing for more targeted education.

Conclusion: This article describes a quality improvement project implemented at a pediatric primary care practice to improve screening for infant safe sleep.

Setting: A single pediatric primary care practice

Population of Focus: Parents/caregivers of infants 0-6 months

Access Abstract

Brent NB, Redd B, Dworetz A, D'Amico F, Greenberg J. Breast-feeding in a low-income population: program to increase incidence and duration. Arch Pediatr Adolesc Med. 1995;149:798-803.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER Lactation Consultant PROVIDER/PRACTICE Provider Training/Education

Intervention Description: To evaluate the efficacy of an intervention program to increase breast-feeding in a low-income, inner-city population.

Intervention Results: There was a markedly higher incidence of breast-feeding in the intervention group, as compared with that of the control group (61% vs 32%, respectively; P = .002). The duration of breast-feeding was also significantly longer in the intervention group (P = .005).

Conclusion: This lactation program increased the incidence and duration of breast-feeding in our low-income cohort. We suggest that similar efforts that are applied to analogous populations may increase the incidence and duration of breast-feeding in low-income populations in the United States.

Study Design: RCT

Setting: Maternal-Infant Lactation Center of Pittsburgh (PA)

Population of Focus: Women attending the prenatal clinic of The Mercy Hospital of Pittsburgh, English-speaking, and nulliparous

Data Source: Mother self-report

Sample Size: Intervention (n=51) Control (n=57)

Age Range: Not specified

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Bright, M. A., Sayedul Huq, M., Patel, S., Miller, M. D., & Finkelhor, D. (2022). Child safety matters: Randomized control trial of a school-based, child victimization prevention curriculum. Journal of interpersonal violence, 37(1-2), 538-556.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Curricular Activities/Training CLASSROOM_SCHOOL

Intervention Description: This study utilized a randomized control trial (RCT) design to evaluate the knowledge acquisition of children who received the Monique Burr Foundation's Child Safety Matters curriculum, a program designed to educate kindergarten to Grade 5 children about bullying, cyberbullying, four types of abuse (physical, sexual, emotional, and neglect), and digital dangers.

Intervention Results: The interaction of treatment and time was significant, F(2, 90) = 17.024, p < .000. Children who received the curriculum increased their knowledge about potentially risky situations, and this knowledge was sustained over 7 months to the follow-up assessment. Children in the control schools did not have similar gains.

Conclusion: The current classroom-based child maltreatment prevention education is a promising strategy to address children's vulnerability to abuse and its consequences.

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Bright, M. A., Zubler, J., Boothby, C., & Whitaker, T. M. (2019). Improving developmental screening, discussion, and referral in pediatric practice. Clinical pediatrics, 58(9), 941-948.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Health_Care_Provider_Practice Screening Tool Implementation Training Provider Training/Education

Intervention Description: Twenty-eight pediatricians completed an in-person meeting, monthly webinars, and individualized feedback from an Expert Work Group on progress across a 3-month action period.

Intervention Results: Statistically significant increases were observed in rates of autism screening, discussions of screening results with families, and referral following abnormal results. There was no statistically significant change in rates of general developmental screening. Comparing self-report with record review, pediatricians overestimated the extent to which they conducted discussion and referral.

Conclusion: Universal screening for all children has yet to be achieved. The current project supports that practice-based improvements can be made and delineates some of the routes to success.

Setting: Clinical practice

Population of Focus: Primary care peditricians

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Brown B, Harris KJ, Heil D, Tryon M, Cooksley A, Semmens E, Davis J, Gandhi K. Feasibility and outcomes of an out-of-school and home-based obesity prevention pilot study for rural children on an American Indian reservation. Pilot and Feasibility Studies 2018; 4:129.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): Training (Parent/Family) Extra-Curricular Activities PARENT_FAMILY CLASSROOM_SCHOOL Family-Based Interventions

Intervention Description: This was an 11-week, two group, randomized feasibility study. Participants were children and their parents at one OOSP on a rural American Indian reservation. Children, ages 6–9, were randomized to receive the Generations Health (GH) intervention or comparison condition. The GH group received daily activities focused on physical activity (PA), nutrition, sleep, and reducing TV/screen time, and frequently engaged parents. The comparison group received usual OOSP activities. To assess intervention feasibility, we measured recruitment and participation rates and program satisfaction. We assessed pre- to posttest changes in body composition, PA and sleep patterns, dietary intake and Healthy Eating Index-2010 (HEI-2010) scores, TV/screen time, and nutrition knowledge. We report recruitment and participation rates as percentages and participants’ program satisfaction as means. Two-tailed paired t tests and 95% confidence intervals were used to detect changes in behavioral and health outcome variables.

Intervention Results: Forty-six children met age eligibility criteria; following screening, 52% (24/46) met the inclusion criteria and 96% (23/24) were randomized to the study. Overall, 91% of the children participated in the intervention and 100% participated in at least some of the posttest assessments. Parents reported high program satisfaction (mean rating of 4, on a 1–5 scale). Our outcome measure for child adiposity, zBMI, was reduced by 0.15 in the GH group, but increased by 0.13 in the comparison condition. Meaningful changes were evident for total kilocalories, HEI-2010 scores, PA, TV/screen time, and nutrition knowledge.

Conclusion: High recruitment, participation and program satisfaction and positive health and behavioral outcomes at 11 weeks provide encouraging indications of the feasibility and potential effectiveness of the intervention.

Study Design: Feasibility RCT

Setting: American Indian Reservation

Population of Focus: Rural students

Data Source: Activity monitors (PA levels), questionnaire (sedentary/screen activity)

Sample Size: 24 students

Age Range: Ages 6-9

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Brown, C. M., Samaan, Z. M., Morehous, J. F., & Perkins, J. (2018). Improving preventative care delivery to underserved pediatric populations through bundled measures. BMJ Open Quality, 7(1), e000129. https://doi.org/10.1136/bmjoq-2017-000129 [Childhood Vaccination NPM]

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education Provider Reminder/Recall Systems Quality Improvement/Practice-Wide Intervention

Intervention Description: The study used a bundled measure that includes immunizations, lead screening, and use of screening tools to improve preventative care service delivery. The interventions included staff education on measure components, introduction of exam room-based phlebotomy to address lead screening completion rates, and population management strategies, including development of a patient registry and use of reminders and visit tracking to increase attendance at well-child visits.

Intervention Results: The percent of bundle completion by 14 months of age increased from a baseline of 58% to 77% following implementation of the QI initiatives. A mean shift was identified after the population manager began proactive targeted outreach for the 12-month visit.

Conclusion: Targeted systems for outreach aimed at bringing patients into the clinic and patient-centred strategies for visit completion are effective at ensuring timely delivery of comprehensive preventative care to an underserved paediatric population.

Study Design: The study is a quality improvement (QI) study that used plan-do-study-act (PDSA) cycles to optimize results.

Setting: The study was conducted at a community-based academic primary care clinic.

Population of Focus: Underserved pediatric patients under 2 years old.

Sample Size: The study does not provide a specific sample size.

Age Range: The target audience is pediatric patients under 2 years old.

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Bruns, E. J., Lee, K., Davis, C., Pullmann, M. D., Ludwig, K., Sander, M., Holm‐Hansen, C., Hoover, S., & McCauley, E. M. (2023). Effectiveness of a Brief Engagement, Problem‐Solving, and Triage Strategy for High School Students: Results of a Randomized Study. Prevention Science, 1-14.

Evidence Rating: Emerging

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

Intervention Description: The core BRISC strategy is implemented in four sessions. In session 1, the SMHP engages the student, assesses current functioning using brief standardized assessment measures, and identifies “top problems” (Weisz et al., 2011). The student is asked to informally monitor a behavior related to one of their top problems (e.g., time spent with friends, days feeling “blue,” number of disputes with parents). In session 2, the SMHP introduces a structured problem-solving framework, and the student chooses a “top problem” to address. Using a structured approach, the student outlines a concrete goal, brainstorms possible steps toward this goal, identifies a specific step, and troubleshoots barriers (D'Zurilla & Nezu, 2010). In session 3, a set of evidence-based, skill-based elements (communication skills, stress and mood management, realistic thinking) are taught, if needed, to help modify the step tried or to identify and support the student’s next step(s). In session 4, the student and SMHP review progress and identify a “post-BRISC pathway”: (1) end treatment/problem resolved, (2) supportive monitoring by the SMHP or other school staff, (3) continued treatment from the SMHP, or (4) referral to more specialized or intensive services. SMHPs are also encouraged to refer students to supportive school-based services (e.g., tutoring, special education), if indicated. BRISC-assigned SMHPs attended a 1.5-day in-person training by two Ph.D.-level clinical psychologists that incorporated strategies (e.g., modeling, role play) found to facilitate uptake of new skills (Rakovshik & McManus, 2010). Although therapists in both conditions were already deployed full time by their agencies into the school setting, the training also reviewed how to manage the unique challenges of SBMH work as it applies to the BRISC framework (e.g., adjusting to school schedules, triaging to school and community supports). SMHPs received bi-weekly phone consultation/coaching from the trainers that included a review of adherence checklists completed by the clinician following each of their sessions, case presentations, and review of and feedback on their BRISC implementation.

Intervention Results: Services Received: Student Report - Results of analyses of longitudinal service receipt as assessed via the SACA are shown in Table 2 and Fig. 2 (model results with confidence intervals are available as online resource 3). There were no differences at baseline between conditions on the proportion of students receiving school-based mental health services. From baseline to 2 months, the proportion of students receiving SMH services, and the number of services received, increased for both conditions. From 2 to 6 months, the proportion of students receiving SMH and the number of SMH services decreased more for the BRISC condition. At 6 months, there were no significant differences between the groups on the proportion of students receiving SMH services, but the number of SMH services received was significantly less for BRISC. This demonstrates that BRISC was associated with increased SMH services between baseline to 2 months and decreased SMH services by 6 months. The proportion of BRISC students who used outpatient MH services significantly decreased across all time points, while the proportion of students in SAU receiving outpatient services decreased from baseline to 2 months and then increased. At 6 months, significantly fewer BRISC students received outpatient services. Clinician Report - Clinician report of client status after 4 sessions was limited to the 9 BRISC and 13 SAU SMHPs still participating in the study in the final year of the study (N=45 and N=65 students, respectively). As shown in Table 3, there was a significant difference after 4 sessions (χ2 = 18.9, p = .004), with adjusted standardized residuals indicating students in the BRISC condition were more likely than SAU to have concluded treatment with no further services planned (37.8% vs. 12.3%, RR = 3.07, RD = 0.25) and to be referred to outside MH services (15.6% vs 3.1%, RR = 5.06, RD = 0.12). SAU students were more likely to continue school-based treatment with no additional services planned (61.5% vs. 35.6%, RR = 0.58, RD =  −0.26).

