HMG Staff Questions about Using the WVP

  1. About The Well-Visit Planner

What is the Well-Visit Planner?

The Well-Visit Planner (WVP) is an online pre-visit planning website that enables the parent to optimize use of visit time by focusing on the priorities, concerns, and other issues specific to the child and family. This interactive tool provides a series of questions to be completed by parents prior to their child’s well-visit, in which they pick which priorities they want to focus on during the upcoming visit. A customized visit guide is then generated foruse by both the child’s parents and health care providers.

The WVP website also includes access to educational materials and discussion tips for each of the Bright Futures (3rd edition) defined visit-specific focus areas. Carefully anchored to national recommendations, the WVP Suite of Tools are currently available for 4 month well-visit up to the 5/6 year well-visit. Below is a list of all the recommended well-visits for which the WVP addresses:

  • 4 months
/
  • 18 months

  • 6 months
/
  • 2 years

  • 9 months
/
  • 3 years

  • 12 months
/
  • 4 years

  • 15 months
/
  • 5-6 years

Are the questions asked in the WVP appropriate for our population?

Questions in the WVP are based on American Academy of Pediatrics Bright Futures Guidelines (3rd edition), which are recognized by pediatricians nationwide as the gold standard for guiding pediatric well-visits and engaging families and communities in the care of their children. A national expert panel developed the WVP to ensure that the questions are both relevant and appropriate for a wide range of young families. The questions contained in the WVP were tested with parents of children under 40 months old to ensure that they were readable and understandable. Most of the questions are written at or below an 8th grade reading level except in cases where doing so changed the meaning of the question or made it incomprehensible. The entire WVP is available in both English and Spanish. The WVP can be taken via computer or on a mobile device (cellular phone, tablet, notebook, etc).

How was the WVP developed and What are people saying about the WVP?

National experts, families and pediatric providers all collaborated in the design, development and testing of the WVP to ensure feasibility and to optimize impact on the quality and efficiency of the well well-child visit for parents, children and provider teams alike. Initial testing documented improvements to provider office workflow, patient engagement, patient experience, and quality of care. The WVP has been implemented in both clinical and community setting, tested extensively and integrated into select pediatric practices’ electronic medical records. Evaluation of the WVP found the tool statistically increased anticipatory guidance for physical care and injury prevention, developmental surveillance, and family psychosocial assessment.

Requiring an average of 10 minutes to complete, 92% of parents reported they would recommend the use of the WVP online tool to other parents. Additionally, 92% of parents said using the WVP increased the value of their visit.

  1. Why Use the WVP?

What are the benefits of adding another mechanism of engagementto our family interactions?

  • Leverages an existing resource to empower families to support their children’s healthy development through the implementation of four Core Components
  • Documenting parents’ concerns expressed at well-child visits and ensuring those concerns are addressed by utilizing the visit guide
  • Solidifying family goals around health and well-being
  • Enhancing parents’ utilization of HMG as an additional resource for complicated interactions with health care providers
  • Strengthening collaboration between amongHMG, health care providers, and families, as well as increasing family engagement

Will our population use an online tool? What if they only access the internet on their mobile device or at the library?

The WVP is available online via a computer or mobile device. For parents that do not have ready access to computers and/or printers, the public library often has these resources available for free. Parents can also complete the WVP on computers in the HMG affiliate site center, if available. If the parent is contacted via the call center and does t have access to a computer, HMG staff can complete the WVP during the call on behalf of the parent and then print and mail and/or email the customized visit guide to a valid mailing address. Both the online and mobile versions include options to print, send (via email), or save a PDF of the visit guide, increasing the adoptability of the tool.

A growing majority of young parents access the internet everyday including families without home computers and families living at or below the poverty line. Getting your families to use the WVP online is less about access to technology and more about building a culture where parents are actively engaged in preparing for their child’s well-visit. If you receive feedback from your families that an internet-based tool is not useful please contact the CAHMI.

  1. How does the WVP work?

What topics are covered in the WVP and how does it work?

