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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Childhood Vaccination with MMR, Flu, and HPV.

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Strategy. Provider Assessment and Feedback

Approach. Initiate provider assessment and feedback to increase childhood vaccinations.

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Overview. These interventions assess providers’ delivery of one or more vaccinations to a client population and present providers with feedback on their performance. Feedback may cover a group of providers (e.g., average performance for a practice) or an individual provider. Feedback also may involve other components such as incentives or benchmarking.

Evidence. Scientifically Rigorous Evidence. Strategies with this rating are most likely to be effective...

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:

  • Provider self-efficacy and competency surveys
  • Clinic audit and feedback data
  • Parent Attitudes About Childhood Vaccines (PACV) Survey

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.
  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • 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. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

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 healthcare providers participating in assessment and feedback programs led by Title V. (Assesses adoption of strategy)
  • Number of feedback sessions or reports delivered to providers. (Evaluates frequency of intervention)

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

  • Percent of feedback reports developed for providers incorporating evidence-based benchmarks. (Measures adherence to quality standards)
  • Percent of feedback sessions including action planning for improvement led by Title V. (Evaluates strategic use of feedback)

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

  • Number of peer-to-peer learning opportunities created through feedback program that reports high level of engagement. (Shows collaborative improvement)
  • Number of system-level changes implemented based on aggregated feedback data. (Assesses broader organizational impact)
  • Number of providers achieving and maintaining "high performer" status in vaccination rates. (Quantifies sustained improvement)
  • Number of new vaccination outreach initiatives developed based on feedback insights. (Measures innovative responses)

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

  • Percent of peer-to-peer learning opportunities created through feedback program that reports high level of engagement. (Shows collaborative improvement)
  • Percent of system-level changes implemented based on aggregated feedback data. (Assesses broader organizational impact)
  • Percent of providers achieving and maintaining "high performer" status in vaccination rates. (Quantifies sustained improvement)
  • Percent of new vaccination outreach initiatives developed based on feedback insights. (Measures innovative responses)

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] Hong K, Leidner AJ, Tsai Y, Tang Z, Cho B, Stokley S. Costs of interventions to increase vaccination coverage among children in the United States: a systematic review. Academic Pediatrics 2021;21(4):S67-77.

[2] Brousseau N, Sauvageau C, Ouakki M, Audet D, Kiely M, Couture C, Pare A, Deceuninck G. Feasibility and impact of providing feedback to vaccinating medical clinics: evaluating a public health intervention. BMC Public Health 2010;10:750.

[3] Melinkovich P, Hammer A, Staudenmaier A, Berg M. Improving pediatric immunization rates in a safety-net delivery system. Joint Commission Journal on Quality & Patient Safety 2007;33(4):205-10.

[4] Nace DA, Hoffman EL, Resnick NM, Handler SM. Achieving and sustaining high rates of influenza immunization among long-term care staff. Journal of the American Medical Directors Association 2007;8(2):128-33.

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.