Using Implementation and Dissemination Concepts to Spread 21st-Century Well-Child Care at a Health Maintenance Organization

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Researchers explored the options for disseminating a model of well-child care that is parent-centered and team-based and includes developmental and preventive visits. They developed three interventions: tailoring well-child care using a Web-based tool to determine child and family needs; using different types of visits, such as e-mail-based visits; and extending visits for children with special health care needs. The research team then developed a framework for implementing and disseminating the model at two sites—a large practice split into two clinical teams, and a small practice—and augmented it with social-network mapping (to identify opinion leaders who are able to influence decisions regarding adopting innovations) and clinician and staff focus groups (to identify barriers and facilitators to implementation). Once implementation is completed at the two initial sites, the researchers will use the same dissemination concepts to spread the model to three additional pediatric practices.