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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 12: Health Care Transition

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Strategy. Provider Training/Workforce Development

Approach. Provide transition training modules to health care professionals.

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Overview. Research has shown that providers report satisfaction and increases in knowledge and skills with training. Workforce development is additionally an evidence-based practice that has utility in related topic areas. Currently, few residency programs incorporate transition training and these programs have not been evaluated sufficiently. However, initial research is encouraging for effectiveness.1 A suggested approach for provider training is that Title V programs could collaborate with state AAP chapters to develop an online module or quality improvement project for providers.

Evidence. Emerging Evidence. There is emerging, recent evidence on the effectiveness of provider training improving transition. This strategy has been tested more than once and results trend positive overall. However, more research is needed for conclusive results. Additionally while a few residency programs incorporate transition training, this has not been evaluated. Access the peer-reviewed evidence through Outcome Evidence for Structured Pediatric to Adult Health Care Transition Interventions: A Systematic Review and Outcomes of pediatric to adult health care transition interventions: An updated systematic review (Got Transition/Center for Health Care Transition Improvement). (Read more about understanding evidence ratings).

Target Audience. Providers.

Outcome. Providers with the training necessary to improve transition services. See the AMCHP/Got Transition NPM 12 Implementation Toolkit: Measurement and Assessment Strategic Approaches for tools to download. 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. There are currently 14 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM. Current agency-based examples drawn from the AMCHP/Got Transition NPM 12 Implementation Toolkit: Health Care Professional Workforce Development Strategic Approaches include:

Sample ESMs. Using the approach “Provide transition training modules to health care professionals (including nurses, public health professionals, social workers,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework. Training modules might include Got Transition/Center for Health Care Transition Improvement's Health Care Transition for Adolescents and Young Adults online video CME course (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 providers who have completed transition training.
  • Number of providers who indicate satisfaction with the transition training.

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

  • Percentage of providers who have completed transition training.
  • Percentage of providers who indicate satisfaction with the transition training.

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

  • Number of providers who have completed transition training and report practice changes.
  • Number of practices who have incorporate transition policies as a result of the training module.
  • Number of adolescents who have transitioned to an adult provider who were seen by a practice that completed the training.

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

  • Percentage of providers who have completed transition training and report practice changes.
  • Percentage of practices who have incorporate transition policies as a result of the training module.
  • Percentage of adolescents who have transitioned to an adult provider who were seen by a practice that completed the training.

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:

1White PH, Cooley WC, Transitions Clinical Report Authorizing Group, American Academy of Pediatrics, American Academy of Family Physicians,& American College of Physicians. Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home. Pediatrics. 2018;142(5):e20182587

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.