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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Transition.

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Strategy. Provider Training

Approach. Increase provider training in the field of youth health transition among residents and current providers

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Overview. Provider training is crucial for Title V programs aiming to improve successful transitions from pediatric to adult healthcare, as pediatric and internal medicine providers often report low comfort levels and lack formal curricula on this topic.[1] These programs can implement a standardized approach by offering formal training to pediatric providers on transition processes, enhancing their knowledge and skills.[2] Training content can include foundational concepts like the distinction between transition and transfer, age-appropriate discussion topics, and medicolegal changes.[1,3] Practical tools, such as one-page guides and EHR smart-phrases for standardized documentation, along with instruction on appropriate billing for transition counseling, should be part of the curriculum.[2,3] Such training significantly increases provider comfort in initiating transition discussions and identifying patient readiness and challenges, encouraging future practice change without significantly increasing visit duration.[1,2] Ultimately, clinician education, supported by relationships with adult clinics and structured workflows, is necessary for consistent transition intervention delivery.[3]

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Participant knowledge and skills assessment data
  • Changes in provider practices and behaviors
  • Data on sustainability indicators

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.
  • 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.

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. Health Teaching (Education and Promotion) (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 or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

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

  • Number of transition training modules developed and made available to health care professionals through collaboration between Title V programs and state AAP chapters. (Measures the availability and usability of training resources)
  • Number of healthcare professionals, including doctors, nurses, public health professionals, mental health counselors, and social workers, who participate in transition training modules. (Measures the reach and engagement of the training initiative)

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

  • Percent of health care professionals who complete all required components of transition training modules and demonstrate mastery of key competencies. (Measures the completion rates and effectiveness of training delivery)
  • Percent of transition training participants who report high levels of satisfaction, relevance, and engagement with the training modules. (Measures the acceptability and perceived value of training among health care professionals)

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

  • Number of quality improvement projects and evaluation studies conducted to assess the effectiveness, implementation, and impact of transition training modules. (Measures the use of data and continuous improvement strategies to optimize training quality and outcomes)
  • Number of policy and education initiatives undertaken to promote the use of transition training in health professional education, certification, and licensure requirements. (Measures the broader systems-level efforts to institutionalize transition training)
  • Number of CYSHCN from communities who receive high-quality, responsive transition services from trained professionals. (Measures the impact of training on advancing health and reducing gaps in transition outcomes)
  • Number of best practices, lessons learned, and successful transition training models disseminated and replicated across states and health professional education programs. (Measures the potential for spread, scale, and sustainability of transition training initiatives)

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

  • Percent of transition training modules that incorporate principles of trauma-informed care and person-centered planning to meet the needs of CYSHCN and their families. (Measures the participatory focus of training content and delivery)
  • Percent of transition training modules that are developed and delivered in partnership with CYSHCN, families, and community community partners to ensure relevance, acceptability, and responsiveness. (Measures the level of youth, family, and community engagement in training design and implementation)
  • Percent reduction in gaps for key transition outcomes (e.g., adult provider engagement, care coordination, self-management skills) between CYSHCN populations served by trained professionals and those served by untrained professionals. (Measures the impact of training on advancing health and closing transition gaps)
  • Percent of CYSHCN and families who report increased knowledge, skills, and self-efficacy in navigating health care systems and supporting their needs as a result of support from trained professionals. (Measures the impact of training on empowering and engaging CYSHCN and families as partners in the transition process)

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] Sathe, M., Werzen, A. S., Davis, N., & Millstein, L. S. (2022). Implementing a Longitudinal Adolescent Transition of Care Curriculum: Identifying Comfort and challenges Among Residents. Cureus.
[2] Katz, D., Lee, S., Sathananthan, V., Bayes Santos, L., & Langshaw, A. (2025). A Standardized Approach to Transition Improves Care of Young Adults with Inflammatory Bowel Disease. Pediatric Quality & Safety, 10(1), e786.
[3] Hasan, R., Lindert, R., Sullivan, D., Roy, S., & Martin, A. J. (2023). Pediatric to adult primary care transition for medically complex youth: A tale of learning from challenges experienced implementing a pilot project during COVID-19. Health Care Transitions, 1, 100027–100027.

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.