Effectively Identify, Target, and Address Social Determinants of Health While earning MOC Parts II & IV and CME

Join the ASHEW QI Movement and Make a Greater Impact on the Lives of Children and Their Families in Wisconsin

About  SDOH/ACEs  Intervention  Getting Started  CME  Participation  Eligibility  Contact

Effectively Identify, Target, and Address Social Determinants of Health While earning MOC Parts II & IV and CME

Join the ASHEW QI Movement and Make a Greater Impact on the Lives of Children and Their Families in Wisconsin

Addressing Social Health and Early Childhood Wellness (ASHEW)

The Addressing Social Health and Early Childhood Wellness (ASHEW) initiative seeks to improve the health, wellness, and development of children through practice and system-based interventions. Practices will increase rates of early childhood screening, counseling, referral, and follow-up for developmental milestones, maternal depression, social determinants of health and social-emotional development.

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The Negative Impact of Stressful or Traumatic Events Experienced in Early Childhood

Social determinants of health (SDOH), as defined by the CDC, are the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes.

While all people are influenced by SDOH, some groups face increased vulnerability. Growing research identifies the significant negative impact of stressful or traumatic events experienced in early childhood. Specifically, exposure to adverse childhood experiences (ACEs) can elicit toxic stress responses. This response produces significant biological changes that can have negative impacts on brain architecture as well as the nervous, endocrine, and immune systems and thus future disease including mental health. This is particularly problematic for children, as their brains are still developing, heightening their vulnerability to outside influences. Children in poverty (currently 21% of all US children) also face additional risk, as they are often exposed to a cluster of stressors that may result in high rates of infant mortality, developmental delays, asthma, ear infections, obesity, and child abuse and neglect.

The Role of Pediatric Intervention

Of the 31 recommended well child visits between ages 0 and 21, 15 take place in the first five years of life. This series of visits provides a unique opportunity to identify, promote, and facilitate positive interventions that impact the trajectory of a child’s physical, social-emotional, and cognitive development. In fact, Bright Futures reports growing evidence that early developmental, behavioral, emotional, and social interventions can have significant effects on lifelong health and wellness. Unfortunately, very few pediatricians and clinics are actually equipped to address social determinants of health and adverse childhood experiences, especially through trauma- and resilience-informed care.

Better Equip Your Practice to Effectively Address SDOH & ACEs

The Wisconsin Chapter of the American Academy of Pediatrics is offering an innovative QI initiative to improve pediatric intervention for SDOH and ACEs . The ASHEW initiative will provide participating practices with the strategies, tools, and resources needed to develop systems and processes for addressing maternal depression, social determinants of health, social-emotional development, and resilience in pediatric primary care practice. Participating practices will learn and apply quality improvement methodology to develop an efficient and effective workflow for assessing, counseling, referring, and following up. Key areas of focus will include enhancing family-centered care, creating a welcoming and culturally inclusive environment, and engaging with community partners to develop a comprehensive referral network to support the needs of children and families

Gain access to innovative resources to help implement change across all four interventions including:

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Questionnaires for Screening

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Conversation Starters for Impactful Counseling

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Information on Developing Clinic Community Partnerships

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In-Person & Virtual Strategy Building

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Data Sharing

Expert & Peer Networking

Earn MOC Parts II & IV and CME While Enhancing Patient Care

25 points of American Board of Pediatrics (ABP) Maintenance of Certification (MOC) Part 4 credit and 20 credits of American Medical Association (AMA) Physician Recognition Award (PRA) Category 1™ Performance Improvement Continuing Medical Education (PI CME) will be available upon successful completion of the project. This project has received approval from the AAP Institutional Review Board (IRB).

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Initiative Involvement and Participation

Participating practices will take part in a number of care improvement activities hosted and supported by the ASHEW team for the duration of the project.

On-demand modules that provide evidence-based education on core topics related to childhood adversity and resilience in the primary care context along with a self-paced QI module that introduces fundamental concepts for understanding the model of improvement. (Both modules offer CME)

Monthly, interactive webinars hosted by the ASHEW team, will provide participating practices with the opportunity to discuss implementation plans, review data, share common challenges, and receive additional education from pediatrician experts.

During months with no webinar, virtual & live learning sessions, hosted by the ASHEW team, will offer participants an opportunity to learn improvement techniques from experts and share their experiences implementing new practices with one another.

During the participation period, each practice, with support from the ASHEW team, will hold at least four meetings, directed by the Clinician Leader, to plan QI tests and changes, review progress, develop solutions to the challenges encountered, and celebrate successes.

Each practice will receive a robust change package that includes helpful resources for each intervention to assist practices in implementing changes, including tools such as questionnaires for screening, conversation starters for impactful counseling sessions, resources on developing clinic community partnerships, and more.

With the support and assistance of the ASHEW team, participating practices will enter 11 cycles of chart review data (minimum of 40 charts each cycle) using the AAP’s QIDA system and receive customized reports that enable them to monitor progress and track improvements. Practice-Level aggregated chart data will be shared with other practice teams, to foster collaboration.

Pediatric and Family Practice Eligibility

Pediatric primary care practices/clinics that wish to participate must:

 Identify a core QI team of at least three committed members.
Agree to fullfill the project requirement and participate in the project for its duration
Have a sufficient level of organizational support (e.g., buy-in from senior leadership, autonomy, time, practice transformation readiness)
If requested,participate as a team in a brief call to confirm eligibility

Developing Your Core QI Team

Participating practice core QI teams should include these four member roles*:  

Clinician Lead (MD, DO, NP, PA)
Serves as the site champion and oversees MOC requirements for the site
Clinical support staff member (RN, LPN, MA)
Oversees practice implementation
Project manager
Authorizes practice-level changes, submits data, and oversees patient scheduling and billing changes
Family advisor
Provides the parent/caregiver perspective to all aspects of the project

*Practices may opt to select a single team member to perform both clinical support and project management responsibilities.


Connect with the WIAAP/ASHEW Team to Get Started

The WIAAP/ASHEW team is here to help you through the registration and QI process! If you have any questions, would like to learn more about enrollment, or are ready to get started, please fill out the form below and a member of the WIAAP/ASHEW team will follow up with you shortly.

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