Conclusion: This project evaluated the potential for improving the efficiency of SMH via a school-based assessment, brief intervention, and triage approach for students with socio-emotional concerns. BRISC provides a first-line intervention using consistent assessment to inform level and type of ongoing services needed in a prevention-oriented, multi-tiered delivery model. Research questions focused on feasibility, fidelity, student report of problems, and ability of BRISC to promote efficiency within SMH. We also measured a range of mental health outcomes over 6-month follow-up to evaluate whether this emphasis on efficiency compromised these outcomes compared to SMH “as usual.” SMHPs who participated in the study were predominantly outpatient clinic providers deployed to the school setting. Their training and established practice were geared to traditional, longer term supportive therapy. The structured, measurement-based, and goal-oriented BRISC approach represented a different way of practicing aligned with data-informed, multi-tiered frameworks used by schools. Despite the learning curve required and deviation from typical practice, SMHPs rated BRISC as feasible, acceptable, and appropriate. Importantly, the majority of SMHPs rated BRISC as easy to learn, “compatible with the school mission,” and “likely to improve students’ social, emotional, and academic success.” SMHPs delivered BRISC with fidelity; however, session 3 fidelity was lower than for other sessions. This was likely due to the complexity introduced by the option to use evidence-based treatment elements as needed. A second key finding was that SMHPs in the BRISC condition were significantly more likely (53% to 15%) to report that they had completed treatment after 4 sessions than SAU. BRISC-assigned SMHPs were also more likely to refer students to alternative and/or more intensive services. Students in the BRISC condition were also significantly more likely to report receipt of SMH at 2 months and less likely to report SMH services at 6 months. These results support the hypothesis that BRISC can promote SMH that is more efficient and better aligned with MTSS and public health frameworks. Finally, we asked whether SMHPs’ use of a brief strategy to achieve greater efficiency would compromise mental health outcomes. To the contrary, students served via BRISC showed significantly greater improvement on their self-rated top mental health problems at 2 and 6 months. Symptom and functioning measures showed significant improvement, but slopes did not differ by condition. Students served by BRISC SMHPs were less likely to receive outpatient care at 6 months. This finding could indicate that BRISC more effectively addressed students’ “top problems” to an extent that reduced their need for longer-term mental health services. Or, it could be that students in the BRISC condition felt more confident in their school-based provider to help them in the future, reducing the need for clinic-based services. Such questions will need to be examined in more in-depth research with longer follow-up.

Study Design: Cluster randomized controlled trial

Setting: 15 school districts in the United States (Maryland, Minnesota, Washington)

Population of Focus: High school students referred to/seeking school mental health services

Sample Size: 457 students

Age Range: 13-18 years old (High School students)

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Butz AM, Bollinger ME, Ogborn J, Morphew T, Mudd SS, Kub JE, Bellin MH, Lewis-Land C, DePriest K, Tsoukleris M (2019). Children with poorly controlled asthma: Randomized controlled trial of a home-based environmental control intervention. Pediatric Pulmonology. 2019 Mar;54(3):245-256. doi: 10.1002/ppul.24239

Evidence Rating: Mixed Evidence

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

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California Maternal Quality Care Collaborative. Elimination of Non-Medically Indicated (Elective) Deliveries Before 39 Weeks Gestational Age: A California Toolkit to Transform Maternity Care. August 2011.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): Other Education Provider Training/Education Development/Improvement of Services Patient Reminder/Invitation

Intervention Description: This intervention presents a toolkit developed by the March of Dimes, California Maternal Quality Care Collaborative, and the California Department of Public Health, aimed at eliminating non-medically indicated (elective) deliveries before 39 weeks of gestation. The toolkit provides guidance and strategies for healthcare providers, hospitals, and policymakers to reduce early elective deliveries (EEDs), which are associated with neonatal morbidities and increased healthcare costs. It identifies common barriers to reducing EEDs, such as lack of effective policies, provider resistance, lack of patient awareness, and data collection challenges. The toolkit offers recommendations to overcome these barriers through policy changes, hard-stop policies, provider and patient education, data collection guidance, and measurement strategies using The Joint Commission's PC-01 measure for EEDs.

Intervention Results: The toolkit highlights several successful quality improvement (QI) interventions implemented by healthcare organizations to reduce early elective deliveries. Intermountain Healthcare, through a multidisciplinary team approach, data-driven interventions, and strict enforcement of policies, reduced elective deliveries before 39 weeks from 28% to less than 3% within six years. Additionally, they observed a decrease in stillbirth rates and no significant increase in maternal morbidity. Magee Women's Hospital achieved a significant reduction in elective inductions before 39 weeks and lower cesarean section rates among nulliparous women after implementing induction guidelines, involving key physician and nursing leaders, and establishing a chain of support for enforcement. The Ohio Perinatal Quality Collaborative reported a decrease in elective deliveries from 25% to less than 5% within 14 months among participating hospitals, along with a decline in stillbirth rates and fewer NICU admissions for infants born between 36 and 38 weeks.

Conclusion: Despite efforts to curb early elective deliveries, the toolkit acknowledges that some areas still face difficulties in achieving desired results. It emphasizes the need for a coordinated effort from various stakeholders, including healthcare providers, hospitals, professional organizations, patient advocates, and policymakers. The toolkit serves as a comprehensive resource, offering evidence-based strategies, educational tools, and case studies to support the elimination of non-medically indicated deliveries before 39 weeks. By addressing barriers, promoting policy changes, enhancing data collection and measurement, and increasing awareness among providers and patients, the toolkit aims to facilitate sustainable improvements in maternal and neonatal health outcomes.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

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Callaghan-Koru, J. A., DiPietro, B., Wahid, I., Mark, K., Burke, A. B., Curran, G., & Creanga, A. A. (2021). Reduction in Cesarean Delivery Rates Associated With a State Quality Collaborative in Maryland. Obstetrics and gynecology, 138(4), 583–592. https://doi.org/10.1097/AOG.0000000000004540

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE Provider Training/Education HOSPITAL Chart Audit and Feedback Guideline Change and Implementation Quality Improvement Policy/Guideline (State) STATE Collaboration with Local Agencies (Health Care Provider/Practice) Collaboratives Policy/Guideline (Hospital)

Intervention Description: Hospitals participating in the MDPQC (Maryland Perinatal-Neonatal Quality Care Collaborative) agreed to implement practices from the "Safe Reduction of Primary Cesarean Births" patient safety bundle, developed by the Council on Patient Safety in Women's Health Care. As a requirement of participation, hospital teams sent at least one team member to each collaborative event. Activities included a June 2016 in-person kick off meeting for two to three representatives from each hospital to familiarize them with the cesarean delivery bundle and the requirements of participation, followed by conference calls that occurred every month in the first year and every 2 months in the second year. Additional in-person meetings for all hospital teams took place at 12 months and at the end of the collaborative (November 2018). Nice webinars on related clinical topics were presented throughout the 30-month period. The collaborative director provided facilitation support to site teams through calls and visits when requested by the site team or when site participation lapsed.

Intervention Results: Among the 26 bundle practices that were assessed, participating hospitals reported having a median of seven practices (range 0-23) already in place before the collaborative and implementing a median of four (range 0-17) new practices during the collaborative. Across the collaborative, the cesarean delivery rates decreased from 28.5% to 26.9% (P=.011) for all nulliparous term singleton vertex births and from 36.1% to 31.3% (P<.001) for nulliparous, term, singleton, vertex inductions. Five hospitals had a statistically significant decrease in nulliparous, term, singleton, vertex cesarean delivery rates and four had a significant increase. Nulliparous, term, singleton, vertex cesarean delivery rates were significantly lower across hospitals that implemented more practices in the "Response" domain of the bundle.

Conclusion: The MDPQC was associated with a statewide reduction in cesarean delivery rates for nulliparous, term, singleton, vertex births.

Setting: 31 Maryland birthing hospitals

Population of Focus: Among the 26 bundle practices that were assessed, participating hospitals reported having a median of seven practices (range 0–23) already in place before the collaborative and implementing a median of four (range 0–17) new practices during the collaborative. Across the collaborative, the cesarean delivery rates decreased from 28.5% to 26.9% (P5.011) for all nulliparous term singleton vertex births and from 36.1% to 31.3% (P,.001) for nulliparous, term, singleton, vertex inductions. Five hospitals had a statistically significant decrease in nulliparous, term, singleton, vertex cesarean delivery rates and four had a significant increase. Nulliparous, term, singleton, vertex cesarean delivery rates were significantly lower across hospitals that implemented more practices in the “Response” domain of the bundle.

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Calvert HG, Mahar MT, Flay B, Turner L. Classroom-based physical activity: Minimizing disparities in school-day physical activity among elementary school students. Journal of Physical Activity and Health. 2018;15(3):161-168.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL Adult-led Curricular Activities/Training Physically Active Classrooms

Intervention Description: Teachers at 5 elementary schools attended training on how to implement CBPA. Data on school-day PA opportunities [physical education (PE), recess, and CBPA] were obtained via calendar and teacher-recorded CBPA logs. Daily step counts were measured via accelerometry in 1346 students across 65 classrooms in first through fifth grades.

Intervention Results: PE, recess, and CBPA contributed significantly to students' daily steps. Males accrued more steps than females over the school day, during PE, and during recess. No gender disparity was seen in the amount of additional steps accrued during CBPA. Overall step counts were lower among fifth-grade students versus first-grade students, but CBPA attenuated this difference such that grade-level differences were not significant in fifth-grade students who received CBPA.

Conclusion: Gender disparities in step totals were present on PE and recess days, but not on CBPA days. CBPA appears to provide equal PA benefits for both genders and to potentially minimize the decline in PA among older students.

Study Design: Quasi-experimental design

Setting: Public elementary schools (teacher-led)

Population of Focus: 1st through 5th grade school children

Data Source: Accelerometer data and teacher self-report

Sample Size: 1,346 students

Age Range: Ages 6-11

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Canty, E. A., Fogel, B. N., Batra, E. K., Schaefer, E. W., Beiler, J. S., & Paul, I. M. (2020). Improving infant sleep safety via electronic health record communication: a randomized controlled trial. BMC pediatrics, 20(1), 468. https://doi.org/10.1186/s12887-020-02369-2

Evidence Rating: Emerging

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

Intervention Description: Research staff from a single maternity ward recruited 184 mothers and their term newborns to participate in this randomized controlled trial to assess whether a patient portal could be used to provide personalized safe sleep care. The portal is capable of supporting two-way information sharing and communication between providers and families. Feasibility of the study was measured by a) the proportion of consenting mothers who enrolled in the portal and b) maternal adherence to prompts to submit photographs of their infant sleeping to the research team through the patient portal. Efficacy was determined via research assistant review of submitted photographs. The assistants were trained to detect sudden unexplained infant death risk factors, including sleep position, based on AAP guidelines. Standardized feedback was returned to mothers through the patient portal.

Intervention Results: One hundred nine mothers (59%) enrolled in the patient portal and were randomized to intervention (N = 55) and control (N = 54) groups. 21 (38, 95% CI 25-52%) intervention group participants sent photographs at 1 month and received personalized feedback. Across both groups at 2 months, 40 (37, 95% CI 28-46%) sent photographs; 56% of intervention group participants who submitted photographs met all safe sleep criteria compared with 46% of controls (difference 0.10, 95% CI - 0.26 to 0.46, p = .75). Common reasons for guideline non-adherence were sleeping in a room without a caregiver (43%), loose bedding (15%) and objects (8%) on the sleep surface.

Conclusion: Utilizing the patient portal to individualize safe infant sleep is possible, however, we encountered numerous barriers in this trial to assess its effects on promoting safe infant sleep. Photographs of infants sleeping showed substantial non-adherence to AAP guidelines, suggesting further needs for improvement to promote safe infant sleep practices.

Setting: Single maternity ward, Penn State Milton S. Hershey Medical Center

Population of Focus: Mothers and their term newborns

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Carlin A, Murphy MH, Nevill A, Gallagher AM. Effects of a peer-led Walking In ScHools intervention (the WISH study) on physical activity levels of adolescent girls: A cluster randomised pilot study. Trials. 2018 Jan 11;19(1):31.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL Peer-led Curricular Activities/Training Extra-Curricular Activities

Intervention Description: Female participants, aged 11-13 years, were recruited from six post-primary schools in Northern Ireland. Participants were randomized by school (cluster) to participate in regular 10-15-min peer-led brisk walks throughout the school week (the WISH study) (n = 101, two schools) or to continue with their usual PA (n = 98, four schools). The primary outcome measure was school-time PA post intervention (week 12), assessed objectively using an Actigraph accelerometer. Secondary outcome measures included anthropometry, cardiorespiratory fitness and psychosocial measures. Changes in PA data between baseline (T0) and end of intervention (week 12) (T1) were analysed using a mixed between-within subjects analysis of variance with one between (group) and one within (time) subjects factor, with two levels.

