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Strengthening the evidence for maternal and child health programs

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Gray C, Fox K,Williamson ME. Improving Health Outcomes for Children (IHOC): First STEPS II Initiative: Improving Developmental, Autism, and Lead Screening for Children: Final Evaluation. Portland, ME: University of Southern Maine Muskie School of Public Service; 2013.

Link: http://digitalcommons.usm.maine.edu/cgi/viewcontent.cgi?article=1014&context=healthpolicy

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), Modified Billing Practices, 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, Engagement with Payers, STATE, POPULATION-BASED SYSTEMS

Intervention Results:

  • Average percentage of documented use of a developmental screening tool increased substantially from baseline to followup for all three age groups (46% to 97% for children under one; 22% to 71% for children 18-23 months; and 22% to 58% for children 24-35 months)
  • Rate of developmental screening based on MaineCare claims increased from the year prior to intervention implementation to the year after implementation for all three age groups (5.3% to 17.1% for children age one; 1.5% to 13.3% for children age two; and 1.2% to 3.3% for children age 3)

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, 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://www.edc.org/hv-coiin-implementing-quality-improvement-achieve-breakthrough-change

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

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.

Link: https://www.ncbi.nlm.nih.gov/pubmed/21123480

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)

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

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.

Link: https://ovidsp.tx.ovid.com/sp-3.29.1a/ovidweb.cgi?QS2=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

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)

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

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.

Link: https://www.ncbi.nlm.nih.gov/pubmed/16818532

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, 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, Engagement with Payers, STATE, POPULATION-BASED SYSTEMS

Intervention Results:

Percentage of screenings using ASQ increased from 15.5% at baseline to 76% at last follow-up

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

Intervention Results:

  • Percentage of SDA use overall increased from 12.5% at baseline to 44.67% at follow-up
  • Among sites providing complete data, 6 sites with 0% SDA screening at baseline increased use of SDA to between 25-100% at follow-up

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, POPULATION-BASED SYSTEMS

Intervention Results:

  • Percentage of use of any screening tool increased from 62% at baseline to 92% at follow-up (P<.001)
  • Percentage use of validated screening tool increased from 32% at baseline to 92% at follow-up (P<.001)

Schonwald A, Huntington N, Chan E, Risko W, Bridgemohan C. Routine developmental screening implemented in urban primary care settings: more evidence of feasibility and effectiveness. Pediatrics. 2009;123(2):660-668.

Link: https://www.ncbi.nlm.nih.gov/pubmed/19171635

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), Screening Tool Implementation Training

Intervention Results:

61.4% of 2-year-olds and 61.6% of 3-year-olds were screened with the PEDS in the postimplementation chart review

Honigfeld L, Chandhok L, Spiegelman K. Engaging pediatricians in developmental screening: the effectiveness of academic detailing. J Autism Dev Disord. 2012;42(6):1175-1182.

Link: https://www.ncbi.nlm.nih.gov/pubmed/21826585

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, Chart Audits (Provider)

Intervention Results:

  • Percentage of screening at 18-month well-child visits increased (P<.05) in all intervention practices
    • Average screening percentages were 70.8% for intervention practices, 46% for control practices
    • One intervention practice had a lower screening % than matched control practice (P=.37)
  • Number of screens performed on the same day as a well-child visit increased from 3,442 in 2008 to 12,533 in 2009

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:

  • Percentages of average developmental and psychosocial screening from baseline to follow-up increased from 78% to 88% (P<.001) and 22% to 29% (P=.002), respectively
  • Percentage of children whose parents reported high-quality care increased from 40% to 52% (baseline to follow-up) among intervention practices, no change in comparison practices (37% to 37%)

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:

Percentage of screenings increased across all practices from 68% to 86% for 9, 18, 24/30-month well-child visits

Carroll AE, Bauer NS, Dugan TM, Anand V, Saha C, Downs SM. Use of a computerized decision aid for developmental surveillance and screening: a randomized clinical trial. JAMA Pediatr. 2014;168(9):815-821.

Link: https://www.ncbi.nlm.nih.gov/pubmed/25022724

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Clinical Decision Support System, PROVIDER/PRACTICE, Public Insurance, STATE, POPULATION-BASED SYSTEMS

Intervention Results:

Significant increase in percentage of children screened with a standardized screening tool at target visits (85% vs 24.4%, P<.001)

Green B, Tarte JM, Harrison PM, Nygren M, Sanders M. Results from a randomized trial of the Healthy Families Oregon accredited statewide program: early program impacts on parenting. Child Youth Serv Rev. 2014;44:288-298.

Link: https://www.sciencedirect.com/science/article/pii/S0190740914002175

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Collaboration with Local Agencies, STATE, POPULATION-BASED SYSTEMS

Intervention Results:

Percentage of children who received developmental screening by age 12 months was 93.8% for intervention and 86.5% for control group (OR=0.41, P<.01)

Kuhlthau K, Jellinek M, White G, Vancleave J, Simons J, Murphy M. Increases in behavioral health screening in pediatric care for Massachusetts Medicaid patients. Arch Pediatr Adolesc Med. 2011;165(7):660-664.

Link: https://www.ncbi.nlm.nih.gov/pubmed/21383254

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, Data Collection Training for Staff

Intervention Results:

Percentage of Medicaid well-child visits with screens increased from 16.6% at baseline to 53.6% follow-up

Minkovitz CS, Hughart N, Strobino D, et al. A practice-based intervention to enhance quality of care in the first 3 years of life: the Healthy Steps for Young Children Program. JAMA. 2003;290(23):3081- 3091.

Link: https://www.ncbi.nlm.nih.gov/pubmed/14679271

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, Provider Training/Education, Educational Material (Provider), Expert Support (Provider), Screening Tool Implementation Training, Office Systems Assessments and Implementation Training, Data Collection Training for Staff

Intervention Results:

Percentage of children with developmental assessments was 83.1% for intervention and 41.4% for control group (OR=8.00; 95% CI=6.69, 9.56; P<.001)
   

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.