Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

Sign up for MCHalert eNewsletter

Evidence Tools
MCHbest. Medical Home: Family Centered Care.

MCHbest Logo

Strategy. Parent and Caregiver Partnership

Approach. Create opportunities for parents, caregivers and adolescents to strengthen their medical knowledge and advocacy skills to enhance the partnership with medical staff

Return to main MCHbest page >>

Overview. In addition to better understanding the medical needs of their children, parents enhance their partnerships with medical professional when they strengthen their medical knowledge and advocacy skills.[1, 2, 3, 4] By participating in interventions like the Parent Participation Improvement Program, or the online content offered through the Integrated Family Delivered Care program, parents learn skills to improve their partnership with nurses and participate in their child's care.[1, 2] Even something as simple as providing content about their child on a "Bit About Me Bedside Boards" can improve relationships between staff and parents, which then can foster parents' engagement in their child's care.[3] A similar approach with adolescent patients resulted in higher self-esteem and the belief that they can be active in patient engagement.[4] Parent participation programs, family-integrated care models, and the use of bedside boards can improve communication, engagement, attachment, and health outcomes.[1, 2, 3]

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):

  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
  • Provider Experience of Care. This strategy improves healthcare professionals' perceptions, feelings, and satisfaction with the work environment and systems they use.
  • Quality of Care. This strategy promotes the degree to which healthcare services meet established standards aimed at achieving optimal health outcomes.

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. Collaboration (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

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 parents and caregivers participating in health literacy and advocacy programs. (Measures family engagement in partnership-building)
  • Number of organizations offering health education for families. (Assesses availability of partnership-building resources)

OUTCOME MEASURES:

  • Number of parents demonstrating increased health literacy and advocacy skills. (Measures impact on family knowledge and skills)
  • Number of healthcare encounters with active family participation in decision-making. (Assesses behavioral changes in family engagement)

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

PROCESS MEASURES:

  • Percent of partnership programs co-designed with diverse families. (Measures authentic family engagement in program development)
  • Percent of education content tailored to diverse cultural and linguistic needs. (Assesses cultural relevance of partnership approaches)

OUTCOME MEASURES:

  • Percent of parents reporting increased confidence in navigating healthcare systems. (Measures family-reported outcomes of partnership-building)
  • Percent of care process involving collaborative decision-making with families. (Assesses shift towards family-centered care)

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

PROCESS MEASURES:

  • Number of coalitions formed to advance family partnership policies. (Measures field-building for system change)
  • Number of payment models incentivizing meaningful family engagement. (Assesses alignment of incentives with partnership goals)

OUTCOME MEASURES:

  • Number of healthcare policies establishing family partnership as a core care component. (Measures policy shifts to institutionalize family engagement)
  • Number of parent leaders serving as healthcare system change supporters. (Shows leadership development impact)

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

PROCESS MEASURES:

  • Percent of partnership initiatives aimed at engaging families from diverse communities. (Measures commitment to inclusivity in partnership efforts)
  • Percent of resources allocated to community-based organizations for family support. (Assesses tailored investment in community capacity)

OUTCOME MEASURES:

  • Percent reduction in disparities in family engagement across diverse groups. (Measures equity impact of partnership initiatives)
  • Percent of families from various backgrounds reporting meaningful partnership in healthcare decisions. (Assesses inclusivity in family engagement practices)

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] Heo YJ, Oh WO. The effectiveness of a parent participation improvement program for parents on partnership, attachment infant growth in a neonatal intensive care unit: A randomized controlled trial. Int J Nurs Stud. 2019 Jul;95:19-27. doi: 10.1016/j.ijnurstu.2019.03.018. Epub 2019 Apr 2. PMID: 31005676.

[2] Banerjee J, Aloysius A, Mitchell K, Silva I, Rallis D, Godambe SV, Deierl A. Improving infant outcomes through implementation of a family integrated care bundle including a parent supporting mobile application. Arch Dis Child Fetal Neonatal Ed. 2020 Mar;105(2):172-177. doi: 10.1136/archdischild-2018-316435. Epub 2019 Jun 21. PMID: 31227521.

[3] Spazzapan M, Vijayakumar B, Stewart CE. A bit about me: Bedside boards to create a culture of patient-centered care in pediatric intensive care units (PICUs). J Healthc Risk Manag. 2020 Feb;39(3):11-19. doi: 10.1002/jhrm.21387. Epub 2019 Aug 26. PMID: 31452293.

[4] Teela L, Verhagen LE, Gruppen MP, Santana MJ, Grootenhuis MA, Haverman L. Including the voice of paediatric patients: Cocreation of an engagement game. Health Expect. 2022 Aug;25(4):1861-1871. doi: 10.1111/hex.13530. Epub 2022 Jun 24. PMID: 35751406; PMCID: PMC9327851.

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.