Intervention Results: Of 199 participants recruited (mean age = 12.4 ± 0.6 years, 27% overweight/obese), 187 had valid accelerometer data for inclusion in subsequent analysis. A significant interaction effect was observed for changes in light intensity PA across the school day (p = 0.003), with those in the intervention increasing their light intensity PA by 8.27 mins/day compared with a decrease of 2.14 mins/day in the control group. No significant interactions were observed for the other PA measures across the intervention. Intervention effects on school-time PA were not sustained four months post intervention.

Conclusion: The intervention increased daily light intensity PA behaviour in these adolescent girls but did not change moderate to vigorous physical activity (MVPA). These findings suggest that a school-based brisk walking intervention may be feasible and can change PA behaviour in the short term, but it is possible that the self-selected walking speeds determined by a peer-leader may not be sufficient to reach MVPA in this age group. Further research is needed to evaluate the potential of school-based brisk walking to contribute to MVPA in adolescent girls.

Study Design: Cluster RCT

Setting: 6 post-primary schools in Northern Ireland

Population of Focus: Girls in participating schools without medical conditions that would limit their participation

Data Source: Accelerometers, BMI, Queens College Step Test (cardiovascular fitness), selfefficacy for PA questionnaire

Sample Size: 6 schools: 101 female students from 2 schools (intervention), 98 female students in 4 schools (control)

Age Range: Ages 11-13

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Carrow, J. N., Vladescu, J. C., Reeve, S. A., & Kisamore, A. N. (2020). Back to sleep: Teaching adults to arrange safe infant sleep environments. Journal of applied behavior analysis, 53(3), 1321–1336. https://doi.org/10.1002/jaba.681

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): PROFESSIONAL_CAREGIVER Education/Training (caregiver) Educational Material (caregiver)

Intervention Description: This study evaluated the effectiveness of behavioral skills training (BTS) to teach safe infant sleep practices to “typically developing adults.” The BTS included instruction, modeling of safe sleep practices, rehearsal, and feedback. Prior to the training, participants received a folder with pamphlets, including one on safe sleep, found through the NJ Department of Health. The study included an evaluation of participant responses to both safe and unsafe infant sleeping practices before, during, and after training.

Intervention Results: BST significantly improved appropriate arrangement of a safe sleep environment for infants for all 8 participants.

Conclusion: Replications are necessary to demonstrate effective BST procedures under the most relevant circumstances, which could result in manualized trainings used to teach healthcare personnel and parents across a number of training sites (e.g., hospitals, private clinics, public support programs). Perhaps discharge policies could include safe arrangement of an infant sleep environment similar to requiring an appropriate car seat for a newborn prior to discharge.

Setting: Private suburban university

Population of Focus: College students

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Casañas, R., Castellvi, P., Gil, J.J. et al. The effectiveness of a “EspaiJove.net”- a school-based intervention programme in increasing mental health knowledge, help seeking and reducing stigma attitudes in the adolescent population: a cluster randomised controlled trial. BMC Public Health 22, 2425 (2022). https://doi.org/10.1186/s12889-022-14662-4

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Support/Counseling/Remediation Teacher/Staff Training Education on Disease/Condition

Intervention Description: We compared three interventions of different durations (Sensitivity Programme (SP), MHL programme and MHL + SR programme) of the EspaiJove.net programme.

Intervention Results: Although a trend of increasing knowledge was found in both parts of the questionnaire in the MHL and MHL + SR groups post-intervention and at 12-month follow-up, in comparison with the SP and the CG, no significant differences were found between groups (SP, MHL and MHL + SR) over time in either of the two parts.

Conclusion: The three interventions of the EspaiJove.net programme (SP, MHL and MHL + SR) seem not to be effective in terms MHL, Stigma and help-seeking behaviours in the short (post-intervention) and long term (6 and 12 months follow up).

Study Design: Cluster randomized controlled trial

Setting: 18 secondary schools in Barcelona, Spain

Population of Focus: 13-14 year old students

Sample Size: 1,032 students

Age Range: 13-14 years old

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Cattaneo A, Bettinelli M, Chapin E, et al. Effectiveness of the Baby Friendly Community Initiative in Italy: a non-randomised controlled study. BMJ Open. 2016;6(5).

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE Hospital Policies POPULATION-BASED SYSTEMS COMMUNITY Community Health Services Policy Provider Training/Education

Intervention Description: To assess the effectiveness of the Baby Friendly Community Initiative (BFCI) on exclusive breast feeding at 6 months.

Intervention Results: The crude rates of exclusive breast feeding at discharge, 3 and 6 months, and of any breast feeding at 6 and 12 months increased at each round of data collection after baseline in the early and late intervention groups. At the end of the project, 10% of infants were exclusively breast fed at 6 months and 38% were continuing to breast feed at 12 months. However, the comparison by adjusted rates and logistic regression failed to show statistically significant differences between groups and rounds of data collection in the intention-to-treat analysis, as well as when compliance with the intervention and training coverage was taken into account.

Conclusion: The study failed to demonstrate an effect of the BFCI on the rates of breast feeding. This may be due, among other factors, to the time needed to observe an effect on breast feeding following this complex intervention.

Study Design: QE: pretest-posttest time-lagged nonequivalent control group

Setting: 18 Local Health Authorities (LHAs) in 9 regions of Italy

Population of Focus: Women living in the area covered by LHA, with infants > 2000g, who spoke Italian, English, French, or Spanish (or who had a relative who spoke these languages), and without a postpartum condition that required admission to the NICU

Data Source: Mother self-report

Sample Size: Early Intervention Group5 • Enrolled (n=2846) • 12-month follow-up (n=2474) Late Intervention Group • Enrolled (n=2248) • 12-month follow-up (n=1931)

Age Range: Not specified

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Cattaneo A, Buzzetti R. Effect on rates of breast feeding of training for the baby friendly hospital initiative. BMJ. 2001;323(7325):1358-1362.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE Hospital Policies Baby Friendly Hospital Initiative Provider Training/Education

Intervention Description: Breastfeeding rates and related hospital practices need improvement in Italy and elsewhere.

Intervention Results: No statistically significant differences in both groups, before and after training, of exclusive breastfeeding at 6 months

Conclusion: Training for at least three days with a course including practical sessions and counselling skills is effective in changing hospital practices, knowledge of health workers, and breastfeeding rates.

Study Design: QE: pretest-posttest time-lagged nonequivalent control group

Setting: 8 hospitals (3 general hospitals and 1 teaching hospital in southern Italy, 3 general hospitals and 1 teaching hospital in central and northern Italy)

Population of Focus: Women with healthy infants > 2000g

Data Source: Mother self-report

Sample Size: Group 1 • Phase 1 (n=529) • Phase 2 (n=515) • Phase 3 (n=516) Group 2 • Phase 1 (n=483) • Phase 2 (n=342) • Phase 3 (n=284)

Age Range: Not specified

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Caudillo, M. L., Hurtado-Acuna, C., Rendall, M. S., & Boudreaux, M. (2022). Association of the Delaware Contraceptive Access Now Initiative with Postpartum LARC Use. Maternal and child health journal, 26(8), 1657–1666. https://doi.org/10.1007/s10995-022-03433-2

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Medicaid Reform Provider Training/Education Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: We estimate the association of the Delaware Contraceptive Access Now (DelCAN) initiative with use of postpartum Long-Acting Reversible Contraception (LARC). DelCAN included Medicaid payment reform for immediate postpartum LARC use, provider training and technical assistance in LARC provision, and a public awareness campaign.

Intervention Results: Relative to the comparison states, postpartum LARC use in Delaware increased by 5.26 percentage points (95% CI 2.90-7.61, P < 0.001) during the 2015-2017 DelCAN implementation period. This increase was the largest among Medicaid-covered women, and grew over the first three implementation years. By the third year of the DelCAN initiative (2017), the relative increase in postpartum LARC use for Medicaid women exceeded that for non-Medicaid women by 7.24 percentage points (95% CI 0.12-14.37, P = 0.046).

Conclusion: The DelCAN initiative was associated with increased LARC use among postpartum women in Delaware. During the first 3 years of the initiative, LARC use increased progressively and to a greater extent among Medicaid-enrolled women. Comprehensive initiatives that combine Medicaid payment reforms, provider training, free contraceptive services, and public awareness efforts may reduce unmet demand for highly effective contraceptives in the postpartum months.

Study Design: Difference in differences design

Setting: Delaware (statewide compared to 15 other states)

Sample Size: 4815 women in Delaware; 88470 women in 15 comparison states

Age Range: 15-50

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Chahin S, Damashek A, Ospina F, Dickson C. Evaluation of a Safe Sleep Training for Home Visitors and Their Clients. J Clin Psychol Med Settings. 2022 Sep;29(3):477-488. doi: 10.1007/s10880-021-09811-2. Epub 2021 Aug 11. PMID: 34378161.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education Home Visit (caregiver) PROFESSIONAL_CAREGIVER HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: This study evaluated the efficacy of a program to train home visitors to talk to clients about infant safe sleep using Motivational Interviewing and cultural sensitivity.

Intervention Results: Home visitors showed significant improvement in MI skill use and cultural sensitivity from pre- to post-test. Regarding client outcomes, our results indicate a significant group by time interaction when predicting changes in client knowledge such that the treatment group showed larger gains than the control group. There were no significant differences between groups when predicting changes in client attitudes or behavior.

Conclusion: MI may be an effective technique for home visitors to help increase families' safe sleep knowledge. Additional research is needed to examine whether such training can translate to changes in families' safe sleep behavior.

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Chahin, S., Damashek, A., Ospina, F., & Dickson, C. (2021). Evaluation of a Safe Sleep Training for Home Visitors and Their Clients. Journal of clinical psychology in medical settings, 10.1007/s10880-021-09811-2. Advance online publication. https://doi.org/10.1007/s10880-021-09811-2

Evidence Rating: Mixed

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE Provider Training/Education PROFESSIONAL_CAREGIVER Education/Training (caregiver) Home Visit (caregiver)

Intervention Description: This study evaluated the efficacy of a program to train home visitors to talk to clients about infant safe sleep using Motivational Interviewing and cultural sensitivity. Conducted as part of the initiative by Cradle Kalamazoo initiative to decrease racial disparities in infant mortality, home visitors attended a 2-day training that incorporated MI skills, cultural sensitivity, and safe sleep information. The MI training was conducted by a licensed Ph.D.-level psychologist as well as a second-year doctoral student in clinical psychology with 1 year of experience conducting clinical work. Home visitor outcomes were assessed using a pre-post design that included self reporting (based on a 16-question safe sleep knowledge questionnaire) and an observational rating by a paid “community mother.” When assessing client outcomes, a quasi-experimental design was used to examine changes in knowledge, attitudes, and safe sleep practices (Fig. 1). The home visitors administered the safe sleep survey to two different groups. The intervention group included 31 clients of home visitors who completed the training. The control group included 44 clients of home visitors who had not completed the training.

Intervention Results: Home visitors showed significant improvement in MI skill use and cultural sensitivity from pre- to post-test. Regarding client outcomes, our results indicate a significant group by time interaction when predicting changes in client knowledge such that the treatment group showed larger gains than the control group. There were no significant differences between groups when predicting changes in client attitudes or behavior.

Conclusion: MI may be an effective technique for home visitors to help increase families' safe sleep knowledge. Additional research is needed to examine whether such training can translate to changes in families' safe sleep behavior.

Setting: Cradle Kalamazoo initiative in Kalamazoo, Michigan

Population of Focus: Home visitors and their clients

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Chaux E, Velásquez AM, Schultze‐Krumbholz A, Scheithauer H. Effects of the cyberbullying prevention program media heroes (medienhelden) on traditional bullying. Aggress Behav. 2016;42(2):157-165.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY Presentation/Meeting/Information Session/Event CLASSROOM Adult-led Curricular Activities/Training

Intervention Description: The main goal of the current study was to analyze the spillover effects of the cyberbullying prevention program Media Heroes (Medienhelden) on traditional bullying.

Intervention Results: Media Heroes was found to reduce traditional bullying. Effects were larger for the long-version of the program than for the short 1-day version. No effects were found on victimization by either cyberbullying or traditional bullying.

