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The Promoting Healthy Development Survey (PHDS)-PLUS: Implementation Guidelines for Medicaid and Other Settings

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The purpose of this manual is to provide detailed guidelines for implementing the Promoting Healthy Development Survey-PLUS (PHDS-PLUS) in Medicaid and other programs and settings. The PHDS-PLUS is a parent survey that assesses whether young children (3–48 months old) receive nationally recommended preventive and developmental services. It is a telephone-administered version of the original PHDS, containing additional items about the child's health, health care utilization, parent's health, and other socio-demographic characteristics.

There are six steps necessary to implement the PHDS-PLUS:

Step 1: Learn about the PHDS-PLUS
Step 2: Specify your PHDS-PLUS implementation strategy
Step 3: Prepare for and conduct survey administration
Step 4: Monitor survey administration and prepare for data analysis
Step 5: Construct quality measures and analytic variables
Step 6: Report your PHDS-PLUS findings.

This manual is organized according to the above-listed steps and their respective subcomponents. Each step is vital to successfully implement a PHDS-PLUS project in your program or setting. Click on the links below to be taken to that section of the PDFs, or click here to open the full manual (335 pages).

Table of Contents
Step 1 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Learn About the Promoting Healthy Development Survey-PLUS
1.1 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif What is the PHDS-PLUS?
1.2 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif What is measured by the PHDS-PLUS?
1.3 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif How has the PHDS-PLUS been used in Medicaid?
1.4 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif What is the added value of the PHDS-PLUS for Medicaid?
1.5 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Development of the PHDS-PLUS
1.6 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Requirements to implement the PHDS-PLUS
1.7 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif PHDS-PLUS resources
Step 2 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Specify Your PHDS-PLUS Implementation Strategy
2.1 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Clarify where you want to end up
2.2 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Identify and engage key partners
2.3 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Plan and confirm the feasibility of your sampling strategy
2.4 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Develop and test any supplemental survey items
2.5 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Identify analytic information to be collected at the time of sampling
Step 3 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Prepare for Survey Administration
3.1 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Organize your implementation team
3.2 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Create the sampling frame and analytic variable data sets
3.3 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Layout your survey administration process and timeline
3.4 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Finalize survey design and CATI set-up
Step 4 IMPORTED: www_commonwealthfund_org__usr_img_spacer.gif Conduct Survey Administration and Prepare for Data Analysis
4.1Conduct survey, track responses, and calculate response rate
4.2Create, clean, and code your PHDS-PLUS data set
4.3Integrate updated enrollment and utilization information
4.4Weight your data set to represent the target population
Step 5Construct Quality Measures and Plan for Reporting PHDS-PLUS Findings
5.1Calculate core PHDS-PLUS quality variables
5.2Calculate core PHDS-PLUS analytic variables
5.3Calculate additional quality measures and analytic variables
5.4Evaluate quality measurement results for subgroups of children
Step 6Report Your PHDS-PLUS Findings to Stimulate System Change
6.1Who: Identify and learn about your key audience
6.2Why and What: Select your primary purpose and key information to include in your reports
6.3Where, When, How: Decide the best way to present your PHDS-PLUS information
1Overview of the PHDS-PLUS survey questions
2Example Pre-Notification Letter
3Text for the Computer Assisted Telephone Interview (CATI)
4Sample state policy audience communication template
5Sample health care provider communication template
6Sample family communication template
7Sample health care plan communication template

For more information, contact: CAHMI—The Child and Adolescent Health Measurement Initiative
Oregon Health & Science University, Department of Pediatrics

The CAHMI staff acknowledges the following individuals and organizations for their invaluable contribution to the development, testing, and demonstration of the Promoting Healthy Development Survey-Plus:

Members of the Promoting Healthy Development State Learning Network (PHDSLN) representing Medicaid, Public Health, and other state offices in Louisiana, Minnesota, Mississippi, and Ohio. Special thanks to the PHDSLN team leaders: Janis Souvestre, John LaCour, Therese Hanna, Barbara Atkinson, Susan Castellano, and Charles Betley.

Key advisors to the PHDSLN and CAHMI state-level quality measurement and improvement efforts including Barbara Lantz, Russell Frank, Judith Shaw, Peter Margolis, Fred Holmes, and the members of the CAHMI Executive Committee.

Staff from states participating in the ABCD I project who collaborated with the CAHMI in the implementation of the PHDS-PLUS in Vermont, North Carolina, and Washington.

Staff from Health Services Advisory Group, OMPRO, DataStat, and Mattson and Sutherland Research. These External Quality Review Organizations (EQRO) or EQRO-like entities have implemented the PHDS-PLUS one or more times.

Christopher Walker who served as the research assistant for the PHDSLN.

The Commonwealth Fund for supporting the PHDS-PLUS, PHDS, and Provider-Level PHDS (ProPHDS) development and implementation over the last seven years. Specifically to Melinda Abrams and Ed Schor for their support, commitment, and vision.

Publication Details



C. Bethell, C. Reuland, and B. Latzke, The Promoting Healthy Development Survey (PHDS-PLUS): Implementation Guidelines for Medicaid and Other Settings, The Commonwealth Fund, November 2005