What is the Cycle of Engagement (COE) Model?

The Cycle of Engagement (COE) model was initially designed in 1997 and has undergone continued development by the CAHMI to guide and catalyze CAHMI’s work to advance data driven partnerships among families, providers, health plans, and communities to:

  • Put children, youth, and families at the center of their own health care and the health systems that serve them
  • Provide engagement-based pre-visit screening and visit planning tools and patient-reported outcomes and quality of care measurement tools
  • Create online data collection, sharing, and reporting platforms to help care teams and families personalize and provide whole-child, whole-family relationship-centered care
  • Catalyze improvement in the early and lifelong health and well-being of ALL children and families

Promoting positive health and flourishing of children, youth and families is our greatest public health need and opportunity! Trusting relationships, personalized care, reliable and comprehensive data and ongoing engagement of families and communities is required. This is the goal of the CAHMI’s Cycle of Engagement model and tools.

The Cycle of Engagement is ...


a personalized, relationship-centered model of child and family care focused on building trust and customizing care based on child and family strengths, social context, needs, and priorities


a family-centered, integrated approach to screening and providing comprehensive whole-child and whole-family based services anchored to best practice evidence and guideline-based care


a measurement process for continuously updating a family-led agenda and assessing and improving the quality of care aligned with family-centered medical homes and value and team-based care


a population health strategy to learn about and use aggregate data on child and family needs and priorities and quality of care to guide and drive cross-sector collaborations to improve systems of care

The Cycle of Engagement Tools

Since 1997, the Child and Adolescent Health Measurement Initiative (CAHMI) has partnered with families, providers, and experts to design, test, and make available two sets of tools that operationalize the Cycle of Engagement model:

If you are interested in the CPK, please visit www.carepathforkids.org.

If you are interested in the COE WVP, please see below to learn more.

Cycle of Engagement Well Visit Planner Approach to Care: Your Families, Your Partners

Personalized - Family Centered --- Guideline and Evidence-Based... Flexible...

“The WVP helped me think about what’s going well with my child and family. I have a better relationship with my child’s doctor now that we focus on my concerns and priorities. Our time together is more productive and satisfying.”

Three Interconnected Tools to Partner with Families and Improve Child Health

The Well Visit Planner (WVP)

A family completed pre-visit planning tool resulting in a personalized Well Visit Guide for the family and care team based on family reports on screenings, priorities, strengths and other topics aligned with Bright Futures Guidelines

The Personalized Connected Encounter (PCE)

A relationship-centered encounter anchored to findings on the Well Visit Guide, providing time to create deeper connections by focusing on priorities, needs and linking to community resources and support.

The Online Promoting Healthy Development Survey (Online PHDS)

A validated, family reported, post-visit assessment of the quality of well child services resulting in reports and improvement resources for care teams and providers, with feedback and resources shared with families.

*These COE WVP tools can be used together or individually, and with all or only some of the families you serve.

The COE model and tools give families a voice and drive more efficient and effective care. Care teams report:

  • Stronger partnerships with families and creating a culture of engagement
  • A streamlined process for conducting and billing for required screenings in a family-friendly way
  • Improvements in workflow and a stronger sense of collaboration in focusing on child and family priorities and needs
  • Using data to understand family needs and priorities to improve together as a team
  • Confidence knowing key screenings and priorities were addressed for all children and families
  • Using population-based data and quality reports to advocate for supports to meet family needs

Research on the Well Visit Planner® shows improved developmental and psychosocial screening and follow up, reduced urgent care, and increased family and provider satisfaction.

CLICK HERE for a summary of the Cycle of Engagement Well Visit Planner Approach to Care.

CLICK HERE for an overview of:

  • Core and optional content for the Well Visit Planner® family pre-visit planning tool
  • Content included in the validated, comprehensive Promoting Healthy Development Survey quality assessment and feedback tool
  • The COE WVP four-phase implementation model
  • The COE WVP alignment with existing requirements and performance standards for promoting high-quality, equitable early childhood preventive and developmental services.

Fast Facts on the COE WVP

  1. Includes 15 age-specific Well Visit Planner tools tailored for each child (ages: 1-week, 1, 2, 4, 6, 9, 12, 15, 18, 24, 30, 36, 48, 60, and 72 months)
  2. Takes 10 minutes to get a personalized Well Visit Guide
  3. Available in English and Spanish
  4. Mobile optimized
  5. Care teams/providers use their secure online portal to customize COE WVP tools, add resources for families, monitor use and access Well Visit Guides, Clinical Summaries, and PHDS quality of care reports
  6. Content for the WVP and PHDS are validated and meticulously aligned with national Bright Futures guidelines in collaboration with experts and families
  7. Families can get a WVP account for ease of use and to store Well Visit Guides and use the WVP for multiple children
  8. The WVP and PHDS are free for families
  9. Getting an COE WVP account is free for early adopters willing to provide feedback and help us make the COE WVP work for you and your families

“Using the Well Visit Planner I found out more about [the child’s] home, family, and how the parent was doing than I otherwise would … we talked about topics we wouldn’t have before without the Well Visit Guide. Most parents were prioritizing topics about their child’s development, how to parent and discipline.” - Provider

Steps to Try Out the COE WVP

Card image cap

Read our two-page overview on the Cycle of Engagement Well Visit Planner Approach to Care!

Card image cap

See a recent national webinar on the CARE_PATH for Kids!

Card image cap

Watch an overview about the Well Visit Planner!