Strategy. Support Clinic Systems in Promoting Attendance of Well-Visits
Approach. Provide information and guidance to actively schedule, code, and remind patients about the adolescent well-visit
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Overview. There is emerging evidence that supporting clinic systems to actively promote and document attendance of a well visit is effective. Specific strategies may include:
• Scheduling a future well-visit when adolescents are in for a sick visit.
• Converting sports physicals to a well-visit through the provision and documentation of well-visit services.
• Sending system reminders (e.g., emails/texts when adolescents are overdue for an annual visit).
Evidence. Emerging Evidence.
Strategies with this rating typically trend positive and have good potential to work. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").
Access the peer-reviewed evidence
through the MCH Digital Library or related evidence source.
(Read more about understanding evidence ratings).
Source. Peer-Reviewed Literature
Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):
- Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
- Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
- Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.
Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).
Intervention Level. Community-Focused
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. Here are sample ESMs to use as models 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).
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Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")
- Number of clinics and healthcare systems provided with information, guidance, and technical assistance from Title V agencies to promote adolescent well-visit attendance. (Assesses the reach and scale of the clinic support initiative)
- Number of clinic staff trained on best practices for scheduling, coding, and reminding patients about adolescent well-visits, including strategies for converting sports physicals and sick visits. (Measures the capacity building efforts to improve clinic process)
- Number of adolescent patients reached through clinic-based reminders (e.g., emails, texts) and outreach efforts to encourage well-visit attendance. (Evaluates the volume and reach of clinic-driven engagement strategies)
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Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")
- Percent of clinics and healthcare systems that have implemented standardized protocols and workflows for scheduling, coding, and reminding patients about adolescent well-visits. (Measures the adoption and institutionalization of best practices)
- Percent of adolescent patients and families who report receiving clear, timely, and personalized communication from clinics about the importance and scheduling of well-visits. (Measures the quality and patient-centeredness of clinic outreach and reminder efforts)
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Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")
- Number of partnerships and collaborations established between clinics, schools, community organizations, and youth-serving programs to promote adolescent well-visits and facilitate referrals and scheduling. (Measures the level of multi-sector engagement and care coordination)
- Number of quality improvement projects and data-driven initiatives implemented by clinics to identify and address differences in adolescent well-visit attendance and preventive care outcomes. (Measures the use of continuous improvement and attendance strategies)
- Number of adolescents from communities with low well-visit rates who attend comprehensive well-visits as a result of tailored clinic outreach, scheduling assistance, and reminder strategies. (Measures the impact on reducing gaps in preventive care access and utilization)
- Number of adolescents identified during well-visits with unmet health needs (e.g., mental health concerns, substance use) and connected to appropriate services and supports. (Measures the impact of well-visits on early identification and intervention)
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Quadrant 4:
Measuring Quality of Effect ("How are they better off?")
- Percent of clinic scheduling, coding, and reminder strategies that are tailored to the needs and preferences of adolescent populations (e.g., language, communication channels, health literacy). (Measures the appropriateness of clinic process)
- Percent of adolescent patients and families who are engaged in the design, implementation, and evaluation of clinic strategies to promote well-visit attendance. (Measures the level of patient and community partnership and input)
- Percent of adolescents who report increased knowledge, motivation, and self-efficacy in scheduling and attending well-visits as a result of clinic-based education, reminders, and support. (Measures the impact on empowering and engaging adolescents in their preventive care)
- Percent of overall adolescent healthcare costs in the jurisdiction that are shifted from emergency and hospital care to preventive and primary care as a result of increased well-visit attendance and early intervention through clinic system improvements. (Measures the long-term financial and system-level impact of the clinic support initiative)
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Note. When looking at your ESMs, SPMs, or other strategies:
- Move from measuring quantity to quality.
- Move from measuring effort to effect.
- Quadrant 1 strategies should be used sparingly, when no other data exists.
- 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.
