Evidence Standards for Child Health Promotion

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DESCRIPTION (PROVIDED BY APPLICANT): Modern medical care for children in the United States includes both identification and treatment of disease and promotion of the child's health and well-being. This proposal supports a conference that will allow diverse stakeholder participants to have substantive input into a larger program, funded by the Commonwealth Fund and the Nemours Health Trust, to develop and disseminate evidence standards for child health promotion policy and practice. Recent surveys have demonstrated that parents value health promotion activity and have come to expect it as part of their children's healthcare. Primary care clinicians turn to their professional organizations and other policymaking organizations for policies to guide the content of these health promotion and disease prevention activities. Policy-makers may rely on expert guidance, or on published studies, or on a combination. Unfortunately, the evidence standards typically used in determining health services have only limited application in child health promotion, resulting in disagreements about policies. The investigators have begun a process to develop evidence standards for child health promotion that would allow for more informed discussions. This process began with a planning conference held March 2006, in conjunction with a meeting of the United States Preventive Service Task Force. At that meeting, three main concepts emerged: (1) The outcomes of child health promotion relate primarily to the child's developmental trajectory, rather than the prevention of specific diseases or medical conditions; (2) Current methods of using evidence to inform policy and practice tend to discount the value of scientific methods other than randomized clinical trials, although these other methods often provide the most reasonable information about child health promotion; and (3) There should be a better match between the type of recommendation under consideration and the data necessary to inform and support such a recommendation. Work is progressing on a program to address these concerns and incorporate them into new ways of developing, assessing, and using scientific information in making decisions on child health promotion policies and practices. This conference will solicit the active participation of experts representing different perspectives: researchers, policymakers, practitioners and consumers. The conference will begin with presentations and discussions of key technical issues, and proceed through a series of carefully designed conference activities to develop a new methodological model. Conference participants will then participate in exercises designed to obtain comments on their results and to develop a plan to disseminate and implement the final results. AHRQ funds are sought to enable the large group of stakeholders to work with us to develop evidence standards that will allow clinicians to work more effectively towards improving the health and well being of American children.