Paula M. Duncan

Improving Delivery of Bright Futures Preventive Services at the 9- and 24-Month Well Child Visit

OBJECTIVES: To determine if clinicians and staff from 21 diverse primary care practice settings could implement the 2008 Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd edition recommendations, at the 9- and 24-month preventive services visits. METHODS: Twenty-two practice settings from 15 states were selected from 51 applicants to participate in the Preventive Services Improvement Project (PreSIP). Practices participated in a 9-month modified Breakthrough Series Collaborative from January to November 2011. Outcome measures reflect whether the 17 components of Bright Futures recommendations were performed at the 9- and 24-month visits for at least 85% of visits. Additional measures identified which office systems were in place before and after the collaborative. RESULTS: There was a statistically significant increase for all 17 measures. Overall participating practices achieved an 85% completion rate for the preventive services measures except for discussion of parental strengths, which was reported in 70% of the charts. The preventive services score, a summary score for all the chart audit measures, increased significantly for both the 9-month (7 measures) and 24-month visits (8 measures). CONCLUSIONS: Clinicians and staff from various practice settings were able to implement the majority of the Bright Futures recommended preventive services at the 9- and 24-month visits at a high level after participation in a 9-month modified Breakthrough Series collaborative.

Health Futures of Youth II: pathways to adolescent health, executive summary and overview

Health Futures of Youth II: Pathways to Adolescent Health, a national invitational conference, was convened on September 14–16, 1998, in Annapolis, Maryland. The Office of Adolescent Health (OAH) in the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration, U.S. Department of Health and Human Services (DHHS) sponsored the conference. Collaborating with OAH in the development of the conference was a non-Federal planning committee co-chaired by Drs. Charles E. Irwin, Jr. and Paula M. Duncan. The structure of the meeting was similar to the Health Futures of Youth conference sponsored by MCHB in 1986 at Daytona Beach, Florida. The recommendations developed at the 1986 meeting played a major role in shaping public health policy for youth during the past decade [1]. The 124 participants at Health Futures of Youth II Conference included many of the Nation’s leading experts on Adolescent Health from fields as diverse as communications, economics, education, law, medicine, nursing, nutrition, psychology, health policy, public policy, social work and sociology. Participants were charged with reviewing the most current research regarding major Adolescent Health issues and then developing recommendations designed to advance knowledge about, and improve, the health status and well-being of our adolescents. Recommendations on priorities for future research, training, and demonstration projects developed at the meeting, were intended to constitute an Adolescent Health agenda for the next decade. Work at the conference emphasized asset building and successes in Adolescent Health, but participants were also urged to find ways to improve the well-being of all adolescents — such as youth with special needs — and to include multiple perspectives in their deliberations. Participants met in six working groups to discuss broad topical areas and formulate sets of recommendations with rationales. Background papers were prepared to help focus the discussion of the work group participants. The four plenary presentations (and their corresponding papers as published in this volume) were included to highlight important crosscutting issues relevant to all of the work groups. On the final day of the conference, the work groups reported their recommendations in a general session and received responses from representatives of the public and philanthropic sectors. The final reports of the six working groups as reported in this volume reflect the integrated responses generated at this last session. The members of the Planning Committee are listed on the title page, and the Appendix lists all the participants in attendance at the conference.

Providing Health Supervision to Support High-Quality Primary Care: The Time is Now

From the Department of Pediatrics, University of Vermont College of Medicine, Burlington, Vt The authors are the editors of Bright Futures: Health Supervision Guidelines for Infants, Children and Youth, Third Edition. Address correspondence to Judith S. Shaw, EdD, MPH, RN, University of Vermont College of Medicine, N329 Courtyard at Given, 89 Beaumont Ave, Burlington, Vermont 05405 (e-mail: judith.shaw@uvm.edu).