Well Woman Visits
The Maternal and Child Health Bureau (MCHB) Title V Maternal and Child Health Services Block Grants to States Program has established 15 National Performance Measures for the 2015-2017 grant cycle. Performance Measure 1 is the percent of women who have had a preventive health visit in the past year. This evidence brief points to a selection of resources for state MCH programs on annual preventive care visits for well women, with an emphasis on evidence-based information.
The Title V Maternal and Child Health Services Block Grant to States Program guidance1 defines the significance of this goal as follows:
A well-woman or preconception visit provides a critical opportunity to receive recommended clinical preventive services, including screening, counseling, and immunizations, which can lead to appropriate identification, treatment, and prevention of disease to optimize the health of women before, between, and beyond potential pregnancies. For example, screening and management of chronic conditions such as diabetes, and counseling to achieve a healthy weight and smoking cessation, can be advanced within a well woman visit to promote women's health prior to and between pregnancies and improve subsequent maternal and perinatal outcomes. The annual well-woman visit has been endorsed by the American College of Obstetrics and Gynecologists (ACOG) and was also identified among the women's preventive services required by the Affordable Care Act (ACA) to be covered by private insurance plans without cost-sharing.
Read More about Performance Measure 1
Performance Measure 1
Percent of women with a past year preventive visit
To increase the number of women who have a preventive visit
Numerator: Women who reported having a routine check-up in the last year
Women, ages 18-44
Healthy People 2020 Objectives
Related to Access to Health Services Developmental Objective 7.0: Increase the proportion of persons who receive appropriate clinical preventive services.
Related to Maternal, Infant, and Child Health Developmental Objective 16.1: Increase the percentage of women delivering a live birth who discussed preconception health with a health care worker prior to pregnancy.
Data Sources and Data Issues
Behavioral Risk Factor Surveillance System (BRFSS)
Data and Statistics
- American Congress of Obstetricians
and Gynecologists (ACOG): Annual Women's Health Care. Assessments and recommendations, clinical guidance on annual women's health, and links to health promotion sites such as Well
Woman, hosted by ACOG's New York state chapter.
- Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN). Research, journals, policy, practice issues, and Health4Women, a site that provides evidence-based information and preventive health guidance for women.
- Centers for Disease Control and Prevention (CDC). Preconception Health
and Health Care (PCHHC) Initiative. Health tips for women, health promotion initiatives, the PCHHC Action Plan, screening tools, and interventions Women's Health. Links to information, resources, research findings, and state and national initiatives to advance women's health and safety.
- Henry J. Kaiser Family Foundation. Women's health indicators compared across states, coverage of women's health policy, facts on women's health coverage under the ACA, and survey findings on women's health coverage.
- Women's Health.gov. Federal government source for women's health information, including coverage of women's health under the ACA (this section is an educational collaboration between the U.S. Office of Women's Health and WebMD).
- Agency for Healthcare Research and Quality (AHRQ). Health Care Innovations Exchange. Promising programs to provide preventive health services to homeless, low-income, and other underserved women. Women's Health. Research findings, data, and information for patients, professionals, and policymakers, including promising preventive health practices.
- Belizan, J. (Ed). 2014. Preconception
interventions. Reproductive Health 11(3 Suppl.):S1-S8. Supplement to Reproductive Health that includes a series of systematic reviews regarding the impact of public health interventions during the preconception period on maternal and child health.
- Humphrey, JR, Floyd, RL. 2012. Preconception
health and health care environmental scan, report on clinical screening
tools and interventions. Atlanta, GA: National Center on Birth Defects and Developmental Disabilities.
- Institute of Medicine (IOM), Committee on Preventive Services for Women. 2011. Clinical
preventive services for women: Closing the gaps. Washington, DC: National Academies Press. This IOM report recommends at least one well-woman preventive care visit annually for adult women. Includes clinical guidelines for heath practitioners, a summary of provisions for women under the Affordable Care Act, and examples of state and private sector plans that provide routine prevention services with no copay.
- Johnson KA et al. on behalf of the PCHHC Steering Committee. 2012. An
action plan for the National Initiative on Preconception Health and
Health Care (PCHHC): A report of the PCHHC Steering Committee, 2012-2014. Atlanta, GA: Centers for Disease Control and Prevention. Preconception Health and Health Care Steering Committee.
- University of North Carolina at Chapel Hill Preconception Health+Health Care Initiative. 2014. National
preconception/interconception care clinical toolkit. Chapel Hill, NC: University of North Carolina School of Medicine, Center for Maternal and Infant Health. Designed to help primary care providers, their colleagues and their practices incorporate preconception health into routine care of women of childbearing age.
- U.S. Preventive Services Task Force. 2014. The guide to clinical preventive services: Recommendations of the U.S. Preventive Services Task Force. Rockville, MD: U.S. Agency for Healthcare Research and Quality. Lists specific screening, counseling, and other interventions for men, women, pregnant women, and children and adolescents.
- Braspenningx, S, Haagdorens, M, Blaumeiser, B, Jacquemyn, Y, Mortier, G. 2013. Preconceptional
care: A systematic review of the current situation and recommendations for
the future. Facts, Views Vision: Issues in Obstetrics, Gynecology and Reproductive Health. 5(1):13-25.
- American College of Obstretricians and Gynecologists. 2014. Guidelines
for women's healthcare: A resource manual (4th ed.). Washington, DC: American College of Obstretricians and Gynecologists. Part III covers well woman care. Includes sections on access to care, the well-woman annual health assessment, and preconception and interconception care. Bibliographies and resource listings are included.
- National Women's Law Center and Oregon Health and Science University. [Annual]. Making
the grade on women's health: A national and state-by-state report card. Washington, DC: National Women's Law Center. Policy and health status data for all 50 states, including women's access to health care services.
- Riley, M, Dobson, M., Jones E., Kirst, N. 2013. Health
maintenance in women. American Family Physician. 87(1):30-37.
- Salganifoff A, Ranji U, Beamesderfer A, Kurani N. 2014. Women
and health care in the early years of the Affordable Care
Act: Key findings from the 2013 Kaiser Women's Health Survey. Menlo Park, CA: Henry J. Kaiser Family Foundation.
Related NCEMCH Resources
1 Health Resources and Services Administration. 2014. Title V
Maternal and Child Health Services Block Grant to States Program: Guidance
for the Title V Application/Annual
Report, Appendix F, p. 74.
Well Woman Visits: Evidence Brief, 1st ed. (November 2014). Author: Beth DeFrancis, M.L.S., NCEMCH