Bright Futures: A New Approach
to Health Supervision for Children
B R I G H T F U T U R E S G U I D E L I N E S F O R H E A LT H S U P E RV I S I O N O F I N FA N T S , C H I L D R E N , A N D A D O L E S C E N T S
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The Bright Futures: Guidelines for Health
Supervision of Infants, Children, and
Adolescents describes a system of care that is
unique in its attention to health promotion
activities and psychosocial factors of health
and its focus on youth and family strengths. It
also is unique in its recognition that effective
health promotion and disease prevention
require coordinated efforts among medical
and nonmedical professionals and agencies,
including public health, social services, mental
health, educational services, home health,
parents, caregivers, families, and many other
members of the broader community. The
Guidelines address the care needs of all chil-
dren and adolescents, including children and
youth with special health care needs and chil-
dren from families from diverse cultural and
ethnic backgrounds.
In 2001, the Maternal and Child Health
Bureau (MCHB) of the US Department of
Health and Human Services’ Health Resources
and Services Administration awarded cooper-
ative agreements to the American Academy
of Pediatrics (AAP) to lead the Bright Futures
initiative. When the third edition of the Bright
Futures Guidelines project started, many sep-
arate “guidelines” advised pediatric health
care professionals on how to conduct a
health supervision visit. Philosophies and
approaches varied with the authoring group’s
goals, but many shared themes were evident.
Among these guidelines, the Bright Futures
Guidelines, the AAP Guidelines for Health
Supervision, and the American Medical
Association (AMA) Guidelines for Adolescent
Preventive Services: Recommendations and
Rationale1 were the most widely used.
Although their similarities were greater than
their differences, the lack of uniformity
presented difficulties for health care profes-
sionals. With the encouragement and strong
support of the MCHB, the AAP and its many
collaborating partners set out to write this
new edition of Bright Futures Guidelines as a
uniform set of recommendations for health
care professionals.
An Evolving Understanding of Health
Supervision for Children
Health supervision for children has evolved
tremendously in the past half century, when it
was first employed to address concerns of
nutrition, child rearing, and the prevention of
infectious diseases. As is true of the 2 previ-
ous editions, this third edition of the Bright
Futures Guidelines has sought to advance the
health of children and youth, with focused
attention to key health components and
interventions. However, few studies have
evaluated health supervision care in this coun-
try, and similar systems do not exist in other
regional or national health care systems for
comparison.
When the Bright Futures Project Advisory
Committee (PAC) convened for the third edi-
tion, the members began with key questions:
What is Bright Futures? How can a new edi-
tion improve upon existing guidelines? Most
importantly, how can a new edition improve
the desired outcome of guidelines, which is
child health? The PAC turned to the previous
editions of Bright Futures Guidelines for
insight and direction.
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