Training

 Individual Support, Group Workshops, and Web-based Delivery (non-measurement based)

State and community agencies may provide training to practices individually or in groups and in-person or online. This assistance can be critical in effective Bright Futures implementation, because practices may not have the resources or time to explore all of the Bright Futures tools and identify strategies for integration. Training can help practices learn how to evaluate their implementation efforts. Using peer medical professionals to lead trainings can improve the effectiveness of the training and ensure that the information being delivered is reliable and relatable.

 Individual training at the practice/clinic site

Characteristics
  • Usually brief, onsite sessions
  • Typically taught by peer practitioners
  • Technical assistance may follow
Benefits
  • Can act as introduction to Bright Futures and QI concepts
  • Through site visits, lets staff feel comfortable asking questions, mentioning barriers, and brainstorming
  • Reaches the entire practice at once
  • Can be less burdensome than other methods if sessions are short
  • Can be interactive and customized
  • Can include a simple evaluation component
  • Can encourage change from inside, rather than above
  • Can provide continuing medical education and nursing credits
Drawbacks
  • May take a long time to implement large-scale change
  • Requires travel to multiple sites
  • Requires training of speakers and facilitators—quality may vary
  • Does not allow practices to network and learn from one another
  • May not be accompanied by any data collection to demonstrate actual implementation of change
  • May not include community partners

 Oregon's START Program

Oregon: The local AAP group, the Oregon Pediatric Society, provides free training to members through its Screening Tools and Referral Training (START) program. Through this program, members can receive training on basic screening tools, including the developmental, autism, and maternal depression screenings mentioned in the Bright Futures Guidelines.

Since 2008, with funding from CareOregon, Northwest Health Foundation, FamilyCare Inc., and the Autzen and Clear One Foundations, the START program has taught providers how to detect and manage developmental and behavioral health issues and how to screen for maternal depression problems. START training incorporates the medical home and team-based care model and includes pediatric primary care providers (ie, physicians, nurse practitioners, and physician assistants), nurses, and office staff. The entire team learns about the importance of and science behind standardized screening, community resources available for children and families, and how to improve the coordination of care so that services are appropriate and effective.

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 Group workshops

Characteristics
  • Small number of short, offsite group workshops
  • Attended by multiple local or regional practices
Benefits
  • Can be used to raise awareness of Bright Futures and pave the way for other forms of training or learning collaboratives·        
  • Can reach a large audience
  • Is less time intensive than models that require monthly calls and data collection
  • Provides practitioners with a large amount of information and lets them pick and choose what to “take home”
  • Can provide continuing medical education and nursing credits
Drawbacks
  • Because of the stand-alone nature, may hinder long-term, sustainable changes and prevent meaningful relationships from forming
  • Lacks technical assistance or evaluation
  • Because evaluation is at the end of the workshop, may assess only intent to implement without means to measure actual change
  • Does not provide MOC credits

 NORTH DAKOTA WORKSHOPS

North Dakota: In November 2012, the North Dakota Department of Health, Division of Family Health hosted a day-long, in-person training on Bright Futures for public health nurses and physicians across the state. Speakers from the AAP traveled to the site and presented an overview of the Bright Futures Guidelines and tools, including evidence for the recommendations and examples of statewide implementation. Topics also included stages of behavioral change and ways to bring Bright Futures into individual practices. Workshop information was provided through presentations, group work, and discussions. The Division of Family Health later uploaded video recordings and presentation materials to the Community Health Section of its Web site.


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 Web-based delivery

Characteristics
  • Online portal and resource clearinghouses designed to provide practices with information and resources that can assist them with Bright Futures implementation
  • Supported by state agency that can provide assistance as needed
  • Webinars that can be recorded, archived, and made available on an agency’s Web site
Benefits
  • Provides self-directed, self-paced online learning that does not require travel
  • Provides a large number of resources and information (eg, special health issues, resources, reference materials, data)
  • Presents information in short, easy-to-read sections; professionals may be too busy to find this information themselves
  • Can potentially reach all providers in an area
Drawbacks
  • Does not ensure that users pick up where they left off
  • Does not necessarily include office-based practice teams
  • Can be expensive to develop and maintain online system
  • May be challenging to get the word out about the program to all providers
  • Does not provide MOC credits

 WISCONSIN WEBCASTS

Wisconsin: In 2011, the Wisconsin Department of Health Services, Division of Public Health, Family Health Section collaborated with the AAP to produce a series of live Webcasts that focused on the needs of public health nurses and featured specific Bright Futures themes. Topics covered included promoting healthy sexual development and sexuality, child development and mental health, healthy nutrition and healthy weight, and community relationships and resources. The Wisconsin Department of Health Services hosts the recordings of these Web sessions on the Bright Futures section of its Web site for continued use by health care providers.

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