Implementation and Evaluation of Bright Futures Curriculum Within CORNET Continuity Practice

The purpose of "Bright Futures" is to promote and improve infant, child, and adolescent health within the context of family and community. CORNET (COntinuity Research NETwork of the Ambulatory Pediatric Association) is a national practice-based research network of resident continuity practices, whose mission is to establish a self-sustaining collaborative research network among pediatric continuing clinic clinicians who will produce quality research in primary care, health care delivery, and education.

"Bright Futures" offers a child and family-centered approach to health promotion in incorporating partnership and communication skills of providers. Two areas of importance are promotion of oral health and prevention of iron deficiency. Residents will be randomized to one of these two groups and will receive web-based education about that particular topic. Residents randomized to group 1 will receive training consisting of 7 modules: 3 on the Bright Futures concepts and 4 on oral health promotion. They will be trained in performing an oral health assessment, identifying caries, and encouraged to establish a dental home for patients. They must communicate with at least one dental practice in the community to determine barriers to care, issues regarding insurance, potential solutions to improve referral, and access to dental care. Residents in group 2 will complete a single educational module on the identification and prevention of iron deficiency. They will be trained to identify iron deficiency and iron deficiency anemia, understand risk prevention strategies, improved methods of identification, and treatment.

Each resident will recruit 3 patients, children between the ages of 12-35 months, for whom he/she is the primary care provider. Each parent-child dyad will participate in one well-child care visit. Each visit will be observed by a faculty preceptor.

This study design was chosen to compare a more sophisticated and time-intensive curriculum to a more modest one. By having a curriculum with minimal overlap between the two groups, the investigators hope to examine the knowledge obtained by the residents, which health promotion aspects they address during their encounters, and to compare the establishment of a dental home in the two groups of patients.