Assessing the Impact of Pediatric-Based Developmental Services on Infants, Families, and Clinicians: Challenges to Evaluating the Healthy Steps Program

Abstract

Throughout a 26-month period, 5565 children enrolled in the evaluation, 2963 (53.2%) children in the intervention group and 2602 (46.8%) in the comparison group. More than 10% of mothers in the Healthy Steps sample are teenagers; 18% have 11 years of education or less; 27% have completed college; 18% are black or African-American; slightly >20% are of Hispanic origin; 36% are single; and close to one-third used Medicaid for their prenatal care. Approximately 7% of infants were low birth weight. When compared with national birth data for the United States as a whole, the Healthy Steps sample seems similarly diverse. However, with the exception of maternal age, the distribution of variables was significantly different from the distribution for US births. There are no differences between intervention and comparison families at randomization sites on any of

Narrowing the Income Gaps in Preventive Care for Young Children: Families in Healthy Steps

“…24 As expected, mothers in low-income families were disproportionately young, non-white, more likely to be Hispanic, without a high school education, not employed, and not married ( Table 2). There were no significant differences by income in parenting experience or birth weight of the baby.…”

“…24 Four data sources were used in the analyses reported here. First, a newborn questionnaire, completed by parents at time of entry into Healthy Steps, included data on sociodemographic characteristics.…”

Community-based interventions to optimize early childhood development in low resource settings

“…This is clearer through some other studies which addressed PCI specifically or as a package involving basic MCHC services and found a beneficial effect on child development. [75][76][77][80][81][82][83] Although it might be true that interventions targeting children or parents have different outcomes, it is difficult to differentiate the effect of the two approaches. Even some specific interventions, like KMC, that target children, have components of PCI, which may have a role to play in mediating the benefits.…”

Developmental Services in Primary Care for Low-Income Children: Clinicians' Perceptions of the Healthy Steps for Young Children Program

“…Overall, the sites served an economically and ethnically diverse population 18 and represented a range of organizational practice settings that included group practices, hospital-based clinics, and pediatric practices in health maintenance organizations.…”

“…14,16,17 The HS Specialists (early childhood educators, nurses, nurse practitioners, social workers, and other professionals with expertise in early childhood development) and physicians received training in HS by the Boston University team. 18 Participating sites implemented written protocols describing key program elements, received program materials and training manuals 19 to guide them in the practical aspects of program implementation, participated in three annual training sessions, and received ongoing monitoring, site visits, and operational support from the national HS program office.…”