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History and Development of the WVP
The WVP was initially tested and implemented at a clinic with 12 pediatricians located in Tualatin, Oregon. This clinic implemented a customized version of the WVP with a unique URL and Electronic Health Record (EHR) integration (Centricity). Their EHR-linkage included several specific fields that were auto-populated with WVP responses and a PDF of the visit guide sent directly to the child’s EHR. In addition to posting informational posters about the WVP in exam and waiting rooms and providing a link on their website, eligible parents were invited via email to complete the WVP 5 days prior to their child’s well visit.
Over 92% of the 3000 parents included in the initial testing reported that:
- they would recommend the tool to other parents;
- they were comfortable with the time required to complete the tool;
- the WVP helped them understand goals for each well visit; and,
- the WVP helped prioritize topics for discussion with their child’s pediatric healthcare professional.
This clinic also used a pre/post measure, the online/web-based Promoting Health Development Survey (PHDS), in conjunction with the WVP to assess quality and content of well child care provided with and without use of the WVP. This clinic was involved in the original research grant to develop the WVP and they continue to use the tool now that the grant has ended.
Three focus group sessions were conducted with Head Start Centers in Oregon to establish the utility of the WVP in HS/EHS centers. There were a number of shared themes in the focus groups, including
- high enthusiasm for the potential benefit of the WVP,
- satisfaction with how the WVP fits into the HS/EHS workflow, and
- training time/resource considerations.
To better cater to the needs of the HS/EHS population, the WVP is being reviewed to ensure the entire tool is at an 8th grade reading level. The training materials for the WVP were revised to allow for HS/EHS center staff to learn how to use the tool independently with little direct instruction from the CAHMI. These training materials include both home visit and center visit workflows that explain how the WVP can facilitate these visits.
The multiple formats of the WVP (online version accessible via tablet, smartphone or computer) are especially appealing to HS/EHS centers that need flexibility when conducting home visits. These focus groups also reaffirmed the importance of developing a mobile version of the WVP to better engage parents, something the CAHMI is actively pursuing.
The WVP is also being used in a study at the University of California, Los Angeles (UCLA), which is being conducted in collaboration with community clinics, including Federally Qualified Health Centers. In addition to parents receiving their personalized visit guide, UCLA is using an EHR-integration WVP option in which only major concerns and alerts from the parental responses on the WVP are linked into the child’s EHR.
The WVP is also being piloted in the Boston Children’s pediatric primary care network (PPOC). In this application, the parent visit guide is integrated into the child’s electronic medical record (EMR) using secure e-faxing methods.