Bright Futures is a national health care promotion and disease prevention initiative that uses a developmentally based approach to address children’s health care needs in the context of family and community. Its purpose is to promote and improve infant, child, and adolescent health within the context of family and community.

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One of the greatest strengths of Bright Futures is that its content and approach are found useful not only to health care professionals, but to a wide variety of families and child health care advocates working to promote child health. These groups consist of, but are not limited to:

• Pediatricians
• Nurse Practitioners
• Mental health professionals
• Oral health professionals
• Dietitians/Nutritionists  
• Child care workers
• Home visitors
• Educators/teachers
• Health educators
• Residency program students 
• Parents
• Families  

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The Education Center is a project of the American Academy of Pediatrics (AAP) funded by the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB). The central responsibility of the Education Center is enhancing the knowledge of health care professionals and the public about Bright Futures philosophy, guidelines and tools, and about the value of clinically based health promotion and prevention.

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The Third Edition builds on the foundation of the first and second editions because it describes a system of health care that is unique in its attention to health promotion activities and psychosocial factors of health and its focus on child, youth, and family strengths and because it recognizes that effective health promotion and disease prevention requires coordinated efforts among a diverse array of medical and nonmedical professionals and agencies.

However, the Third Edition breaks new ground in several ways. It is structured differently from earlier editions in that it begins with 10 thematically focused chapters that highlight key issues that repeatedly emerge across the developmental stages. These themes are of critical importance in efforts to promote the health and well-being of infants, children, youth, and families. In addition, the Third Edition’s health supervision guidance for each Bright Future visit is organized around priorities that assist the health care professional to focus the visit on the most important issues for a child of that age. Anticipatory guidance activities for each visit are presented in several ways, including a brief note for health care professionals, sample questions, discussion points, and suggested guidance for parents, children, and youth.

Evidence for effectiveness was a core criterion for including, or excluding, certain interventions and recommendations in this edition. The Bright Futures Project Advisory Committee used several approaches to incorporate evidence to the extent possible. Finally, this edition recognizes that health care supervision must keep pace with changes in family, communities, and society. As a result, discussions about care for children and youth with special health care needs, cultural competence, and complementary and alternative care are incorporated throughout this Edition.

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In addition to the training materials and the EQIPP module described above, efforts are underway to update the second edition of Bright Futures in Practice: Nutrition, which was last published in 2002. The third edition, scheduled for release in 2010, will be completely consistent with the Bright Futures Guidelines for Health Supervision, Third Edition. A companion Bright Futures in Practice:  Nutrition Pocket Guide is scheduled for release in September 2010.

The Bright Futures for Families Pocket Guide is under development by Family Voices along with a set of Bright Futures for Families Theme Sheets. When completed in 2010, these materials will be available at www.brightfuturesforfamilies.org.

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Yes, in October 2009 the AAP Bright Futures Education Center released the Bright Futures Tool and Resource Kit, a new resource designed to help pediatricians and other health care practitioners put the Guidelines into practice. The Kit and the Guidelines fit together beautifully: the Guidelines provides the background knowledge that makes it possible to use the Tool and Resource Kit effectively, and the Kit is a resource that helps providers carry out the Guidelines efficiently, thoroughly, and intuitively.

The Kit provides questionnaires, forms, handouts, and other tools for each of the Bright Futures well-child visits, from prenatal to age 21. All materials are provided on a CD for easy download. Providers can use or adapt these materials to meet the needs of their practices and ensure they cover all the bases when delivering care to their patients. The Tool and Resource Kit includes 3 groups of core tools:

1. Pre-visit Questionnaires, which parents (or adolescent patients) fill out before seeing the caregiver. This form asks about Bright Futures priority topics appropriate for the particular age-based visit, and allows the patient or parent to note any special concerns. Having the patient or parent fill out the form before the visit means that practitioners have more quality and personal time to spend with patients — time that would otherwise have been spent asking the questions on the form.


2. Documentation Forms, which give the practitioner guidance on which questions to ask and issues to address, based on the age of the child and the visit’s Bright Futures priorities. These simple, 1-page forms are more than just typical encounter forms. They help practitioners make sure to touch on the right topics for the visit. If used consistently over a patient’s entire pediatric lifetime (up to 21 years), they ensure that the child has received all of the Bright Futures recommended screenings and that no aspect of care has fallen through the cracks.


3. Parent Handouts, which cover the anticipatory guidance priorities discussed in each visit. At least 5 parent-friendly handouts have been developed for each age-based visit, and the information has been drawn from thoroughly tested and researched materials developed by experts in each topic. The Handouts cover the anticipatory guidance topics from the Guidelines, as well as a wide range of other issues relevant to the needs of all children.

The Tool and Resource Kit also features additional materials to enhance providers’ ability to conduct a Bright Futures visit. They include parent/patient education handouts on a range of issues relevant to the needs of all infants, children, and adolescents; practice management tools for preventive care; and developmental, behavioral, and psychosocial screening and assessment tools.

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Yes, as an outgrowth from the Bright Futures Training Intervention With Office Staff (BFTI) project,AAP has developed a 3-volume set of tools. The year-long pilot project funded by the Commonwealth Fund, tested a framework that included 6 office system components:

1) Using a preventive services prompting system
2) Using structures screening to assess developmental and behavioral needs
3) Evaluating parental strengths and needs
4) Using recall and reminder systems
5) Linking to community resources
6) Identifying children with special health care needs

The BFTI represents a unique "office systems" approach to improving specifically the delivery of developmental screening and preventive services for children under age 5. This collaborative learning intervention involves engaging multidisciplinary office teams from primary care practices over a period of approximately 1 year in implementing in their office setting 6 of the key components and strategies listed above that embody the Bright Futures philosophy.

Lessons learned from the BFTI project has served as the foundation for the new EQIPP ("Educating Quality Improvement in Pediatric Practices" module coming in early 2010.

For more information, access the 3 Volume Set of Materials, read the full journal article outlining the findings of the Bright Futures Training Intervention With Office Staff  and view a multimedia presentation of the project findings.

 

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The AAP was funded by MCHB to carry out the Bright Futures Initiative and to develop and publish the Third Edition of the Bright Futures Guidelines and associated materials. The National Center for Education in Maternal and Child Health (NCEMCH) at Georgetown University developed and published the Second Edition of the the Bright Futures Guidelines and continues to develop reated materials.

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You can find out about the latest Bright Futures developments through Bright Futures workshops and by signing up to receive electronic newsletters by requesting it through our contact form. Visit our exhibit booths at national meetings of pediatrics professionals.

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Some materials are available free of charge. Please use the contact form to submit a request. Others materials may be purchased online at the AAP online bookstore.

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Yes, all Bright Futures materials are copyrighted. To use the current Bright Futures materials, please fill out our contact form.

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Selected Bright Futures materials, available at the AAP online bookstore, have been translated into Spanish. AAP is currently investigating the possibility of translating Bright Futures materials into other languages.

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>A national process evaluation that assessed the evolution and use of Bright Futures was conducted during 2003-2004 and described the experiences of those involved in using Bright Futures in child health policy and practice. In addition, a series of case studies were conducted in 2005 that detail the stories of several states using Bright Futures to foster child health promotion. Documents on these studies can be found at:

	Assessing the Bright Futures for Infants, Children and Adolescents Initiative
	Using Bright Futures in Public Health Efforts to Promote Child Health: Findings from Six Case Studies

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Yes, workshops are being conducted to train professionals who work with children in the Bright Futures approach, and we are working with our partners to expand this effort. Please send us a request through our contact form to receive more information.

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