Bright Futures for Infants, Children, and Adolescents

Launched by HRSA’s Maternal and Child Health Bureau in 1990, Bright Futures is a major initiative to improve the quality of health promotion and preventive services for infants, children and adolescents.

• Bright Futures Web site (not a U.S. Government Web site)
• Assessing the Bright Futures for Infants, Children and Adolescents Initiative: Findings from a National Process Evaluation (not a U.S. Government Web site)

MCHB and the American Academy of Pediatrics Partner to Implement Bright Futures
The Bright Futures Initiative has a new home at the American Academy of Pediatrics (AAP), which has established the Bright Futures Education Center and Pediatric Implementation Project under cooperative agreements with the Bureau. Under the AAP’s leadership, the focus is on implementation of the Bright Futures guidelines to improve health promotion and preventive services. New materials and toolkits are being created to help health care professionals, public health experts, families and communities use Bright Futures. A network of “Bright Futures practices” will demonstrate implementation of the Bright Futures Guidelines in clinical settings.

Why Bright Futures?
At the beginning of the 20th century, infectious diseases caused most of the morbidity and mortality in children. Although there has been great success in reducing contagious diseases, children today face new issues. Over the past several decades, major economic, social, and demographic changes have significantly affected American families. These societal changes have brought shifts in the chief causes of morbidity and mortality among children and adolescents.

Injuries are now the leading cause of death for children older than 1 year. In addition, a significant percentage of American children have mental and emotional disorders. Developmental problems, educational failure, too much risk taking, lack of supervision, and child abuse are also among these "new morbidities." Also, the population of children with special health needs due to illness or disability has grown.

Activities
Bright Futures responds to current and emerging preventive and health promotion needs of infants, children and adolescents. Through Bright Futures, the HRSA Maternal and Child Health Bureau and its partners:

• Enhance the knowledge and skills of health care providers to help them practice developmentally appropriate, preventive health care in the context of family and community
• Develop and disseminate materials for health professionals and families to implement the Bright Futures approach to prevention and health promotion
• Foster partnerships among families, health professionals, and communities, and
• Encourage family participation in health promotion and disease prevention activities.

Bright Futures Guidelines for Health Supervision for Infants, Children and Adolescents, cornerstone of the initiative, is a set of comprehensive health supervision guidelines addressing health promotion and disease prevention in infancy, early childhood, middle childhood, and adolescence. Through collaboration between the HRSA Maternal and Child Health Bureau and the National Center for Education in Maternal and Child Health at Georgetown University in Washington, D.C., the Bright Futures Guidelines were developed by interdisciplinary panels of experts from a wide variety of child health fields, such as dental care, nutrition, nursing, and pediatrics. Since 1995, more than 1.3 million copies of the document and related materials have been distributed throughout the Nation.

Building on the Bright Futures Guidelines, Bright Futures in Practice is a series of publications that highlight critical health promotion issues. Topics include oral health, physical activity, nutrition and mental health. Each publication includes relevant health supervision guidelines; addresses the special issues, concerns, and common questions of parents; and provides tools and resources for health care providers and families.

Through a variety of public-private partnerships, Bright Futures materials are developed, disseminated, and put into practice. So far, Bright Futures has partnered with numerous individuals, professional organizations, national voluntary organizations, as well as academic institutions and corporations. Some of these Bright Futures materials are pocket guides, anticipatory guidance cards, an activity book for children and families, videos, and interdisciplinary model curricula.

How Bright Futures is Making a Difference

California: 1,000 physicians of Kaiser Permanente Northern California, an HMO serving 2.6 million people, adopted "Bright Systems," based on Bright Futures principles.

New Jersey: Bright Futures training that focused on anticipatory guidance and family interviewing was provided for nurses statewide.

New Mexico: Elements from Bright Futures in Practice: Nutrition were incorporated into the State Children's Health Insurance Program Screening and Risk Reduction Initiative.

Tennessee:The University of Tennessee and University of North Carolina conducted a "train the trainer" for public health professionals in eight southeastern States. The project was titled, "Maximizing Resources for Better Results! Extending Bright Futures Through Community-Based Nutrition Planning."

Massachusetts: The State created its own Bright Futures campaign and appointed a Bright Futures State coordinator.

Washington: Whatcom County is implementing Bright Futures through a network of shared information among WIC, Health Start, pediatric practices and other community partners.

Resources

• Bright Futures at Georgetown University materials and information from the National Center for Education in Maternal and Child Health
• Bright Futures for Families materials and resources that complement Bright Futures materials for health care professionals