Conclusion: Strategies to complement traditional and cyberbullying prevention efforts are discussed.

Study Design: Cluster RCT: pretest-posttest

Setting: Germany

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=1075) Analysis sample (n=722) Long-Intervention (n=12 classes); Short-Intervention (n=7 classes); Control (n=16 classes) Cyberbullying (n=709); Traditional Bullying (n=709); Cybervictimization (n=714); Traditional Victimization (n=718)

Age Range: 11/17/2022

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Chen YT, Hsiao FH, Lee CM, Wang RH, Chen PL. Effects of a parent-child interactive program for families on reducing the exposure of school-aged children to household smoking. Nicotine & Tobacco Research 2016;18(3):330–40.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER Group Education Telephone Support Educational Material CAREGIVER Education/Training (caregiver) Educational Material (caregiver)

Intervention Description: This study examined the effects of a parent–child interactive program on reducing children’s exposure to ETS at home and enhancing parents’ and children’s prevention strategies.

Intervention Results: The percentage of children with urine cotinine levels greater than or equal to 6ng/ml was significantly lower in the intervention group than it was in the control group at both the 8-week and 6-month assessments. The intervention significantly reduced parental smoking in the presence of children and increased parents’ prevention of children’s ETS exposure and children’s ETS avoidance behavior from the baseline to the 20-week assessment.

Conclusion: This is a preliminary study design aimed at creating a program for reducing children’s ETS exposure at home. Further research to produce evidence supporting the application of the parent–child interactive program in primary schools is suggested. The theoretical basis of the intervention design can serve as a reference for nursing education and the design of health education programs.

Study Design: Single-blind, two-group, repeated-measures clustered randomized controlled trial design

Setting: Community (schools)

Population of Focus: School-aged children’s reduction of SHSe

Data Source: Elementary schools were the unit of assignment

Sample Size: 75 parent and child dyads in 6 elementary schools (grades 3 to 6)

Age Range: Not specified

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Cheon, S. H., Reeve, J., Marsh, H. W., & Jang, H. R. (2023). Cluster randomized control trial to reduce peer victimization: An autonomy-supportive teaching intervention changes the classroom ethos to support defending bystanders. American Psychologist.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Teacher/Staff Training CLASSROOM_SCHOOL

Intervention Description: We capitalized on recent methodological advances and integrated self-determination theory with a social-ecological perspective.

Intervention Results: A doubly latent multilevel structural equation model with follow-up mediation tests showed that experimental-group teachers created a substantially more supportive classroom climate, leading student bystanders to embrace the defender role. This classroom-wide (L2) emergence of pro-victim peer bystanders led to sharply reduced victimization (effect size = -.40). Unlike largely unsuccessful past interventions that focused mainly on individual students, our randomized control trial intervention substantially reduced bullying and victimization.

Conclusion: Focusing on individual students is likely to be ineffective (even counterproductive) without first changing the normative climate that reinforces bullying. Accordingly, our intervention focused on the classroom teacher. In the classrooms of these teachers, bystanders supported the victims because the classroom climate supported the bystanders.

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Chödrön, G., Barger, B., Pizur-Barnekow, K., Viehweg, S., & Puk-Ament, A. (2021). "Watch Me!" Training Increases Knowledge and Impacts Attitudes Related to Developmental Monitoring and Referral Among Childcare Providers. Maternal and child health journal, 25(6), 980–990. https://doi.org/10.1007/s10995-020-03097-w

Evidence Rating: Emerging

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

Intervention Description: The intervention in the study was the "Watch Me!" training program, which aimed to increase childcare providers' knowledge and impact attitudes related to developmental monitoring and referral practices. The "Watch Me!" training program is designed to provide childcare providers with the necessary knowledge and tools to conduct developmental monitoring and make recommended referrals when there is a concern about a child's development. The training program covers five key components of developmental monitoring, including tracking development, recognizing delays, talking to parents about development, talking to parents about concerns, and making referrals. The program is designed to equip childcare providers with the knowledge and skills to effectively carry out these components of developmental monitoring and referral practices. The training program utilizes web-based surveys to assess the impact of the training on knowledge and attitudes related to developmental monitoring and referral practices. It also includes pretest-posttest design to evaluate the effectiveness of the training program in improving childcare providers' knowledge and attitudes. Overall, the "Watch Me!" training program is designed to increase awareness, knowledge, and skills among childcare providers to support early identification and intervention for children with developmental concerns.

Intervention Results: Childcare providers demonstrated a significant pre-post increase in perceived knowledge and access to the tools to engage in five core components of developmental monitoring after completing "Watch Me!" training. There was also a significant pre-post increase in childcare providers' ability to list the child's doctor as an appropriate referral (39 pre-63% post), but not in the ability to list Part C/Part B programs as an appropriate referral (56 pre-58% post). CONCLUSIONS FOR PRACTICE: "Watch Me!" training may be effective at impacting targeted areas of knowledge and attitude about developmental monitoring among childcare providers in the short term.

Conclusion: Yes, the study found statistically significant findings related to the impact of the "Watch Me!" training program on childcare providers' knowledge and attitudes related to developmental monitoring and referral practices. The study found that completing the training program had a significant immediate impact on childcare providers' perception that they had the knowledge and could access tools needed to carry out the five components of developmental monitoring, including tracking development, recognizing developmental delays, talking to parents about development, talking to parents about developmental concerns, and making referrals when there was a concern about a child's development. The study also found that there was a significant pre-post increase in childcare providers' ability to list the child's doctor as an appropriate referral when there was a concern about their development. However, there was no significant pre-post increase in the ability to list Part C/Part B programs as an appropriate referral. Overall, the study suggests that the "Watch Me!" training program may be effective at impacting targeted areas of knowledge and attitude about developmental monitoring among childcare providers in the short term.

Study Design: The study design used in this research is a pretest-posttest design. The study aimed to evaluate the impact of the "Watch Me!" training program on childcare providers' knowledge and attitudes related to developmental monitoring and referral practices. The participants completed a web-based pretest before the training program and a web-based posttest after completing the training program. The study used a purposeful sampling strategy to recruit childcare programs for program-wide implementation to ensure participation of programs representing the following predetermined important criteria: geographic diversity, center- and home-based, regulated and unregulated, national accreditation status, and QRIS participation and rating level. The data collected from the pretest and posttest were analyzed using generalized linear mixed models.

Setting: The study was conducted in childcare settings, specifically targeting childcare providers. The "Watch Me!" training program was implemented to assess its impact on childcare providers' knowledge and attitudes related to developmental monitoring and referral practices. The participants in the study were childcare providers who completed the "Watch Me!" training program, and the data collection involved web-based surveys to evaluate the impact of the training on the participants' knowledge and attitudes. The study aimed to assess the effectiveness of the training program in increasing knowledge and changing attitudes related to developmental monitoring and referral practices among childcare providers. Therefore, the setting for the study was within the context of childcare facilities and providers who play a crucial role in early childhood development and care.

Population of Focus: The target audience for the study is childcare providers who work in childcare settings. The study aimed to evaluate the impact of the "Watch Me!" training program on childcare providers' knowledge and attitudes related to developmental monitoring and referral practices. The participants in the study were childcare providers who completed the "Watch Me!" training program, and the data collection involved web-based surveys to evaluate the impact of the training on the participants' knowledge and attitudes. The study's findings suggest that the "Watch Me!" training program may be effective at impacting targeted areas of knowledge and attitude about developmental monitoring among childcare providers in the short term. Therefore, the study's target audience is childcare providers who play a crucial role in early childhood development and care and can benefit from the "Watch Me!" training program to improve their knowledge and attitudes related to developmental monitoring and referral practices.

Sample Size: The sample size for the study was 127 childcare providers who completed the "Watch Me!" training program and participated in the web-based surveys to evaluate the impact of the training on their knowledge and attitudes related to developmental monitoring and referral practices. The participants were from various types of childcare programs, including Head Start/Early Head Start, regulated centers, regulated homes, unregulated centers, and other/unknown programs. The study used a pretest-posttest design to assess the impact of the training program on the participants' knowledge and attitudes, and the data were analyzed using generalized linear mixed models.

Age Range: The study did not focus on a specific age range of children. Instead, the study aimed to evaluate the impact of the "Watch Me!" training program on childcare providers' knowledge and attitudes related to developmental monitoring and referral practices. The training program focuses on five key components of developmental monitoring, including tracking development, recognizing delays, talking to parents about development, talking to parents about concerns, and making referrals. These components are relevant for children of all ages, from infancy to early childhood. Therefore, the study's findings are applicable to childcare providers who work with children of all ages and can benefit from the "Watch Me!" training program to improve their knowledge and attitudes related to developmental monitoring and referral practices.

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Chokshi, B., Chen, K. D., & Beers, L. (2020). Interactive Case-Based Childhood Adversity and Trauma-Informed Care Electronic Modules for Pediatric Primary Care. MedEdPORTAL : the journal of teaching and learning resources, 16, 10990. https://doi.org/10.15766/mep_2374-8265.10990

Evidence Rating: Moderate

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

Intervention Description: Training health professionals for the skills and capacity to respond adequately to children and adults who have been exposed to adverse childhood experiences is recognized as an essential need in health care. Accessible opportunities to educate physicians and physician-trainees are limited. Four computer-based e-modules were created focusing on addressing childhood adversity and implementing trauma-informed care in the pediatric primary care setting. These childhood adversity and trauma-informed care (CA-TIC) e-modules were designed as an individualized, self-directed experience to allow for distance learning with flexibility to be embedded into existing coursework. To foster an engaging learning environment, we narrated the modules, prioritized images, and included the opportunity for participant interaction via multiple-choice and short-answer questions. Twenty-eight pediatric residents, two medical students, four attending physicians, and one fellow at Children's National Hospital completed the e-modules.

Intervention Results: Overall, participants rated the CA-TIC e-modules 4.6 (SD = 0.5) out of 5 for design and quality. Using paired t tests and Wilcoxon signed rank tests, we found statistically significant score increases from presession to postsession for participants' knowledge, attitudes, practice, and confidence related to CA-TIC. The most commonly cited learning points and practice changes included asking about trauma in practice and the seven C's of resilience.

Conclusion: A trauma-informed, strengths-based approach to care can assist health care providers in mitigating the link between adversity and related poor health outcomes. The CA-TIC e-modules provide an opportunity to train health professionals using an innovative, self-directed, and low-resource mechanism.

Study Design: Pre-post study

Setting: Pediatric primary care practices in connection with Children’s National Hospital

Population of Focus: Pediatric health care providers (pediatric residents, medical students, attending physicians, and fellows)

Sample Size: 35 pediatric health care providers 28 pediatric residents, 2 medical students, 4 attending physicians, and 1 fellow

Age Range: Adults who take care of pediatric populations

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Cinko, C., Thrasher, A., Sawyer, C., Kramer, K., West, S., & Harris, E. (2023). Using the Project ECHO Model to Increase Pediatric Primary Care Provider Confidence to Independently Treat Adolescent Depression. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 47(4), 360–367. https://doi.org/10.1007/s40596-023-01800-x

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement/Practice-Wide Intervention Provider Training/Education

Intervention Description: The model for the Extension for Community Healthcare Outcomes (Project ECHO®) was used to extend specialist support to the pediatric medical home for the treatment of adolescent depression by taking a comprehensive, disease-specific approach. Child and adolescent psychiatrists constructed a course to train community pediatric primary care providers (PCPs) to screen patients for depression, initiate evidence-based interventions, and provide ongoing management. Participants were assessed for changes in clinical knowledge and self-efficacy. Secondary measures included self-reported practice change and emergency department (ED) mental health referrals 12 months pre- and post-course completion.

Intervention Results: Sixteen out of 18 participants in cohort 1 and 21 out of 23 participants in cohort 2 completed the pre- and post-assessments. Clinical knowledge and self-efficacy showed statistically significant improvement pre- and post-course completion. ED mental health referrals from participant PCPs decreased by 34% (cohort 1) and 17% (cohort 2) after course completion.

