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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Medical Home: Personal Doctor or Nurse.

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Strategy. Respectful, Person-Centered Care

Approach. Address specific needs experienced by children and families in a way that tailors care to patients’ norms, customs, backgrounds, beliefs, values, language, and literacy skills

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Overview. Recognizing and addressing barriers to care is crucial to improving healthcare utilization. By providing high quality care, including language interpretation services and training for healthcare providers, trust can be increased and families can be encouraged to establish a relationship with a personal doctor or nurse. In particular, pediatricians can play a significant role in improving healthcare experiences and health outcomes by providing supportive care to populations who have additional health needs, such as connecting transgender youth to gender-affirming services, including specialty clinics as well as providing social support to patients and families. Making patients feel comfortable and supported in their health-care setting is essential to forming a connection with the primary healthcare team, especially in the patient-centered medical home model.[1]

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.
  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
  • 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. Direct Care (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-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 healthcare providers and staff who receive training on respectful, person-centered care. (Assesses workforce capacity building for responsive care)
  • Number of medical interpreters, community health workers, and patient navigators hired to support children and families from multiple linguistic backgrounds. (Shows impact of language access infrastructure)

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

PROCESS MEASURES:

  • Percent of healthcare providers and staff who receive training on respectful, person-centered care. (Assesses workforce capacity building for responsive care)
  • Percent of medical interpreters, community health workers, and patient navigators hired to support children and families from multiple linguistic backgrounds. (Shows impact of language access infrastructure)

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

PROCESS MEASURES:

  • Number of community partnerships and collaborations led by Title V established to inform, guide, and support the implementation of care strategies who report high levels of engagement. (Measures community engagement)
  • Number of children and families who report high levels of satisfaction, and trust in their healthcare experiences. (Measures patient-reported outcomes)

OUTCOME MEASURES:

  • Number of communities that experience improved health outcomes and enhanced trust and engagement in the healthcare system as a result of widespread adoption of comprehensive care practices. (Measures impact of population health work)
  • Number of best practices, tools, and resources for competent care that are disseminated, adapted, and scaled across healthcare organizations and systems. (Shows spread and replication of effective care models)

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

PROCESS MEASURES:

  • Percent of community partnerships and collaborations led by Title V established to inform, guide, and support the implementation of care strategies who report high levels of engagement. (Measures community engagement)
  • Percent of children and families who report high levels of satisfaction, and trust in their healthcare experiences. (Measures patient-reported outcomes)

OUTCOME MEASURES:

  • Percent of communities that experience improved health outcomes and enhanced trust and engagement in the healthcare system as a result of widespread adoption of comprehensive care practices. (Measures impact of population health work)
  • Percent of best practices, tools, and resources for competent care that are disseminated, adapted, and scaled across healthcare organizations and systems. (Shows spread and replication of effective care models)

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] Guss, C. E., Eiduson, R., Khan, A., Dumont, O., Forman, S. F., & Gordon, A. R. (2020). “It'd Be Great to Have the Options There”: A Mixed-Methods Study of Gender Identity Questions on Clinic Forms in a Primary Care Setting. Journal of Adolescent Health, 67(4), 590-596.

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.