Meet the Team


The Child and Adolescent Health Measurement Initiative (CAHMI) team is based out of the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland and is under the leadership and vision of Dr. Christina Bethell. You can learn more about CAHMI at www.cahmi.org.

Dr. Christina Bethell

Christina Bethell, PhD, MPH, MBA
Director of the CAHMI
Professor, Bloomberg School of Public Health
Johns Hopkins University

Paige Endsley, MPH
Sr. Research Program Coordinator

Naraa Gombojav, PhD
Assistant Scientist

Ramona Poblete
Research Assistant

Mary Wahl, MPH
Research Program Manager

Salvia Zeeshan, M.D., MPH
Post-Doctoral Research Fellow

Joseph VerValin
Research Data Analyst

Alexys N. Butler, MS
Program Coordinator

Cycle of Engagement History and Development


The CAHMI has collaborated with parents, pediatric providers and national experts at the national, state, health plan, practice, and provider level to design, develop and test the Cycle of Engagement (COE) model and tools. The testing has demonstrated the feasibility, efficiency and effectiveness of the COE tools in improving the quality and outcomes of care for children.

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Well-Visit Planner
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Online Promoting Healthy Development Survey
CARE_PATH for Kids

Advisors and Funders


The CAHMI’s Cycle of Engagement efforts have been funded by numerous partners over the years, including Health Resources and Services Administration’s Maternal and Child Health Bureau, the American Academy of Pediatrics, the Head Start National Center with the Administration of Children and Families, the American Board of Pediatrics, the Commonwealth Fund, and CAHMI’s internal budget.

The current COE efforts are funded by CAHMI’s internal budget and current grants.

The CAHMI would like to thank all of its advisors who have supported the design and development of the COE model and tools.

Where we are now and what is planned


The decades of dedication to the COE work has made this model, tools and resources ready for dissemination, outreach and scaling.

Our current and future efforts for the COE include:
  • Keeping content updated based on best practices, maximum consensus measurement and national guidelines: Continued systematic review and updating of the COE content using qualitative and quantitative measurement selection and testing methods to reflect best practices, emerging field consensus, and the most current Bright Futures Guidelines.
  • Updating all tools to have Spanish and other language versions of content and materials for expanded cultural accessibility.
  • Continued dissemination and implementation: Building on ongoing implementation experience, we will ensure the COE resources continue to be formatted, packaged, communicated and made available for use in streamlined and easy-to-understand ways.
  • Readying for interoperable EHR platforms: Prepare to deploy the appropriate connections in the COE software to enable integration with and interoperability across EHR’s using the next generation of Universal API’s (i.e. Fast Healthcare Interoperability Resources; FHIR).