The WVP is anchored to the American Academy of Pediatrics’ and Maternal and Child Health Bureau’s Bright Futures Guidelines(3rd edition)and includes key age-specific developmental milestones for each of the 4, 6, 9, 12, 15, 18, 24 and 36 month and 4, 5 and 6 year well-visits. There are three steps to completing the WVP:



  • Step 1: Answer a questionnaire about your child and family. Includes questions about positive observations of the child, child health and developmental surveillance, the child and family environment, and identification of special health care needs.
  • Step 2: Pick your priorities. Includes age-specific topics and embedded educational materials. General topics include family functioning, nutrition and feeding issues, establishing routines, behavior and development, language development, toilet training, TV and media use, guidance and discipline, sleep, domestic violence, oral health, and safety concerns.
  • Step 3: Visit Guide. Dynamically generated from steps one and two, the visit guide is a summary of responses that are important to discuss with the child’s health care provider, selected priorities with relevant example questions, and space for notes. This visit guide is essential for linkage of the WVP to family engagement at their child’s well-visit.

The WVP Guide to Topics and Questions provides a comprehensive list of questions asked specific to each age group. You can also walk through the WVP at any time for free.

What is the reading level of the questions in the WVP?

The questions contained in the WVP were tested with parents of children under 40 months old to ensure readability and understandability. Most of the questions are written at or below an 8th grade reading level except in cases where doing so changed the meaning of the question or made it incomprehensible.

Will the WVP help families with children with special health care needs (CSHCN)? What if the child is doing fine and doesn’t need any help?

Yes, the WVP can help all families, including children with special health care needs. The WVP is a planning tool to help families identify priority topics, prepare for the next well-child visit, and engage the family in their child’s health, regardless of how the child’s current health status. Even if a child is doing fine, there may be important issues to discuss, concerns that the family has, or other issues not directly related to the child’s current health or developmental status — for example, currentor potential dangers in the neighborhood or at school, anticipated changes in a family’s situation such as job change or move, or problems with the health of a family member. Moreover, the child’s or family’s situation may change between the time the guide is filled out and the visit takes place. The WVP can support the family by promptingideas about important topics to discuss during the visit.

Is there a paper version of the WVP?

Yes, Shared Encounter Forms (SEFs) provide the family with an opportunity to answer the WVP questions, but many of the benefits of the WVP are missing. These include the summary Visit Guide which highlights topics important to discuss with the medical provider, and access to educational resources on topics of interest to the family. The SEFs are only available for the all ages for which the WVP available. Additionally, it is only in English, limiting the population reach.This should be used only as a “last resort” for families to engage in the WVP at your site.

Will the HMG affiliate site receive a copy of the WVP Visit Guide?

Staff may ask families to share a copy of their personalized visit guide for HMG records if the parent is comfortable doing so. This is not a requirement of utilizing the WVP, and the de-identified data from parents will be available for each HMG site.

Does the WVP include any standardized screening tools? How will these fit with HMG’s existing screening resources?

The WVP is a general surveillance tool to which more specific screeners can be added. The WVP includes the Children with Special Health Care Needs (CSHCN) screener, and has the capability of adding links to publicly available screeners such as the Ages and Stages Questionnaire (ASQ) for those that have purchased the tool. Based on results from these common screeners in the WVP, families can then be directed to further screening from the provider or from the HMG care coordinator.

How long does it take to implement the WVP and what is involved?

We recommend allocating one to two months for preparing staff to implement the WVP, depending on the size and scope of your HMG affiliate site. The CAMHI will provide training for staff as well as additional resources to support implementation. These additional resources include a Pre-Implementation Guide, Implementation Map, Family Participation Tracker, and Implementation Toolkit, to name a few. Additional documents, including FAQs and family and provider information will also be included in resources for all HMG sites. These resources are all available on the HMG WVP Implementation portal on the CAHMI website.

  1. Family Engagement

Why is it important to engage parents in well-child care?

Despite improvements in some areas, studies continue to show persistent gaps in the quality of well-child care and the nation’s capacity to promote the healthy development of young children. Improving communication and partnershipsamong families, providers, and family resource centers is essential for improving quality of care to meet the unique priorities and needs of each child and family. The CAHMI designed the guideline-based, easy to use WVP to help providers efficiently meet their well-visit quality goals and ultimately to improve the wellness of children and families.

When shouldI introduce the WVP to parents?

