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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 10: Adolescent Well-Visit

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Strategy. Quality Improvement (QI) Initiatives to Increase Adolescent Well-Visits

Approach. Develop and adopt multicomponent QI initiatives within pediatric practices to increase annual well-visits for adolescents.

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Overview. Studies show that pediatric practices that implement multicomponent quality improvement (QI) initiatives can increase adolescent well-care visits compared to practices that do not implement QI programs.1

Evidence. Moderate. Quality improvement initiatives based on this strategy are likely to work. 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. Pediatric practices; adolescent patients.

Outcome. Increase annual well-visits for adolescents. 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 from across all states/jurisdictions 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 “Develop and adopt multicomponent QI initiatives within pediatric practices to increase annual well-visits for adolescents,” 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 pediatric practices that implemented QI initiatives to increase annual well-visits for adolescents.

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

  • Percent of pediatric practices that implemented QI initiatives to increase annual well-visits for adolescents.

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

  • Number of adolescent patients who had annual well-visits at pediatric practices that implemented QI initiatives.

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

  • Percent of adolescent patients who had annual well-visits at pediatric practices that implemented QI initiatives.

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.


Reference:

1 Rose M, Maciejewski H, Nowack J, Stamm B, Liu G, Gowda C. Promoting pediatric preventive visits through quality improvement initiatives in the primary care setting. The Journal of Pediatrics 2021;228: 220-227.

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.