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Strengthening the evidence for maternal and child health programs

Evidence Tools
NPM 10

young woman speaking with a doctorAdolescent Well-Visit

The Title V Maternal and Child Health Services Block Grant to States Program guidance defines the significance of this goal as follows:

Adolescence is a period of major physical, psychological, and social development. As adolescents move from childhood to adulthood, they assume individual responsibility for health habits, and those who have chronic health problems take on a greater role in managing those conditions. Initiation of risky behaviors is a critical health issue during adolescence, as adolescents try on adult roles and behaviors. Risky behaviors often initiated in adolescence include unsafe sexual activity, unsafe driving, and use of substances, including tobacco, alcohol, and illegal drugs.

Receiving health care services, including annual adolescent preventive well visits, helps adolescents adopt or maintain healthy habits and behaviors, avoid health?damaging behaviors, manage chronic conditions, and prevent disease. Receipt of services can help prepare adolescents to manage their health and health care as adults.

The Bright Futures guidelines recommend that adolescents have an annual checkup starting at age 11. The visit should cover a comprehensive set of preventive services, such as a physical examination, discussion of health?related behaviors, and immunizations. It recommends that the annual checkup include discussion of several health?related topics, including healthy eating, physical activity, substance use, sexual behavior, violence, and motor vehicle safety.

NPM 10 Tools

Introductory Resources

Summary of the Evidence

The following trends emerged from analysis of peer- reviewed evidence. While findings might not completely align with your ESM, they can serve as ideas to expand your ESM.

  • Expanded insurance coverage appears to be effective.
  • Patient reminders appear to be somewhat effective.
  • There is insufficient evidence of the effectiveness for school-based health centers.

Access the published evidence.

Evidence Analysis Reports

Promising Practices

You can access strategies from AMCHP’s Innovation Station below.

Practice Name Primary Interest  State  Level of Evidence
Boys' Health Advocacy Program Child Health SD Promising
Hospital Transition Planning Tool Adolescent Health TX Best
Youth Health Improvement Initiative Adolescent Health VT Promising
Providers and Teens Program Adolescent Health WI Promising

Sample ESMs

The following ESMs fall under measurement categories 2 – 4 and can be used as models.

State  Sample ESM Numerator Denominator Unit Category
NH % of adolescents ages 12-21 at MCH-contracted health centers who have at least one comprehensive well-care visit with a PCP or an OB/GYN practitioner # of adolescents at MCH-contracted health centers who had at least one comprehensive well- care visit with a PCP or an OB/GYN Total # of adolescent patients ages 12-21 years of age at the MCH- contracted health centers Percent 2
MI Of the health care providers who complete the Motivational Interviewing web course and the professional development training, the percent who report skills in effectively counseling youth on changing risky behaviors # of providers who complete both trainings that report skills to effectively counsel youth on changing risky behavior # of providers who complete both the Motivational Interviewing web course and professional development training Number 3
PR % of youths in MCAH Positive Youth Development Youth Health Promoters Project who express increase in their PYD core assets # of YHPP participants that demonstrate an increase in PYD core assets # of YHPP Percent 4 participants surveyed in a year Percent 4

Sample Strategies and Evidence-based/informed Strategy Measures (ESMs) (WCHPC). A list of sample strategies and ESMs for each of the 15 NPMs. Sources are provided at the end of the document. 

Related ESMs. You can access ESMs being implemented by other states/jurisdictions that may serve as models for future work with NPM 10.

Additional Learning

  • NPM 10 Transformation Tools (MCH Navigator and National MCH Workforce Development Center). Learning resources, implementation strategies, and links to the evidence base for the competencies needed to carry out NPM 10 activities.
  • Taking Action with Evidence Implementation Roadmap (Association of MCH Programs (AMCHP) and WCHPC). Archived webinars and additional learning and implementation resources.
  • Historical Resources from the MCH Digital Library (NCEMCH). This bibliography is automatically generated to pull resources from MCHLine, the MCH Library's online catalog of seminal resources, in support of NPM 10. Coming soon.
  • Evidence-Based Clinical Preventive Services for Adolescents and Young Adults. (National Adolescent and Young Adult Health National Resource Center).

Additional Resources

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.