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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 1: Well-Woman Visit

MCHbest Logo well-woman visit

Strategy. Nurse-Led Multicomponent Interventions

Approach. Support multicomponent interventions led by nurse practitioners to improve access to preventive services for women in health care settings.

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Overview. Emerging evidence indicates that multicomponent, quality improvement initiatives led by nurses can increase the rate of preventive screenings and routine health visits among uninsured and underserved women.  Staff engagement, team-building activities, eligibility screening and enrollment, patient education, and case log management are among the components that can improve outcomes.

Evidence. Emerging. There is emerging, recent evidence on the effectiveness of nurse-led, multicomponent interventions. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Providers; Patient/Consumers.

Outcome. Increase preventive screenings and annual well-woman visits among uninsured and underserved women. 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 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.

Sample ESMs. Using the approach “Support multicomponent interventions led by nurse practitioners to improve access to preventive services for women in health care settings,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of health care centers that trained nursing staff to lead a multicomponent initiative to increase preventive screenings and well-visits for women.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of health care centers that trained nursing staff to lead a multicomponent initiative to increase preventive screenings and well-visits for women.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of women ages 18-44 who attended a well-woman visit or received preventive screening as a result of a Title V-funded, nurse-led multicomponent initiative in a health care setting.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of women ages 18-44 who attended a well-woman visit or received preventive screening as a result of a Title V-funded, nurse-led multicomponent initiative in a health care setting.

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).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


 

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.