Conclusion: These findings indicate that utilizing the Project ECHO format to provide subspecialist support and education on the treatment of depression can improve pediatric PCPs' clinical knowledge and confidence in their ability to independently treat depression. Secondary measures suggest that this can translate into practice change and improved treatment access with decreased ED referrals for mental health assessments by participant PCPs. Future directions include more robust outcomes measurement and developing more courses with an in-depth approach to a single or similar cluster of mental health diagnoses such as anxiety disorders.

Study Design: Pre-post study

Setting: Pediatric primary care offices connected to a large midwestern academic children's hospital

Population of Focus: Pediatric primary care providers, including medical doctors, nurse practitioners, and other healthcare professionals working in pediatric primary care settings

Sample Size: 41 providers

Age Range: Primary care providers serving pediatrics patients 0-17

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Clevesy, M. A., Gatlin, T. K., Cheese, C., & Strebel, K. (2019). A project to improve postpartum depression screening practices among providers in a community women’s health care clinic. Nursing for women's health, 23(1), 21-30.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Training (Parent/Family) EMR Reminder Technology-Based Support

Intervention Description: The intervention described in the document aligns with a discernible strategy. The specific intervention involved a comprehensive educational in-service for the providers at the clinic, which included an overview of the significance of postpartum depression (PPD), the consequences associated with PPD among women and their children, instruction and directions regarding how to use the Edinburgh Postnatal Depression Scale (EPDS) screening tool, and how to document PPD screening in the electronic health record (EHR) system . This intervention aligns with a strategy of education and training to improve providers' knowledge and skills in PPD screening and documentation. Additionally, the implementation of the EPDS dialog box with a flag in the EHR system was part of the intervention, which aimed to facilitate standardized screening and documentation practices . This aligns with a strategy of integrating technology and standardized tools into clinical practice to improve screening and documentation processes. The study described in the document does analyze a multicomponent intervention. The intervention included multiple components such as the educational in-service, development of the EPDS dialog box in the EHR system, and provider follow-up. The study involved pre- and post-education questionnaire results, electronic health record chart reviews, and data analysis to assess the impact of the multicomponent intervention on PPD screening practices.

Intervention Results: The study found that PPD screening documentation rates increased from 56% to 92.7% after the intervention, indicating a significant improvement in PPD screening rates. Of the 124 electronic health record (EHR) charts audited after the project intervention, 115 charts had documentation of EPDS screening, demonstrating a substantial increase in provider-documented screening rates with the implementation of the EPDS tool . The data analysis showed a significant improvement in PPD screening rates from 56% before the project to 92.7% after the project intervention . The project outcomes identified greatly improved provider self-reported knowledge of the Affordable Care Act (ACA) preventive PPD perinatal care services . These results indicate that the multicomponent intervention, including education, training, and the implementation of the EPDS tool in the EHR system, had a significant positive impact on PPD screening practices among providers in the community women's health care clinic.

Conclusion: PPD screening education for health care providers and the addition of EPDS criteria to the electronic health record were associated with increased screening rates for PPD at a community women’s health care clinic.

Study Design: The study design/type used in the project to improve postpartum depression (PPD) screening practices among providers in the community women's health care clinic is a quasi-experimental study. The study used a pre- and post-intervention design to evaluate the impact of the multicomponent intervention on PPD screening practices and providers' knowledge in the community women's health care clinic. The study involved pre- and post-education questionnaire results, electronic health record chart reviews, and data analysis to assess the impact of the intervention on PPD screening practices , . However, the study did not include a control group, which is a characteristic of a true experimental study design. Therefore, the study design/type used in this project is a quasi-experimental study.

Setting: The setting for the study was a local community women's health care clinic located in the southwestern United States. The clinic primarily served minority women of lower socioeconomic status, including Hispanic and African American women, and those who were uninsured. The clinic provided care for postpartum women and was the focus of the project to improve postpartum depression (PPD) screening practices among healthcare providers. The clinic also served as a teaching setting for obstetrician-gynecologists, family practice medical residents, medical students, and nurse practitioner students. The average birth rates per physician in the clinic ranged from 40 to 45 births per month

Population of Focus: The target audience for the study is healthcare providers, specifically obstetrician-gynecologists and advanced practice registered nurses, who provide care to postpartum women in a community women's health care clinic. The study aimed to improve the PPD screening practices among healthcare providers in the clinic by implementing a standardized screening tool and providing education and training on preventive PPD screening practices and documentation recommendations . The study's findings and recommendations are relevant to healthcare providers who care for postpartum women and can be applied in various healthcare settings to improve PPD screening practices and outcomes. Additionally, the study's findings may be of interest to healthcare administrators, policymakers, and researchers who are interested in improving maternal mental health outcomes and reducing the burden of PPD.

Sample Size: The project involved the audit of 125 electronic health record (EHR) charts to assess the pre-intervention PPD screening rates . Additionally, after the project intervention, data were collected from 124 EHR charts over a 3-month period to evaluate the impact of the intervention on PPD screening practices . Therefore, the sample size for the EHR chart audits was 125 before the intervention and 124 after the intervention.

Age Range: The age range of the study was not explicitly mentioned in the provided document. Therefore, I cannot provide specific information regarding the age range of the participants in this study. If you have access to the original document, I would recommend checking the full text for any additional details on the age range of the participants.

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Coffman, M. J., Scott, V. C., Schuch, C., Mele, C., Mayfield, C., Balasubramanian, V., ... & Dulin, M. (2020). Postpartum depression screening and referrals in special supplemental nutrition program for women, infants, and children clinics. Journal of Obstetric, Gynecologic & Neonatal Nursing, 49(1), 27-40.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Training Screening Tool Implementation

Intervention Description: The intervention described in the article is the implementation of PPD screening using the two-item Patient Health Questionnaire (PHQ-2) followed by the nine-item PHQ (PHQ-9) and the Edinburgh Postnatal Depression Scale for those who scored 2 or greater on the PHQ-2. Participants who scored 10 or greater on the PHQ-9 or Edinburgh Postnatal Depression Scale were referred for case management services.

Intervention Results: The study found that participants with no health insurance and limited support in caring for their infants were more likely to report symptoms of PPD. Overall, 302 women were screened for PPD, indicating the feasibility of PPD screening in WIC clinics. Of the 19 participants referred to case management, 47% (n = 9) accessed care. The results of focus groups illuminated barriers to screening and treatment programs for women at the individual, local, and macrosystem levels. The study concludes that while PPD screening in WIC clinics is feasible, some participants did not receive mental health services after referral because of various barriers, which highlights the need to integrate mental health providers into WIC clinics

Conclusion: Our findings show the feasibility of PPD screening in WIC clinics. However, some participants did not receive mental health services after referral because of various barriers, which highlights the need to integrate mental health providers into WIC clinics.

Study Design: The study design is a descriptive, cross-sectional study followed by a process evaluation

Setting: The study was conducted in Charlotte, North Carolina, in two Mecklenburg County Public Health WIC clinics

Population of Focus: The target audience for the study is women older than 18 years with infants younger than 12 months who were visiting WIC clinics, as well as case managers, nutritionists, advisory board members, and students who served as research assistants

Sample Size: The initial sample size was 302 women older than 18 years with infants younger than 12 months who were visiting WIC clinics, and the second group included case managers, nutritionists, advisory board members, and students who served as research assistants (n = 31)

Age Range: The age group of the participants is women older than 18 years with infants younger than 12 months who were visiting WIC clinics

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Cole, J. W., Chen, A. M. H., McGuire, K., Berman, S., Gardner, J., & Teegala, Y. (2022). Motivational interviewing and vaccine acceptance in children: The MOTIVE study. Vaccine Volume 40, Issue 12, 15 March 2022, Pages 1846-1854 [Childhood Vaccination NPM]

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education Technology-Based Support

Intervention Description: The intervention involved an educational intervention for providers and the integration of an MI-based communication tool called MOTIVE (MOtivational Interviewing Tool to Improve Vaccine AcceptancE)

Intervention Results: Statistically significant differences were observed between the groups for age and ethnicity, with a larger proportion of younger age groups and more patients of Hispanic/Latino ethnicity in the intervention period

Conclusion: Use of an MI-based communication tool may decrease vaccine refusals and improve childhood vaccination coverage rates, particularly for IIV.

Study Design: The study utilized a pre-post intervention design, with data collected retrospectively from the electronic health record (EHR) during two time periods: a baseline period and an intervention perio

Setting: the Rocking Horse Community Health Center (RHCHC) in the United States

Population of Focus: Children aged 0–6 years and their parents or guardians

Sample Size: A total of 2504 patients were included in the baseline period, and 1954 patients were included in the intervention period

Age Range: Children aged 0–6 years

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Cole, M. B., Qin, Q., Sheldrick, R. C., Morley, D. S., & Bair-Merritt, M. H. (2019). The effects of integrating behavioral health into primary care for low-income children. Health services research, 54(6), 1203–1213. https://doi.org/10.1111/1475-6773.13230

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education Quality Improvement/Practice-Wide Intervention Patient-Centered Medical Home

Intervention Description: To evaluate the impact of TEAM UP-an initiative that fully integrates behavioral health services into pediatric primary care in three Boston-area Community Health Centers (CHCs)-on health care utilization and costs.

Intervention Results: After 1.5 years, TEAM UP was associated with a relative increase in the rate of primary care visits (IRR = 1.15, 95% CI 1.04-1.27, or 115 additional visits/1000 patients/quarter), driven by children with a MH diagnosis at baseline. There was no significant change in avoidable health care utilization or cost.

Conclusion: Expanding the TEAM UP behavioral health integration model to other sites has the potential to improve primary care engagement in low-income children with MH needs.

Study Design: Difference in difference approach

Setting: Three Boston-area pediatric medical home community health center (CHC) sites that serve low-income and demographically diverse patient populations.

Population of Focus: Children age 17 and younger with Medicaid coverage, who were enrolled in BMC HealthNet, and who had a PCP visit within the last 18 months

Sample Size: 2,616 children

Age Range: Children ages 17 and younger

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Collins BN, Lepore SJ, Winickoff JP, Nair US, Moughan B, Bryant-Stephens T, Davey A, Taylor D, Fleece D, Godfrey M. (2018). An Office-Initiated Multilevel Intervention for Tobacco Smoke Exposure: A Randomized Trial. Pediatrics. 2018 Jan;141(Suppl 1):S75-S86. doi: 10.1542/peds.2017-1026K

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE Provider Training/Education HOSPITAL Continuing Education of Hospital Providers Policy/Guideline (Hospital) Educational Material (Provider) Guideline Change and Implementation

Intervention Description: We hypothesized that a pragmatic, multilevel treatment model including (ask, advise, refer [AAR]) coupled with individualized, telephone-based behavioral counseling promoting child tobacco smoke exposure (TSE) reduction would demonstrate greater child TSE reduction than would standard AAR.

Intervention Results: Complete case analysis demonstrated that compared with control parents (29.9%), significantly more parents in the experimental condition (45.8%) eliminated their children’s exposure to all sources of tobacco smoke both inside and outside their homes at 3-month follow-up. In addition, more parents in AAR/counseling than in AAR/attention control eliminated all sources of TSE (45.8% vs. 29.9%) and quit smoking (28.2% vs. 8.2%).

Conclusion: The results indicate that the integration of clinic- and individual-level smoking interventions produces improved TSE and cessation outcomes relative to standalone clinic AAR intervention. Moreover, this study was among the first in which researchers demonstrated success in embedding AAR decision aids into electronic health records and seamlessly facilitated TSE intervention into routine clinic practice.

Study Design: RCT

Setting: Community (home)

Population of Focus: Tobacco-smoking parents living in low-income, urban communities with children <11 years old exposed daily to tobacco smoke in the home. Additional inclusion criteria: daily smoker, >17 years old, and speaking English

Data Source: Structured telephone interviews for baseline data collection and 3-month follow-up.

