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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Developmental Screening.

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Strategy. Telephone-Based Developmental Screening. (National, State, for Centralized)

Approach. Support the use of a national telephone access number in collaboration with community-based family services

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Overview. Families in Los Angeles County with children ages 0 to 5 years who called 2-1-1- for assistance with basic needs, such as food, housing, employment and child care, were offered developmental screening by phone conducted by a specialized care coordinator using the Parental Evaluation of Developmental Status. (PEDS) Online system. The care coordinator used automated risk assessments and shared decision-making with parents to connect families to needed services including early intervention, behavioral health and social support services, and early care and education, including Head Start.[1]

Evidence. Moderate Evidence. Strategies with this rating are likely to work. These strategies have been tested more than once and results trend positive overall; however, further research is needed to confirm effects, especially with multiple population groups. These strategies also trend positive in combination with other strategies. (Clarifying Note: The WWFH database calls this "some 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):

  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.
  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

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. Population/Systems-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).

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

PROCESS MEASURES:

  • Number of calls received by the national telephone access number from families seeking assistance with basic needs and child development concerns. (Measures the reach and utilization of the centralized screening service)
  • Number of care coordinators trained to conduct telephone-based developmental screening using validated tools like PEDS Online. (Quantifies the workforce capacity to provide the screening intervention)

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

PROCESS MEASURES:

  • Percent of telephone-based developmental screening calls that adhere to standardized risk assessment and shared decision-making protocols. (Assesses fidelity to evidence-based screening practices)
  • Percent of families calling the access line who are offered telephone-based developmental screening as part of the intake and assistance process. (Measures the consistency of screening service delivery)

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

PROCESS MEASURES:

  • Number of communities that adopt the telephone-based developmental screening model in collaboration with their 2-1-1 for early childhood resource lines. (Measures the spread and scale-up of the innovative approach)
  • Number of joint training and data-sharing agreements established between the telephone access line and early intervention, behavioral health, and social service agencies. (Assesses the level of systems integration and coordination)

OUTCOME MEASURES:

  • Number of communities that show an increase in early identification and intervention rates for developmental delays after implementing the telephone-based screening model. (Shows the population health impact of the systems-level approach)
  • Number of families screened and served by the telephone-based screening initiative who report increased resilience and access to supportive community resources. (Assesses the broader family well-being outcomes of the integrated screening and linkage process)

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

PROCESS MEASURES:

  • Percent of telephone-based developmental screening services provided in languages other than English. (Measures usability and responsiveness of the service)
  • Percent of families engaged in telephone-based screening who share key characteristics. (Measures the reach and focus of the intervention on populations facing access issues)

OUTCOME MEASURES:

  • Percent reduction in gaps in developmental screening and service utilization rates between various groups after implementation of the telephone-based access model. (Measures impact on health access and reach)
  • Percent increase in the proportion of children from communities facing challenges to healthcare access who are identified early and linked to developmental supports through the collaborative telephone screening initiative. (Measures progress toward population-level identification in early intervention access and outcomes)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. 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.

References

1 Nelson BB, Thompson LR, Herrera P, Biely C, Zarate D, Aceves I, Estrada I, Chan V, Orantes C, Chung P. Telephone-Based Developmental Screening and Care Coordination Through 2-1-1: A Randomized Trial. Pediatrics (2019) 143 (4): e20181064. https://doi.org/10.1542/peds.2018-1064.

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.