MCHbest. NPM 1: Well-Woman Visit
Strategy. Engagement of Other MCH Programs to Disseminate Information and Make Referrals for Well-Woman Visits
Approach. Provide education on the importance of the Well-Woman Visit to other MCH programs such as WIC, Healthy Start, MIECHV and other home visiting programs; encourage these programs to make referrals for visits.
Overview. Educational materials focused on the Well-Woman Visit can be integrated into the educational efforts of vaginoscopies MCH programs, such as WIC, Healthy Start, MIECHV, and other home visiting programs. Provide specific interventions to connect women to their primary care provider, medical home, and insurance. Track the use of preventative annual care by evidence-based program, if possible. Note: while these programs do not serve all women, they do serve women with the lowest rates of use of the well-woman visit.
Evidence. Expert Opinion. Evidence for this strategy is based on experience from the field and related evidence focused on a variety of efforts to integrate additional “components” into other evidence-based Maternal and Child Health programs.1 (Read more about understanding evidence ratings).
Target Audience. Systems.
Outcome. Percent of women with a past year preventive visit. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.
Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
CA expands the availability of well-woman health services by increasing the number of access points within local health jurisdictions (BIH Program, AFLP, CHVP, CPSP, CCS, WIC, etc.) and measuring the percent of local health jurisdictions that have adopted a protocol to ensure that all persons in Maternal and Child and Adolescent Health Programs are referred for enrollment in health insurance and complete a preventive visit.The Role of Title V. Title V can:
- Work with the MIECHV program to determine how home visitors are trained with respect to women’s health issues, jointly develop training, and assist with training of MIECHV home visitors and other home visitors in state.
- Work with the WIC program to determine the extent to which WIC personnel routinely ask women about whether they have a medical home and the extent to which adult WIC participants are linked to insurance and to a medical home; based on this assessment, work with WIC to develop trainings to assure WIC personnel refer women to insurance coverage and a medical home.
- Develop a toolkit that can be utilized by all MCH partner programs with a focus on well-woman care and the well-woman visit to include modules on the well-woman visit and its importance, how to determine if a woman has a medical home, how to refer to a medical home, how to link women to Medicaid or other insurance, how to track women’s use of preventive health care.
For additional suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies.
Sample ESMs. Using the approach “Provide education on the importance of the Well-Woman Visit to other MCH programs such as WIC, Healthy Start, MIECHV and other home visiting programs; encourage these programs to make referrals for visits,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).
1 Evidence for this strategy is drawn from similar approaches:
Integrating Breastfeeding into Home Visiting:
- McGinnis, S., Lee, E., Kirkland, K., Miranda-Julian, C., & Greene, R. (2018). Let’s talk about breastfeeding: The importance of delivering a message in a home visiting program. American Journal of Health Promotion, 32(4), 989-996.
- Kronborg, H., Væth, M., Olsen, J., Iversen, L., & Harder, I. (2007). Effect of early postnatal breastfeeding support: a cluster‐randomized community based trial. Acta Paediatrica, 96(7), 1064-1070.
- Mackrain M, Fitzgerald E, Fogerty S, Martin J, O'Connor R, Arbour M. The HV CoIIN: implementing quality improvement to achieve breakthrough change in exclusive breastfeeding rates within MIECHV home visiting. MIECHV TACC, June 2015
Integrating Developmental Screening into Home Visiting:
- 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.
Integrating a focus on Child Safety/Injury Prevention into Home Visiting:
- Filene, J. H., Kaminski, J. W., Valle, L. A., & Cachat, P. (2013). Components associated with home visiting program outcomes: A meta-analysis. Pediatrics. 132(0 2), S100-109. doi: 10.1542/peds.2013-1021H.
Integrating Oral Health Component through the WIC Program:
- Lipper, J. Advancing Oral Health through the Women, Infants, and Children Program: A New Hampshire Pilot Project. Center for Health Care Strategies, 2016. https://www.chcs.org/media/NH-State-WIC-Profile_041316.pdf
Integrating WIC and Immunization Services:
- Shefer, A., Fritchley, J., Stevenson, J. et al. Linking WIC and Immunization Services to Improve Preventive Health Care among Low-income Children in WIC. Journal of Public Health Management and Practice, 2002; 8(2): 56-65. https://journals.lww.com/jphmp/Fulltext/2002/03000/Linking_WIC_and_Immunization_Services_To_Improve.8.aspx
Integrating Women’s Health Care into the Well-Baby Visit:
- Caskey R, Stumbras K, Rankin K, Osta A, Haider S, Handler A. A novel approach to postpartum contraception: A pilot project of pediatricians' role during the well-baby visit. Contracept Reprod Med. 2016;1:7. Srinivasan S, Shlar L, Rosener S, Frayne D. Delivering interconception care during well-child visits: An IMPLICIT network study. J Am Board Fam Med. 2018;31(2), 201-10.