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Strengthen the Evidence for Maternal and Child Health Programs

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Displaying records 1 through 6 (6 total).

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.

Link:

NPM: 6: Developmental Screening
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, Chart Audits (Provider), 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

Intervention Results:

Percentage of developmental screenings at 9-, 18-, 24-, and 30-months all increased from baseline to follow-up (P<.001)
  • Percentage of children screened using standardized developmental screening tool completed by parents increased from baseline to follow-up (11.6% to 32.4%; P<.001)
  • Mackrain M, Dworkin PH, Harden BJ, Arbour M. HV CoIIN: Implementing quality improvement to achieve breakthrough change in developmental promotion, early detection, and intervention. MIECHV TACC, April 2015.

    Link: https://georgetown.box.com/s/8q229hameb3038jxallodao9ss3q55lc

    NPM: 6: Developmental Screening
    Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Quality Improvement/Practice-Wide Intervention

    Intervention Results:

    The HV CoIIN’s theory of change includes a comprehensive approach for the development and implementation of reliable and effective systems for surveillance, screening, referral, follow-up, and intervention, with the goal of supporting all children’s development and getting vulnerable children access to appropriate and timely supports. Within the first 9 months, the HV CoIIN is generating promising movement toward breakthrough change across indicators, for example: By instituting mechanisms to track and provide ongoing surveillance of developmental and behavioral well-being, home visitors are asking over 80% of parents about their child’s development, behavior, or learning at every home visit. By standardizing and measuring efficacy of processes for developmental and behavioral screening, programs are screening approximately 70% of children at appropriate intervals. By incorporating protocol and practice for intentionally supporting children with a positive screen or parental concerns, home visitors are providing 80% or more of families with individualized support related to their child’s development, behavior, or learning within regularly scheduled home visits.

    Lannon CM, Flower K, Duncan P, Moore KS, Stuart J, Bassewitz J. The Bright Futures Training Intervention Project: implementing systems to support preventive and developmental services in practice. Pediatrics. 2008;122(1):e163-171.

    Link: http://pediatrics.aappublications.org/content/122/1/e163

    NPM: 6: Developmental Screening
    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), Quality Improvement/Practice-Wide Intervention, Data Collection Training for Staff, Office Systems Assessments and Implementation Training, Chart Audits (Provider), Expert Feedback Using the Plan-Do-Study-Act-Tool, POPULATION-BASED SYSTEMS, STATE, Collaboration with Local Agencies (State), Collaboration with Local Agencies (Health Care Provider/Practice)

    Intervention Results:

    Office system changes most frequently adopted were use of recall/reminder systems (87%), a checklist to link to community resources (80%), and systematic identification of children with special health care needs (80%). From baseline to follow-up, increases were observed in the use of recall/reminder systems, the proportion of children's charts that had a preventive services prompting system, and the families who were asked about special health care needs. Of 21 possible office system components, the median number used increased from 10 to 15. Comparing scores between baseline and follow-up for each practice site, the change was significant. Teams reported that the implementation of office systems was facilitated by the perception that a component could be applied quickly and/or easily. Barriers to implementation included costs, the time required, and lack of agreement with the recommendations.

    Malik F, Booker JM, Brown S, McClain C, McGrath J. Improving developmental screening among pediatricians in New Mexico: findings from the developmental screening initiative. Clin Pediatr. 2014;53(6):531-538.

    Link: https://www.ncbi.nlm.nih.gov/pubmed/24658910

    NPM: 6: Developmental Screening
    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, Quality Improvement/Practice-Wide Intervention, Data Collection Training for Staff, Chart Audits (Provider), Expert Feedback Using the Plan-Do-Study-Act-Tool, Collaboration with Local Agencies (State), Collaboration with Local Agencies (Health Care Provider/Practice), STATE, POPULATION-BASED SYSTEMS

    Intervention Results:

    At baseline, there were dramatic differences among the practices, with some not engaged in screening at all.

    Margolis PA, McLearn KT, Earls MF, et al. Assisting primary care practices in using office systems to promote early childhood development. Ambul Pediatr. 2008;8(6):383-387.

    Link: https://www.ncbi.nlm.nih.gov/pubmed/19084789

    NPM: 6: Developmental Screening
    Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Expert Support (Provider), Quality Improvement/Practice-Wide Intervention, Data Collection Training for Staff, Office Systems Assessments and Implementation Training

    Intervention Results:

    The number of care delivery systems increased from a mean of 12.9 to 19.4 of 27 in collaborative practices and remained the same in comparison practices (P=.0002). The proportion of children with documented developmental and psychosocial screening among intervention practices increased from 78% to 88% (P<.001) and from 22% to 29% (P=.002), respectively. Compared with control practices, there was a trend toward improvement in the proportion of parents who reported receiving at least 3 of 4 areas of care.

    King TM, Tandon SD, Macias MM, et al. Implementing developmental screening and referrals: lessons learned from a national project. Pediatrics. 2010;125(2):350-360.

    Link: https://www.ncbi.nlm.nih.gov/pubmed/20100754

    NPM: 6: Developmental Screening
    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, Quality Improvement/Practice-Wide Intervention, Data Collection Training for Staff, Screening Tool Implementation Training, Chart Audits (Provider)

    Intervention Results:

    At the project's conclusion, practices reported screening more than 85% of patients presenting at recommended screening ages. They achieved this by dividing responsibilities among staff and actively monitoring implementation. Despite these efforts, many practices struggled during busy periods and times of staff turnover. Most practices were unable or unwilling to adhere to 3 specific AAP recommendations: to implement a 30-month visit; to administer a screen after surveillance suggested concern; and to submit simultaneous referrals both to medical subspecialists and local early-intervention programs. Overall, practices reported referring only 61% of children with failed screens. Many practices also struggled to track their referrals. Those that did found that many families did not follow through with recommended referrals.
       

    This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.