Promoting Pediatric Primary Prevention (P4) Challenge: Innovations in Pediatric Primary Care to Improve Child Health

Phase 1 Winners announced May 7, 2021.

Informational webinar Exit Disclaimer, which took place on January 15, 2021, and presentation slides (PDF - 282 KB).

Sign up for the P4 Challenge listserv Exit Disclaimer for regular updates.

Promoting Pediatric (P4) Challenge Primary Prevention

About the P4 Challenge

Vaccinations and well-child visits help prevent outbreaks of childhood diseases. Recent CDC data show that fewer children got vaccines on time this year compared to last year because of the COVID-19 pandemic.

The P4 Challenge invited applicants to propose and implement innovative approaches to increase access to and utilization of well-child visits and/or immunizations services within primary care settings.

Innovative approaches in Phase 1 aim to increase a key pediatric health performance measure such as:

  • Number of well-child visits (number of visits/number of children in the target population)
  • Well-child visit disparities (comparing measures across two or more subpopulations)
  • Doses administered of specific vaccines; coverage of the primary pediatric vaccination series (for example, number of MMR vaccines given/number of children 12-18 months in the target population)
  • Disparities within the community on a specific immunization metric (comparing measure across two or more subpopulations)

In Phase 1 of the P4 Challenge, 50 winners are receiving $10,000 to deploy the proposed approach in Phase 2.

Goal of the P4 Challenge

The CDC reports that declines in vaccination coverage might leave young children and communities vulnerable to vaccine-preventable diseases such as measles.

Well-child visits also declined Exit Disclaimer since the COVID-19 pandemic. These visits are an important venue for counseling, as well as vaccine administration and documentation.

At well-child visits, providers can also screen for developmental delays and parents can raise concerns about a child’s physical problems, behavior and mental health and receive personalized guidance on healthy nutrition, exercise and safety.

It’s important to get the message out to parents and caregivers that children should maintain well-child visits and get timely vaccinations in their medical home. Children who are not up-to-date with vaccinations recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP) should be seen in primary care as soon as possible for catch-up vaccination.


DECEMBER  2020 – MAY 2021:  Phase 1

MAY 2021: Phase 1 Winners announced, prize money distributed, and Phase 2 begins

SEPTEMBER 2021: Phase 2 performance results and program progress reports submitted for Phase 2 judging

OCTOBER 2021: Phase 2 Winners announced


Total Cash Prize Pool: Up to $1,000,000

Phase I Winners: 50

Phase I Winner Prize Amount: $10,000 each

Phase II Winners: Up to 20

Phase II Winner Prize Amount: $25,000

The Phase 2 prize purse is $500,000. We expect to award up to 20 Phase 2 winners who will each be awarded up to $25,000.

In the event we choose fewer than 20 Phase 2 winners, the $500,000 will be split evenly among those teams selected.

Winning approaches will be promoted widely by MCHB and key partners.

Submission Requirements:

Phase one: Teams will submit a 3-5 page concept paper. Proposals must be no longer than 5 pages, with up to two additional pages for letters of support.

The following sections shall be included in the concept paper:

Section Maximum Length
Executive summary and the problem in your community. (2 paragraphs max)

Describe the population you serve that would be affected by the proposed intervention. Please include descriptors such as:

  • Population demographics, such as number of children served, parent education, payer mix, insurance status, race, ethnicity, and other demographics
  • Urban or rural population (and degree of rurality)
  • Age group for those targeted in your solution
(Half page max)

Describe your team, including:

  • The partnerships included
  • The role of the partners
  • The team's capabilities, experience, and commitment

Include letter(s) of support indicating support of each partner other than the lead organization.

Also describe any gaps you may have in your team's ability to implement the solution; technical and partnership assistance may be available.

(1 page max)

Describe your intervention.

  • What is your innovative solution to increase access to and utilization of well-child visits and/or immunizations in your community?
  • Describe your approach, intervention or strategy, its novelty, and how your proposal will address the problem.
  • How will the prize funds help in your implementation?
  • How will your solution sustain beyond the P4 Challenge and continue to help the community?
  • How will you approach and incorporate patient/family-centered design (e.g., barriers to access and utilization for preventive services for children, parents’ hesitancy regarding vaccination and well-child visits (during the pandemic)?
(1 page max)

Describe your data.

  • What baseline can you set for measuring immunizations and/or well-child visits?
  • How do you and will you perform your data collection and analysis to demonstrate improvement in well-child visits and/or immunization rates (or disparities in rates) at the end of Phase 2?
  • Include a description of how patient confidentiality will be maintained throughout the proposed project, in accordance with the HIPAA Security Rule.
(1 page max)

Judging Criteria

Phase 1

Understanding of Population Served and Its Need

  • Does the contestant demonstrate an understanding of the population served, key barriers to access to well child visits and/or immunizations, and need for innovative approaches to address the stated problem?


  • How well does the contestant leverage appropriate partnerships to maximize impact in its community?
  • Is the intervention feasible given the prize money and time frame?
  • How well does the contestant demonstrate connections to primary care?
  • How well does the approach incorporate patient/family-centered design (e.g., addressing barriers to access and utilization for preventive services for children, parents’ hesitancy regarding vaccination, and well-child visits during the pandemic)?
  • Regarding the contestant’s data collection and analysis approach:
    • How well has the contestant demonstrated a clear plan to capture baseline data and to show improvement in the targeted outcome(s)?
    • How feasible is the approach?
    • Does the planned approach protect patient information appropriately?


  • How innovative is the design and the content of the intervention, and how responsive is the intervention to the community’s need and the available data?
  • How promising is the intervention with respect to potential for buy-in from the population of focus?

Potential Impact

  • How likely is the proposed solution to increase well-visits and/or immunizations in a participating or collaborating primary care setting?
  • How likely is the plan to measure impact accurately?
  • How likely is the proposed solution to be sustained?

Phase 2

Impact and Approach

  • Based on the data, how effective of an intervention did the contestant introduce (a recorded increase in well-visits and/or immunizations)?
  • How well did the contestant demonstrate their ability to adapt and strengthen the intervention based on data and feedback along the way?
  • How effectively did the contestant mobilize partnerships to increase impact of the intervention?


  • How strong is the potential for the intervention to be sustained beyond the duration of the P4 Challenge?
  • How strong is the potential for scaling in other, similar communities?


  • How well does the contestant set itself apart from the Phase 2 competition in delivery of its innovation?
  • How promising is the intervention in terms of potential for buy-in from the population of focus?
Date Last Reviewed:  May 2021