Sample Size: 334 providers. 327 participants (n=163 AAR and counseling, n=164 AAR and control)

Age Range: Not specified

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Colson ER, Joslin SC. Changing nursery practice gets inner-city infants in the supine position for sleep. Arch Pediatr Adolesc Med. 2002;156(7):717-720.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE Provider Training/Education

Intervention Description: To determine whether an educational intervention to change nursery practice would result in more inner-city parents placing their infants in the supine position for sleep.

Intervention Results: Infant observations showed that 20% and 99% of the infants in the well-newborn nursery were placed in the supine position before and after the intervention respectively (p<0.05). Parents reported that 37% and 88% of nursery staff exclusively placed infants to sleep in the supine position before and after the intervention respectively (OR=12.5, 95% CI: 5.7-27.7). Parent report showed that 42% and 75% of parents usually placed infants to sleep in the supine position at home before and after the intervention respectively (OR=4.2, 95% CI: 2.1-7.9).

Conclusion: After an educational intervention to change practice in a well-newborn nursery, many more parents reported placing their infants in the supine position for sleep,

Study Design: QE: pretest-posttest

Setting: Yale-New Haven Hospital (New Haven, CT); Pediatric Primary Care center of the Yale-New Haven Hospital

Population of Focus: Infants in the well-newborn nursery during the postpartum stay; Parents of infants at the infants’ 2-week health supervision visit

Data Source: Infant observation and Parent report

Sample Size: Baseline (n=100) Follow-up (n=100)

Age Range: Not specified

Access Abstract

Connolly J, Josephson W, Schnoll J, et al. Evaluation of a youth-led program for preventing bullying, sexual harassment, and dating aggression in middle schools. J Early Adolesc. 2014:0272431614535090.

Evidence Rating: Evidence Against

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM Peer-led Curricular Activities/Training

Intervention Description: A YLP to reduce bullying, sexual harassment, and dating aggression was compared experimentally with the board-mandated usual practice (UP).

Intervention Results: Significant improvements were found in knowledge and attitudes in both programs. Students receiving the YLP showed significant reductions in anxiety and maintained their school connectedness (all ps < .05).

Conclusion: The results suggest that youth-led prevention is an effective approach for tackling peer aggression in school settings.

Study Design: Cluster RCT: pretest-posttest

Setting: Canada

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Pretest (N=509): Intervention (n=209); Control (n=300) Posttest (N=447): Intervention (n=183); Control (n=264) Analysis: Intervention (n=183 complete data; n=209 FIML); Control (n=264 complete data; n=300 FIML)

Age Range: 11/14/2022

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Conover, N., Vanderpool, J., Ginsberg, J., Kawan, M., & Spatz, D. L. (2022). Establishing a Breastfeeding Consortium for Clinicians in Pediatric Outpatient Care. MCN: The American Journal of Maternal/Child Nursing, 10-1097.

Evidence Rating: Emerging

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

Intervention Description: To increase consistency of breastfeeding care and interventions across a large primary care network, we established an Ambulatory Breastfeeding Consortium (ABC) focused on information sharing and discussion centered on care of breastfeeding and lactating families.

Intervention Results: The ABC has been effective in engaging primary care nurses and other clinicians and disseminating information while encouraging discussion on the importance of providing informed care to breastfeeding families.

Conclusion: Although more breastfeeding-specific education is recommended for clinicians, the ABC serves as a model for primary care clinicians to improve their knowledge and provide support for families through education, shared experience, and awareness across many pediatric primary care network sites.

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Conroy, K., Rea, C., Kovacikova, G. I., Sprecher, E., Reisinger, E., Durant, H., Starmer, A., Cox, J., & Toomey, S. L. (2018). Ensuring Timely Connection to Early Intervention for Young Children With Developmental Delays. Pediatrics, 142(1), e20174017. https://doi.org/10.1542/peds.2017-4017

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Multicomponent Approach Office Systems Assessments and Implementation Training Data Collection Training for Staff

Intervention Description: The intervention implemented in the study aimed to improve the process of referring patients to early intervention (EI) services. The multifaceted intervention included several components: 1. Patient and provider activation: The improvement team met with local EI staff to review eligibility criteria and best practices in motivating families to connect with EI. An EI brochure was developed to educate families on EI's services and evaluation process. 2. Centralizing and tracking referrals through an EI registry: The referral routes were streamlined by encouraging the use of an electronic order form within the electronic medical record (EMR) to direct the referral into the database after an intake visit had been scheduled. An EI registry was utilized to track referrals and facilitate follow-up for patients. 3. Plan-Do-Study-Act (PDSA) cycles: The team conducted a series of PDSA cycles regarding communication with EI sites to refine the intervention and address any identified barriers. The intervention was designed to address the identified drivers of successful EI referral and to streamline the referral process, ensuring that patients were connected with EI in a timely manner. The multifaceted approach aimed to improve the connection of patients to EI services and to track the effectiveness of the intervention.

Intervention Results: The percentage of patients evaluated by EI within 120 days increased from a baseline median of 50% to a median of 72% after implementation of the systems (N = 309). After implementation, the centralized referral system was used a median of 90% of the time. Tracking of referral outcomes revealed decreases in families refusing evaluations and improvements in exchange of information with EI.

Conclusion: Yes, the study reported statistically significant findings related to the evaluation of patients referred to early intervention (EI) services. The study found that the percentage of patients evaluated by EI within 120 days of referral increased from a baseline median of 50% to a median of 72% after the implementation of the new referral process. Additionally, the study identified demographic and clinical predictors of successful evaluation, with insurance status and specific diagnoses being statistically significant factors associated with timely evaluation. Furthermore, the study used t tests, χ2 testing, and multivariate logistic regression to identify these predictors and assess the statistical significance of the findings. The results of the study demonstrated the effectiveness of the intervention in improving the timely connection of patients to EI services.,

Study Design: The study design used in this research is a quality improvement (QI) initiative. The authors engaged in a quality improvement study to redesign the early intervention (EI) referral process with the goal of ensuring that 70% of patients referred to EI were evaluated by the program. The QI initiative involved implementing a multifaceted referral process, including a centralized electronic referral system used by providers, patient navigators responsible for processing all EI referrals, and a tracking system post-referral to facilitate identification of patients failing to connect with EI. The study utilized a QI approach to address the issue of timely connection to early intervention for young children with developmental delays.,

Setting: The quality improvement initiative was implemented at an academic hospital-based primary care clinic that cares for approximately 16,000 patients, with 17% of them being under 3 years of age and potentially eligible for early intervention services. The families primarily reside in urban neighborhoods, and 68% of them are Medicaid insured. The pediatric provider team consists of attending physicians, nurse practitioners, and resident physicians. The clinic serves a low-income population, and 20% of well-child visits are billed as having a developmental-behavioral concern. The study was conducted in this setting to improve the connection of patients to early intervention services.

Population of Focus: The target audience for the study includes healthcare professionals, particularly those involved in pediatric primary care, early intervention programs, and quality improvement initiatives. Additionally, policymakers and researchers interested in early childhood development, developmental services, and interventions for children with developmental delays would also find the study relevant. The findings and recommendations from the study are likely to be of interest to professionals and organizations involved in improving the coordination of early intervention referrals and services for young children with developmental delays.

Sample Size: The sample size for the study was 309 patients who were referred to early intervention services from the academic primary care clinic. Of these patients, 219 were evaluated within 120 days of referral. The study analyzed the demographic and diagnostic characteristics of the patients and their associations with timely referral to early intervention services.

Age Range: The article discusses early intervention for children under the age of 3 years who are experiencing or at risk for developmental delays.

Access Abstract

Costantino, C., Casuccio, A., Marotta, C., Bono, S. E., Ventura, G., Mazzucco, W., ... & Restivo, V. (2019). Effects of an intervention to prevent the bullying in first-grade secondary schools of Palermo, Italy: the BIAS study. Italian journal of pediatrics, 45(1), 1-9.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Teacher/Staff Training CLASSROOM_SCHOOL

Intervention Description: This study investigates the prevalence of bullying and the short-term effects on students' bullying perceptions of a preventive intervention conducted among teachers of first-grade secondary schools in Palermo, Sicily (Italy).

Intervention Results: A total of 402 students participated in the study (72.7% response rate). A decrease in the number of bullying episodes after the intervention was reported by the students in all types of bullying explored (physical, verbal, and indirect bullying, observers, resiliency, and prosociality), with all three methods. In particular, a statistically significant decrease in all the bullying areas investigated (except for resiliency) was reported for students attending schools of an intermediate socioeconomic level.

Conclusion: Even if many school-based interventions have been implemented to reduce school bullying throughout the world, this is one of the first conducted in Europe and it assesses the effectiveness among students of an anti-bullying intervention tailored for teachers. The encouraging results in reducing the number of bullying episodes together with the low cost in terms of human and economic resources could suggest an extension of this research on a regional/national scale.

Access Abstract

Côté-Arsenault, D., Denney-Koelsch, E., & Elliott, G. (2021). ‘Creating a safe space’: how perinatal palliative care coordinators navigate care and support for families. International Journal of Palliative Nursing, 27(8), 386-400.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education Enabling Services Expert Support (Provider) HEALTH_CARE_PROVIDER_PRACTICE PATIENT_CONSUMER

Intervention Description: This study sought to describe the PPCC's approach to care, their guiding principles and the roles, knowledge and skills that enable them to provide exemplary care.

Intervention Results: Findings include the PPCC's position within the healthcare system, guiding principles, goals, roles and responsibilities, and knowledge and skills. Two figures enhance the understanding of the PPCCs approach to creating a safe space for the family, supporting the interdisciplinary team and facilitating coordinated birth planning.

Conclusion: Every perinatal palliative care programme should include a PPCC. Future research on clinical training could examine the effectiveness of an educational intervention, using the detailed knowledge and skills learned in this study as a curriculum.

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Cross D, Shaw T, Hadwen K, et al. Longitudinal impact of the cyber friendly schools program on adolescents’ cyberbullying behavior. Aggress Behav. 2016;42(2):166-180.

Evidence Rating: Evidence Against

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) CLASSROOM Adult-led Curricular Activities/Training Peer-led Curricular Activities/Training Training (Parent/Family) SCHOOL Teacher/Staff Meeting Teacher/Staff Training School Rules

Intervention Description: The Cyber Friendly Schools (CFS) group-randomized controlled trial measured the longitudinal impact of a whole-school online cyberbullying prevention and intervention program, developed in partnership with young people.

Intervention Results: The program was associated with significantly greater declines in the odds of involvement in cyber-victimization and perpetration from pre- to the first post-test, but no other differences were evident between the study conditions. However, teachers implemented only one third of the program content.

Conclusion: More work is needed to build teacher capacity and self-efficacy to effectively implement cyberbullying programs. Whole-school cyberbullying interventions implemented in conjunction with other bullying prevention programs may reduce cyber-victimization more than traditional school-based bullying prevention programs alone.

Study Design: Cluster RCT: pretest-posttest

Setting: Australia

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Pretest (N=3382): Intervention (n=1878); Control (n=1504) Posttest 1 (N=2940): Intervention (n=1593); Control (n=1347) Posttest 2 (N=2874): Intervention (n=1582); Control (n=1292)

Age Range: 13-15

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D’Halluin AR, Roussey M, Branger B, Venisse A, Pladys P. Formative evaluation to improve prevention of sudden infant death syndrome (SIDS): a prospective study. Acta Paediatr. 2011;100(10):e147-e151.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER Education/Training (caregiver) Educational Material (caregiver) Assessment (caregiver) PROFESSIONAL_CAREGIVER PARENT_FAMILY Notification/Information Materials (Online Resources, Information Guide)

Intervention Description: To evaluate formative evaluation, a pedagogic method that sensitizes mothers to sudden infant death syndrome (SIDS), as a new way to improve prevention of SIDS.

Intervention Results: At follow-up, 91.9% and 86.8% of the mothers reported practicing supine sleep position in the intervention and control group respectively (p=0.16; OR=1.7, 95% CI: 0.7-4.0).

