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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. NPM 10: Adolescent Well-Visit

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Strategy. Patient Reminders/Navigator Program

Approach. Support a patient reminder program that includes telephone and mailed reminders.

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Overview. Managed care-based mail or telephone reminders/multiple calls improved adolescent immunizations and preventive visits, with modest costs.1 Note: the addition of transportation services (and coordination through phone/mailed reminders) also increased attendance rates.

Evidence. Emerging. Patient reminders appear to have a positive impact on attendance in well-visits. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Patient/Consumer.

Outcome. Increased percentage of adolescents, ages 12 through 17, with a preventive medical visit in the past year. 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 a patient reminder program that includes telephone and mailed reminders,” 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 adolescents that received mail or telephone reminders about yearly well-visits.

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

  • Percent of adolescents that received mail or telephone reminders about yearly well-visits.

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

  • Number of adolescents that attended an immunization or preventive visit and attribute remembering the visit to a patient reminder.

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

  • Percent of adolescents that attended an immunization or preventive visit and attribute remembering the visit to a patient reminder.

Note. When looking at your ESMs, SPMs, or other strategies: (1) move from measuring quantity to quality; (2) move from measuring effort to effect; (3) Quadrant 1 strategies should be used sparingly, when no other data exists; and (4) the most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

Reference:

1 Szilagyi PG, Albertin C, Humiston SG, et al. A randomized trial of the effect of centralized reminder/recall on immunizations and preventive care visits for adolescents. Acad Pediatr. 2013;13(3):204-213.

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.