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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 6: Developmental Screening

MCHbest Logo toddler and doctor playing with their noses

Strategy. Provider Training

Approach. Train medical, social service, childcare providers, and home visitors on the importance of utilizing validated developmental screening tools.

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Overview. There is growing evidence that professional training may increase developmental screening rates.1

Evidence. Moderate Evidence. Programs based on this strategy are likely to work, but further research is needed to confirm effects. 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. Medical and childcare providers.

Outcome. Increased knowledge of the importance of developmental screening and confidence in using appropriate tools to accomplish screenings. Eventual goal of receipt of developmental screening using a parent-completed screening tool. 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.

The Enhancing Developmentall Oriented Primary Care (EDOPC) project created training programs to address barriers to developmental screenings, including lack of practitioner confidence in using validated screening tools.Project staff and peer educators (physicians and nurse practitioners) delivered a one-hour, on-site training on using the Ages & Stages Questionnaires to primary care providers and their entire office staff.

EDOPC also promote the routine use of screenings tools by increasing awareness of opportunities for providers to bill for screening services. Among a sample of primary care sites, where chart reviews were conducted, the EDOPC project increased developmental screening rates to the target of 85% of patients at most sites.2

The Role of Title V. Title V agencies can support health care provider training on developmental screening tools through a number of appraoaches:

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 “Train medical, socisl service, and childcare providers on developmental screening,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:

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

  • Number of medical and childcare providers that receive developmental screening training.

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

  • Percent of medical and childcare providers that receive developmental screening training.

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

  • Number of medical and childcare providers that receive developmental screening training who reported initiating developmental screens with parents in practice.

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

  • Percent of medical and childcare providers that receive developmental screening training who reported initiating developmental screens with parents in practice.

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:

1Garcia S, Brown E, Strobino D, & Minkovitz C. National Performance Measure 6 Developmental Screening Evidence Review. Strengthen the Evidence Base for Maternal and Child Health Programs. 2018. Women's and Children's Health Policy Center, John Hopkins University, Baltimore, MD.

2Alen SG, Berry AD, Brewster JA, Chalasani RK,& Mack PK. Enhancing developmentally oriented primary care: an Illinois initiative to increase developmental screening in medical homes. Pediatrics. 2010: 126 Suppl 3, S160-S164.

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.