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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
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Strategy. Nurse-Led Multicomponent Interventions

Approach. Support multicomponent interventions led by nurse practitioners to improve access to preventive services for women in health care settings

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Overview. Research indicates that multicomponent, quality improvement initiatives led by nurses can increase the rate of preventive screenings and routine health visits among uninsured women or women with additional needs. Staff engagement, team-building activities, eligibility screening and enrollment, patient education, and caseload management are among the components that can improve outcomes.

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential 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:

  • Project proposals and contracts
  • Patient survey and feedback mechanisms
  • Healthcare providers (NPs) activity logs and tracking data

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • Policy. This strategy helps to promote decisions, laws, and regulations that promote public health practices and interventions.
  • 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. 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 healthcare settings implementing nurse-led multicomponent interventions to improve access to preventive services for women. (Measures the adoption of the intervention model across the healthcare system)
  • Number of nurse practitioners trained to lead multicomponent interventions, including staff engagement, team-building, eligibility screening, patient education, and case management. (Measures the capacity building efforts to support the interventions)

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

  • Percent of healthcare settings that have integrated nurse-led interventions into their standard operating procedures and quality improvement plans. (Measures the institutionalization and sustainability of the intervention model)
  • Percent of nurse practitioners leading interventions who receive ongoing training, mentoring, and performance feedback to ensure continuous quality improvement. (Measures the support provided for intervention leaders' professional development and success)

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

  • Number of community outreach events and patient education sessions conducted by Title V with nurse practitioners to raise awareness about the importance of preventive services and the availability of nurse-led interventions. (Measures the interventions' community engagement and health literacy promotion activities)
  • Number of referral pathways and care coordination protocols established between nurse-led interventions and other healthcare and social service providers to support women's holistic health needs. (Measures the interventions' integration with broader systems of care)
  • Number of women who report increased knowledge, self-efficacy, and engagement in their own preventive health care as a result of their participation in nurse-led interventions. (Measures the interventions' effect on women's empowerment and health literacy)
  • Number of nurse practitioners reporting increased job satisfaction, professional growth, and leadership skills as a result of their involvement in leading multicomponent interventions. (Measures the interventions' impact on the nursing workforce and practice environment)

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

  • Percent of Title V funding dedicated to supporting nurse-led interventions in healthcare settings serving women. (Measures the allocation of resources to areas of greatest need and potential impact)
  • Percent of nurse-led interventions that actively involve women from a focus population in the design, implementation, and evaluation of the intervention components. (Measures the level of patient and community engagement in the intervention process)
  • Percent reduction in differences for preventive service utilization and health outcomes between women from various groups, who were engaged through nurse-led interventions, and the general population. (Measures progress toward the elimination of gaps in service provision)
  • Percent improvement in population health indicators (e.g., reduced rates of preventable illnesses, increased life expectancy) in communities served by healthcare settings implementing nurse-led interventions, compared to baseline. (Evaluates the interventions' contribution to advancing public health goals)

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] Will, J. A., & Cheney, T. J. (2024). Navigating funding benchmarks: A research note. Journal of Applied Social Science, 19(1), 131-138.
[2] Kaczorowski, J., Hearps, S. J., Lohfeld, L., Goeree, R., Donald, F., Burgess, K., & Sebaldt, R. J. (2013). Effect of provider and patient reminders, deployment of nurse practitioners, and financial incentives on cervical and breast cancer screening rates. Canadian family physician Medecin de famille canadien, 59(6), e282–e289.
[3] Kiser, L. H., & Butler, J. (2020). Improving equitable access to cervical cancer screening and management. AJN The American Journal of Nursing, 120(11), 58-67.

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.