Conclusion: Formative evaluation using an educative questionnaire could improve maternal awareness on SIDS risk factors and their compliance with recommendations about SIDS prevention.

Study Design: RCT

Setting: Maternity department of the Rennes University Hospital

Population of Focus: Mothers hospitalized during the immediate postpartum period between Jun 19 and Aug 28, 2005 who were not hospitalized for abnormal or high-risk pregnancies and did not have newborns hospitalized in neonatology

Data Source: Mother report

Sample Size: Baseline (n=320) Follow-up (n=292)  Intervention (n=148)  Control (n=144)

Age Range: Not specified

Access Abstract

Del Rey R, Casas JA, Ortega R. Impact of the ConRed program on different cyberbulling roles. Aggress Behav. 2016;42(2):123-135.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY Training (Parent/Family) CLASSROOM Adult-led Curricular Activities/Training SCHOOL Teacher/Staff Training Media Campaign (Print Materials, Public Address System, Social Media)

Intervention Description: This article presents results from an evaluation of the ConRed cyberbullying intervention program.

Intervention Results: Repeated measures MANOVA showed that cyber victims, cyber aggressors and cyberbully/victims reduced their involvement in cyberbullying. Moreover, cyber-victims and bystanders adjusted their perceptions about their control of personal information on the Internet, and cyber aggressors and bystanders reduced their Internet dependence.

Conclusion: The ConRed program had stronger effects on male participants, especially in heightening their affective empathy.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Spain

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (N=875) Intervention (n=586); Control (n=289)

Age Range: 11/19/2022

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Dela Cruz A, Mueller G, Milgrom P, Coldwell S. A community-based randomized trial of postcard mailings to increase dental utilization among low-income children. J Dent Child (Chic). 2012;79(3):154-158.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER Education/Training (caregiver)

Intervention Description: The purpose of this randomized, controlled trial was to measure the impact of postcard mailings on dental utilization by low-income children through a dental society program designed to increase access to dental care.

Intervention Results: There was no significant difference in the utilization of preventive dental services between intervention group 1 (61%) and the control group (60%) or between intervention group 2 (62%) and the control group (60%).

Conclusion: Postcard mailings did not significantly increase utilization of preventive dental services. Other strategies to increase utilization of preventive oral health measures are needed.

Study Design: RCT

Setting: Yakima County in WA

Population of Focus: Children aged 12-36 months enrolled in Medicaid and Basic Health Plus as of September 30, 2002

Data Source: Medicaid claims

Sample Size: Group 1 (n=2,014) Group 2 (n=2,014) Group 3 (n=1,779)

Age Range: not specified

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Di Noia J, Monica D, Sikorskii A, Nelson J. Pilot Study of a Farm-to-Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Intervention Promoting Vegetable Consumption. J Acad Nutr Diet. 2021 Oct;121(10):2035-2045. doi: 10.1016/j.jand.2020.12.020. Epub 2021 Jan 22. PMID: 33487590; PMCID: PMC8295404.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Training (Parent/Family) Farmers Markets

Intervention Description: The intervention combined behaviorally focused instruction and handouts with the introduction of a WIC-based farmers' market, field trips to an area farmers' market, telephone coaching and support before and after trips, and recipe demonstrations and tastings.

Intervention Results: At mid-intervention, objectively measured vegetable intake was higher among participants in the control group as compared with the intervention group; self-reported intake did not differ by group. Post-intervention, objectively measured and self-reported vegetable intake were higher among participants in the intervention group as compared with the control group. Receipt of the intervention was associated with a greater likelihood of FMNP voucher redemption. Voucher redemption rates were 87% in the intervention group and 28% in the control group (odds ratio = 17.39, 95% confidence interval [8.64, 35.02]).

Conclusion: Meaningful associations found between the intervention, vegetable intake, and FMNP voucher redemption suggest that the program is appropriate for efficacy testing.

Study Design: RCT

Setting: Urban WIC agency sites

Population of Focus: English- or Spanish-speaking adults who were recipients of Farmers' Market Nutrition Program (FMNP) vouchers or caregivers of child voucher recipients.

Sample Size: 297

Age Range: n/a

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Dittus, P. J., Harper, C. R., Becasen, J. S., Donatello, R. A., & Ethier, K. A. (2018). Structural Intervention With School Nurses Increases Receipt of Sexual Health Care Among Male High School Students. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 62(1), 52–58. https://doi.org/10.1016/j.jadohealth.2017.07.017

Evidence Rating: Moderate

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

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Doherty RF, Knab M, Cahn PS. Getting on the same page: an interprofessional common reading program as foundation for patient-centered care. J Interprof Care. 2018 Jul;32(4):444-451. doi: 10.1080/13561820.2018.1433135. Epub 2018 Feb 20. PMID: 29461137.

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education Patient-Centered Medical Home Quality Improvement/Practice-Wide Intervention

Intervention Description: common reading program in their first year. 12-16 months later, participate in focus groups discussions

Intervention Results: 5 primary themes - seeing family members as stakeholders, establishing common ground with peers and affirming the larger reason for graduate school, applying lessons from clinical practice that see the parient as a person, experiencing an emotional connections with a story and its characters, taking alternative perspectives/stepping into the shoes of the patient

Conclusion: Story can be a global way to construct meaning. In health care, health professionals must piece together the illness narrative to fully appreciate their client’s illness experience (Clark, 2014; Kleinman, 1988). A common reading program provides a means for helping interprofessional learners construct this narrative. Through shared reading and reflection on a fictional account, health professions students better understand the dimensions of illness, what it means to give and receive care, and the uncertainty of the human condition. This narrative, experiential approach for socializing entering graduate students to the health professions can serve to impart the values of patient-centered care from day one. When implemented in an integrative and comprehensive inter-professional education curriculum, it has the potential to encourage students to embrace the dual identity entailed by interprofessional professionalism. Facilitation of a common reading follows best practices in interprofessional learning by creating and sustaining group culture and role modeling reflection, values, and challenges to stereotypes (Barr, 2013; Bridges, Davidson, Odegard, Maki, & Tomkowiak, 2011; Carpenter & Dickerson, 2016; Interprofessional Education Collaborative, 2016; Institute of Medicine, 2015; Oandasan & Reeves, 2005). Although no known studies to date have evaluated the staying power of common reading programs, our findings mirror research in liberal arts education that suggest first-year seminars are best practice in the development of a holistic student, citizen, and lifelong learner (Association of American Colleges and Universities, 2007; Padgett, Keup, & Pascarella, 2013). A common reading appears to be a relatively low-cost, high-yield interprofessional educational activity that serves to develop health professions students’ knowledge, attitudes, and behaviors in patient-centered care. It is easily introduced into educational programs and bridges both uniprofessional and interprofessional learning. A common reading program can curtail typical alignment challenges between programs, timetables, and faculty (Barr, Helme, & D’Avray, 2014) since students complete the reading pre-matriculation and reflect on the reading during program orientation. It facilitates meaningful conversations across a variety of backgrounds and experiences, and translates contexts from academic to clinical education settings along the continuum of learning. A common reading may be an effective and lasting way for educators to establish a patient-centered, perspective-taking approach to care in pre-licensure health professions students. Assigning and facilitating discussion on a common reading imparts the message to students that the institution values the human aspects of care. It is an effective way to foster interprofessionalism and make patient-centered care explicit for novice health professionals. Themes elicited from this research suggest the staying power of this pedagogy in regard to perspective-taking, understanding family as stakeholders, and the importance of seeing the patient as a person. A common reading program allows the learner to engage with an illness narrative, connecting learner to patient and preparing students for collaborative practice.

Study Design: An exploratory case study approach using focus groups and thematic analysis was used to evaluate whether students’ attitudes about a literary account of illness endured a year after clinical and professional education

Setting: MGH Institute of Health Professions, an independent graduate school in Boston, Massachusetts, - second-year students in nursing, physical therapy, occupational therapy, and communication sciences and disorders (i.e., speech-language pathology) entry-level programs .

Population of Focus: second-year students in nursing, occupational therapy, physical therapy, and speech-language pathology - second-year students in nursing, physical therapy, occupational therapy, and communication sciences and disorders (i.e., speech-language pathology) entry-level programs .

Sample Size: 316 students from the four participating health professions programs, with representation from nursing, physical therapy, occupational therapy, and speech-language pathology . Additionally, 24 students agreed to participate in the focus group discussions, with the four professions represented as follows: nursing (n = 4), occupational therapy (n = 5), physical therapy (n = 8), and speech-language pathology (n = 7) .

Age Range: college students

Access Abstract

Domino M. Measuring the impact of an alternative approach to school bullying. J Sch Health. 2013;83(6):430-437.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM Adult-led Curricular Activities/Training

Intervention Description: Social-Emotional Learning and Positive Youth Development provide a theory-driven alternative for approaching bullying and victimization by strengthening social competencies that reduce related youth risk behaviors.

Intervention Results: Participants in TTL reported significant reductions in bullying (p < .001), and victimization (p < .001), from pretest to posttest, and compared to controls (p < .001). Findings remained consistent between sexes (p < .001). Control groups experienced increases in bully and victim behaviors during the same time period, which were significantly reduced following participation in TTL (p < .001).

Conclusion: Identifying intervention alternatives to address bullying behaviors must remain a research priority. This study supports the application of theory-driven SEL and PYD constructs within a curriculum designed to improve social competencies of all students.

Study Design: QE: pretest-posttest time-lagged control group

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (N=336) Fall 2009: Intervention (n=160); Control (n=163) Spring 2010: Intervention (n=163); Control (n=163)

Age Range: Mean: 12.2

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Dorjulus B, Prieto C, Elger RS, Oredein I, Chandran V, Yusuf B, Wilson R, Thomas N, Marshall J. An evaluation of factors associated with safe infant sleep practices among perinatal home visiting participants in Florida, United States. J Child Health Care. 2023 Mar;27(1):78-90. doi: 10.1177/13674935211044871. Epub 2021 Sep 14. PMID: 34517738.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Home Visit (caregiver) Training (Parent/Family) PARENT_FAMILY PROFESSIONAL_CAREGIVER

Intervention Description: This evaluation examined the rates of safe infant sleep practices and associated factors among 1985 participants enrolled in Florida Maternal, Infant, and Early Childhood Home Visiting (FL MIECHV) programs during 2017-2019.

Intervention Results: Most caregivers (70%) reported always placing their babies to sleep on their back, alone, and without soft bedding. Factors such as primary language, race, education, housing situation, and year the Safe Baby™ curriculum implemented were significantly associated with safe infant sleep practices.

Conclusion: Bearing this in mind, FL MIECHV can tailor safe sleep education, messaging, and strategies to support participants at highest risk. Recent adoption of the Safe Baby™ curriculum, and associated staff training, was an important factor influencing parents' infant sleep practices.

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Drew AL, Keller TE, Spencer R, Herrera C. Investigating mentor commitment in youth mentoring relationships: The role of perceived program practices. J Community Psychol. 2020 Sep;48(7):2264-2276. doi: 10.1002/jcop.22409. Epub 2020 Jul 11. PMID: 32652581.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Support/Counseling/Remediation Training Mentor Engagement

Intervention Description: The intervention described in the study is mentoring programs for youth. The unique aspect of this mentoring program is its inclusion of mentors from programs with a wide variety of structures, models, settings, and sizes, and its accounting for between-program differences using multilevel modeling .

Intervention Results: The results of the study indicated that mentor commitment to the relationship was predicted by satisfaction, investment, and available alternatives. Additionally, the study found that setting clear expectations, pre-match training, and matching based on preferences across program types were influential in mentor commitment , .

Conclusion: The conclusion drawn from the study suggests that the investment model is applicable beyond its previous application to one-on-one mentoring to other models of mentoring, such as team or group mentoring. The study also highlights the role of setting clear expectations, pre-match training, and matching based on preferences across program types .

