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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 7: Injury Hospitilization

MCH Best Logo mother and young girl in pajamas holding hands

Strategy. Person-to-Person Interventions Outside the Clinical Setting

Approach. Adopt person-to-person interventions such as the drug disposal program, Count it! Drop it! Lock it!

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Overview. Evidence suggests that critical components of peer-education based strategies include the educational component, an opportunity for discussion, and an opportunity for caregivers and child to practice skills.1 A systematic review concluded that peer-to-peer interventions for caregivers, conducted outside of the clinical setting, were effective in reducing risk behaviors in children.2,3

Evidence. Moderate Evidence. Programs based on this strategy are likely to work. This strategy has been tested more than once and results trend positive overall. Peer education components can also include communication campaigns, dissemination of written materials, educational programs, and one-on-one counseling. Access the findings from the environmental scan through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Patients/Consumers/Caregivers.

Outcome. Injury Prevention. 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 15 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.

Sample ESMs. Using the approach “Adopt peer-to-peer interventions such as the drug disposal program, Count it! Drop it! Lock it!” 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 peer-to-peer intervention programs.
  • Number of counties that adopt peer-to-peer intervention programs.

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

  • Percent of participants who participated in peer-to-peer intervention programs and responded that the program contained good content.
  • Percent of counties that adopt peer-to-peer intervention programs.

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

  • Number of participants who participated in peer-to-peer intervention programs and responded that they iincreased knowledge related to safe behaviors.
  • Number of participants who participated in peer-to-peer intervention programs and responded that they intend to adapt safe behaviors.
  • Number of counties that adopt Count it! Drop it! Lock it! Educational programs that have formal partnerships with schools, healthcare providers, pharmacists, law enforcement or other sectors to increase reach of educational programs.

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

  • Percent of participants who participated in peer-to-peer intervention programs and responded that they iincreased knowledge related to safe behaviors.
  • Percent of participants who participated in peer-to-peer intervention programs and responded that they intend to adapt safe behaviors.
  • Percent of counties that adopt Count it! Drop it! Lock it! Educational programs that have formal partnerships with schools, healthcare providers, pharmacists, law enforcement or other sectors to increase reach of educational programs.

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.

References:

1 Burrus, B., Leeks, K. D., Sipe, T. A., Dolina, S., Soler, R., Elder, R., . . . Dittus, P. (2012). Person-to-person interventions targeted to parents and other caregivers to improve adolescent health: a community guide systematic review. American Journal of Preventive Medicine, 42(3), 316-326. doi: 10.1016/j.amepre.2011.12.001.

2 Strengthen the Evidence for MCH Programs: Environmental Scan of Strategies -- National Performance Measure #7

3 Children's Safety Network. Evidence-based and evidence-informed strategies for child and adolescent injury prevention. Education Development Center (2019).

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.