The WVP will be offered to parents by HMG centralized access point staff. While interacting with families, the HMG centralized access point staff will offer parents the opportunity to complete the age-appropriate WVP. As the WVP is an online tool, parents will be encouraged to access the tool either through a computer or their mobile device (or an on-site computer if the interaction is in-person). Centralized access point staff will be trained to provide key information to families, including the importance and value of the WVP, the application to the child’s care, and how to use the WVP to plan for an upcoming well-visit with their child’s primary care provider. On average, the WVP takes less than 10 minutes to complete; despite this time, we expect the WVP to enhance communication between HMG staff and families. As HMG sites’ centralized access point staff routinely follow-up with families, they will ask about completion of the WVP and if parents utilized the visit guide at their child’s well-visit.

How many families should I engage in use of the WVP?

Start by engaging a minimum of 30-50 families during the pilot period. HMG affiliates are encourage to engage as many families as possible.

How canI introduce the WVP to parents so they are willing to use it?

Getting families to actively engage in their child’s healthcare can be challenging. However, the WVP is specifically designed to ease this process. The HMG WVP Implementation Portal includes many resources, such as video tutorials and informational and customizable flyers, that help teach your families about the WVP and encourages them to use it. We also provide scripts for inviting families to participate via email, phone calls, or in person.

  1. Partnering with Providers

Are pediatricians expecting to see the WVP?

Pediatricians will be familiar with American Academy of Pediatrics Bright Futures Guidelines, however they might not know about the WVP. The WVP Visit Guide, whichparents receive after completing the tool andcan be sent to their provider or printed and brought to their provider, has orienting information for the healthcare provider.

How and with what do I engage providers on learning about the WVP?

HMG sites will also be expected to incorporate the WVP into their ongoing education and outreach to child health providers. Given the strong existing relationships some sites have with many child health practices, or their location (e.g. central access point is in a hospital setting), many HMG sites are well-positioned to share knowledge regarding how the WVP supports parents in prioritizing concerns and questions, thereby extending the reach of this innovation. In addition to recognizing the value of the WVP within the HMG sites, providers will also be directed towards available resources which expand their capacity to further engage the WVP within their practice. Engagement of providers with the WVP has potential to greatly impact the amount of families reached by the WVP in these communities.

If your HMG site has a relationship with the providers that care for your families, we encourage you to contact them; if your site does not yet have established relationships with child health care providers or practices, we encourage you to leverage the WVP and associated resources to serve as a starting point for these helpful partnerships. Providers can be directed to the HMG-WVP Implementation portal on the CAHMI website, where they will find provider-specific resources, including flyers and FAQs.

  1. Patient Confidentiality and Use of WVP Data

Does the WVP collect Protected Health Information (PHI)?

NO: The WVP does not collect protected health information (PHI) or information that can lead to the identification of the parent or child. For the public use website parents are asked to provide two pieces of personally identifiable information: child’s first name and child’s date of birth. However, this information is NEVER stored in our database. Rather, the child’s first name and date of birth are used “on-the-fly” to auto-populate into the well-visit guide and to calculate the appropriate upcoming well-child visit for which the WVP tool will be tailored to. That visit (e.g. 4 month, 6 month, 9 month etc.) is stored in our database rather than the date of birth.Parents must consent and agree to the Terms & Conditions of the WVP before completing it.

Parents can, if they choose, email themselves or their provider the Visit Guide, but this takes place outside of our website. The CAHMI is not responsible for the transmission of any personally identifiable information sent via email through a parent or provider’s personal or professional email accounts.Identifying information connected to the computer (IP address) will not be recorded by the CAHMI at any time.

It is up to the HMG sites to collect any information they want from the families at the time of the referral to the WVP and to use the WVP Family Participation Tracker and/or site-specific software if they want to follow-up with families use of the WVP.

How is the WVP information being used? Where is data being stored?

The Well-Visit Planner is part of a study conducted by the Child and Adolescent Health Measurement Initiative and approved by the Institutional Review Board at Johns Hopkins Bloomberg School of Public Health. As such, the CAHMI tracks overall use of the WVP and population-level information to learnhow and where the tool is being used. The CAHMI uses the information for research purposes and improvement of program materials. The CAHMI does not have the ability to identify individuals from the data that is stored. The online WVP includes an informed consent form which the parent must fill out completely prior to using the tool. Currently the WVP is only available to parents who are 18 years or older due to privacy and legal restrictions.