Study Design: a quantitative research study that utilized surveys and scales to measure mentor commitment, satisfaction, investment, available alternatives, and mentor perceptions of program practices , ,

Setting: diverse, encompassing a wide range of mentoring programs with various structures, models, settings, and sizes .

Population of Focus: mentors and youth

Sample Size: 593 mentors

Age Range: youth

Access Abstract

DuBois DL, Portillo N, Rhodes JE, Silverthorn N, Valentine JC. How Effective Are Mentoring Programs for Youth? A Systematic Assessment of the Evidence. Psychol Sci Public Interest. 2011 Aug;12(2):57-91. doi: 10.1177/1529100611414806. PMID: 26167708.

Evidence Rating: Moderate

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Support/Counseling/Remediation Training Mentor Engagement

Intervention Description: The intervention described is formal mentoring programs from the YMCA Reach & Rise TM Mentoring Program and Big Brothers Big Sisters (BBBS) Lone Star. This mentoring program is unique in that it focuses on specific competencies of adult mentors and their impact on youth.

Intervention Results: The results of the study found that mentor training, age, gender, race/ethnicity, number of years of mentoring experience, and highest level of school completed predict the level of each of the six mentoring competency skills of effective mentorship.

Conclusion: The conclusion of the study is that mentor training and demographic factors have a significant impact on the competencies of adult mentors in formal mentoring programs and their impact on youth.

Study Design: quantitative correlational research methodology

Setting: mentoring programs within the North Texas region.

Population of Focus: adult mentors in formal mentoring programs from the YMCA Reach & Rise TM Mentoring Program and Big Brothers Big Sisters (BBBS) Lone Star

Age Range: 12/18/2024

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Duncan S, Stewart T, McPhee J, Borotkanics R, Prendergast K, Zinn C, Meredith-Jones K, Taylor R, McLachlan C, Schofield G. Efficacy of a compulsory homework programme for increasing physical activity and improving nutrition in children: a cluster randomised controlled trial. International Journal of Behavioral Nutrition and Physical Activity. 2019;16(1):80.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL Homework/Extra Credit Presentation/meeting/information Session (Classroom) Adult-led Curricular Activities/Training

Intervention Description: A total of 675 children aged 7-10 years from 16 New Zealand primary schools participated in the Healthy Homework study. Schools were randomised into intervention and control groups (1:1 allocation). Intervention schools implemented an 8-week applied homework and in-class teaching module designed to increase physical activity and improve dietary patterns. Physical activity was the primary outcome measure, and was assessed using two sealed pedometers that monitored school- and home-based activity separately. Secondary outcome measures included screen-based sedentary time and selected dietary patterns assessed via parental proxy questionnaire. In addition, height, weight, and waist circumference were measured to obtain body mass index (BMI) and waist-to-height ratio (WHtR). All measurements were taken at baseline (T0), immediately post-intervention (T1), and 6-months post-intervention (T2). Changes in outcome measures over time were estimated using generalised linear mixed models (GLMMs) that adjusted for fixed (group, age, sex, group x time) and random (subjects nested within schools) effects. Intervention effects were also quantified using GLMMs adjusted for baseline values.

Intervention Results: Significant intervention effects were observed for weekday physical activity at home (T1 [P < 0.001] and T2 [P = 0.019]), weekend physical activity (T1 [P < 0.001] and T2 [P < 0.001]), BMI (T2 only [P = 0.020]) and fruit consumption (T1 only [P = 0.036]). Additional analyses revealed that the greatest improvements in physical activity occurred in children from the most socioeconomically deprived schools. No consistent effects on sedentary time, WHtR, or other dietary patterns were observed.

Conclusion: A compulsory health-related homework programme resulted in substantial and consistent increases in children's physical activity - particularly outside of school and on weekends - with limited effects on body size and fruit consumption. Overall, our findings support the integration of compulsory home-focused strategies for improving health behaviours into primary education curricula.

Study Design: Cluster RCT

Setting: Primary schools in Auckland or Dunedin

Population of Focus: 3rd-5th year students

Data Source: Pedometers, questionnaires (diet, television and computer usage), anthropometrics

Sample Size: 675 students from 16 schools

Age Range: Ages 7-10

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Earls MF, Hay SS. Setting the stage for success: implementation of developmental and behavioral screening and surveillance in primary care practice--the North Carolina Assuring Better Child Health and Development (ABCD) Project. Pediatrics. 2006;118(1):e183-188.

Evidence Rating: Emerging Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE Provider Training/Education Educational Material (Provider) Expert Support (Provider) Participation Incentives Modified Billing Practices Data Collection Training for Staff Screening Tool Implementation Training Office Systems Assessments and Implementation Training Expert Feedback Using the Plan-Do-Study-Act-Tool Collaboration with Local Agencies (State) Collaboration with Local Agencies (Health Care Provider/Practice) Engagement with Payers STATE POPULATION-BASED SYSTEMS Audit/Attestation HEALTH_CARE_PROVIDER_PRACTICE Audit/Attestation (Provider)

Intervention Description: Early identification of children with developmental and behavioral delays is important in primary care practice, and well-child visits provide an ideal opportunity to engage parents and perform periodic screening. Integration of this activity into office process and flow is necessary for making screening a routine and consistent part of primary care practice.

Intervention Results: In the North Carolina Assuring Better Child Health and Development Project, careful attention to and training for office process has resulted in a significant increase in screening rates to >70% of the designated well-child visits. The data from the project prompted a change in Medicaid policy, and screening is now statewide in primary practices that perform Early Periodic Screening, Diagnosis, and Treatment examinations.

Conclusion: Although there are features of the project that are unique to North Carolina, there are also elements that are transferable to any practice or state interested in integrating child development services into the medical home.

Study Design: QE: pretest-posttest

Setting: Partnership for Health Management, a network within Community Care of North Carolina

Population of Focus: Children ages 6 to 60 months receiving Early Periodic Screening, Diagnosis, and Treatment services

Data Source: Child medical record

Sample Size: Unknown number of charts – screening rates tracked in 2 counties (>20,000 screens by 2004)

Age Range: Not specified

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Ekstrom A, Kylberg E, Nissen E. A process-oriented breastfeeding training program for healthcare professionals to promote breastfeeding: an intervention study. Breastfeed Med. 2012;7(2):85-92.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE Provider Training/Education

Intervention Description: The aim of the study was to evaluate the effects of process-oriented training in supportive breastfeeding counseling for midwives and postnatal nurses on the time lapse between the initial breastfeeding session, introduction of breastmilk substitutes and solids, and the duration of breastfeeding.

Intervention Results: The IG mothers had a significantly longer duration of exclusive breastfeeding, even if the initial breastfeeding session did not occur within 2 hours after birth, than the corresponding group of CGA mothers (p=0.01). Fewer infants in the IG received breastmilk substitutes (in the first week of life) without medical reasons compared with the control groups (p=0.01). The IG infants were significantly older (3.8 months) when breastmilk substitutes were introduced (after discharge from the hospital) compared with the infants in the control groups (CGA, 2.3 months, p=0.01; CGB, 2.5 months, p=0.03).

Conclusion: A process-oriented training program for midwives and postnatal nurses was associated with a reduced number of infants being given breastmilk substitutes during the 1st week without medical reasons and delayed the introduction of breastmilk substitutes after discharge from the hospital.

Study Design: Cluster RCT

Setting: 10 municipalities in southwest Sweden

Population of Focus: First time, Swedish-speaking mothers with singleton, healthy, full-term births delivered spontaneously, by vacuum extraction, or by cesarean section, and who had been cared for by a healthcare professional in one of 10 municipalities

Data Source: Mother self-report

Sample Size: 3 Days Postpartum3 • Intervention (n=206/172) • Control Group A (n=162/148) • Control Group B (n=172/160)

Age Range: Not specified

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Erlick, M., Fioravanti, I. D., Yaeger, J., Studwell, S., & Schriefer, J. (2021). An Interprofessional, Multimodal, Family-Centered Quality Improvement Project for Sleep Safety of Hospitalized Infants. Journal of patient experience, 8, 23743735211008301. https://doi.org/10.1177/23743735211008301

Evidence Rating: Emerging

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE Training/Education Educational Material (provider) Audit/Attestation (provider) PROFESSIONAL_CAREGIVER Education/Training (caregiver) HOSPITAL Quality Improvement Crib Card

Intervention Description: This quality improvement project used an interprofessional, multimodal approach to improve sleep safety for hospitalized infants. The working group for this project included the Director of Quality Improvement for the Department of Pediatrics, a Pediatric Hospitalist, a Senior Advanced Practice Nurse in Pediatrics, Senior Associate Counsel for the Office of Counsel, and a medical student with a background in social work. The interdisciplinary group met to review and discuss improvements to communication and facilitated the development of five family interventions: a designated safe sleep web page, a clear bedside guide to safe sleep, additional training for nursing staff in motivational interviewing, a card audit system, and electronic health record smart phrases. A short survey was conducted to assess how the safe sleep toolkit has been useful to care providers in the Children’s Hospital. 

Intervention Results: With the initial pilot implementation of the K-cards, staff reported increased ease of audits. Adherence to recommended safer sleep measures was a major barrier in previous attempts to improve institutional sleep safety (1). By making adherence easier, providers may be more likely to both participate in quality improvement tracking measures and follow-up with families directly.

Conclusion: These coordinated interventions reflect advantages of an interprofessional and family-centered approach: building rapport and achieving improvements to infant sleep safety.

Setting: Golisano Children’s Hospital

Population of Focus: Hospital healthcare providers

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Esmeray, N., & Yanikkerem, E. (2022). The effect of education given to women with hearing impairments on the behaviours of Pap smear screening. European journal of cancer care, 31(2), e13550. https://doi.org/10.1111/ecc.13550

Evidence Rating: Scientifically Rigorous

Intervention Components (click on component to see a list of all articles that use that intervention): Other Person-to-Person Education PATIENT_CONSUMER Educational Material Provider Training/Education HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: This study was a controlled trial study with longitudinal design. The sample consisted of 156 women (intervention = 78, control = 78) who registered in hearing-impaired associations in Izmir, Turkey. The education about cervical cancer and Pap smear test was given to intervention group with face-to-face interviews by using Turkish sign language. Three months later, the women were contacted and asked whether they have had a Pap smear test, and the total knowledge score of intervention groups was evaluated.

Intervention Results: There was not a statistically significant difference between the mean total score of knowledge about cervical cancer and Pap smear test in intervention (0.6 ± 1.6) and control (1.1 ± 1.9) groups. After 3 months, having a Pap smear test was found to be statistically significantly higher between groups (intervention = 29.5%, control = %1.2), and the mean cervical cancer and Pap smear knowledge score of the intervention group (9.2 ± 1.4) was found to be statistically significantly higher than the score before education (0.6 ± 1.6).

Conclusion: Education of cervical cancer and Pap smear test increased knowledge level and behaviour of Pap smear test of the women.

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Espelage DL, Low S, Polanin JR, Brown EC. Clinical trial of second step© middle-school program: Impact on aggression & victimization. J Appl Dev Psychol. 2015;37:52-63.

Evidence Rating: Moderate Evidence

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM Adult-led Curricular Activities/Training

Intervention Description: School-based social-emotional (SEL) programs that address interpersonal conflict and teach emotion management have succeeded in reducing youth aggression among elementary school youth, with few studies in middle schools.

Intervention Results: Multilevel analyses revealed significant intervention effects for two of the seven outcomes. Students in intervention schools were 56% less likely to self-report homophobic name-calling victimization and 39% less likely to report sexual violence perpetration than students in control schools in one state.

Conclusion: SS-SSTP holds promise as an efficacious program to reduce homophobic name-calling and sexual violence in adolescent youth.

Study Design: Paired cluster RCT: pretestposttest

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Pretest: Intervention (n=2029); Control (n=1676) Posttest: Intervention (n=1548); Control (n=1170) Analysis: Intervention (n=2029); Control (n=1676)

Age Range: 11/13/2022

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