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

McLearn, Kathryn Taaffe; Strobino, Donna M.; Hughart, Nancy; Minkovitz, Cynthia S.; Scharfstein, Daniel O.; Marks, E.; Guyer, Bernard

doi:10.1093/jurban/jth108

Cited by 6 publications

(7 citation statements)

References 17 publications

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“…Eleven articles were identified through a reference search of accepted articles. Thirty-three articles were accepted; these included 13 articles primarily on alternative formats for WCC, 16,25-36 2 articles primarily on nonclinical locations for WCC, 37,38 17 articles primarily on nonphysicians/ non-NPs added to enhance WCC, 17,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] and 1 miscellaneous article. 55 Of 13 WCC format articles, 5 were on non-face-to-face formats, [25][26][27][28]36 and 8 were on group visit formats.…”

Section: Resultsmentioning

confidence: 99%

“…Among the 13 articles, 8 analyzed data from a large, national 3-year prospective, randomized controlled and quasi-experimental trial at 15 US sites that evaluated the program with 5565 newborns. 17,39,40,[45][46][47][48][49] Three articles report data from an extension study at a large integrated health maintenance organization, [41][42][43] and 2 report findings from residency continuity clinics that implemented HS as part of the national program. 44,50 Chart review and parent interview at child age 30 to 33 months revealed that intervention children were more likely to have timely well-child visits (eg, 12-month visit 90% vs 81%, P , .001), be up-to-date on vaccinations at 24 months (83% vs 75%, P , .001), remain at the practice for $20 months (70% vs Outcomes:…”

Section: Nonphysician Providersmentioning

confidence: 99%

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Well-Child Care Clinical Practice Redesign for Young Children: A Systematic Review of Strategies and Tools

et al. 2013

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BACKGROUND AND OBJECTIVE: Various proposals have been made to redesign well-child care (WCC) for young children, yet no peerreviewed publication has examined the evidence for these. The objective of this study was to conduct a systematic review on WCC clinical practice redesign for children aged 0 to 5 years. METHODS:PubMed was searched using criteria to identify relevant English-language articles published from January 1981 through February 2012. Observational studies, controlled trials, and systematic reviews evaluating efficiency and effectiveness of WCC for children aged 0 to 5 were selected. Interventions were organized into 3 categories: providers, formats (how care is provided; eg, non-face-to-face formats), and locations for care. Data were extracted by independent article review, including study quality, of 3 investigators with consensus resolution of discrepancies. RESULTS:Of 275 articles screened, 33 met inclusion criteria. Seventeen articles focused on providers, 13 on formats, 2 on locations, and 1 miscellaneous. We found evidence that WCC provided in groups is at least as effective in providing WCC as 1-on-1 visits. There was limited evidence regarding other formats, although evidence suggested that non-face-to-face formats, particularly web-based tools, could enhance anticipatory guidance and possibly reduce parents' need for clinical contacts for minor concerns between well-child visits. The addition of a non-medical professional trained as a developmental specialist may improve receipt of WCC services and enhance parenting practices. There was insufficient evidence on nonclinical locations for WCC. CONCLUSIONS:

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Section: Resultsmentioning

confidence: 99%

Section: Nonphysician Providersmentioning

confidence: 99%

Well-Child Care Clinical Practice Redesign for Young Children: A Systematic Review of Strategies and Tools

et al. 2013

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“…In the USA, nephrologists were found to be more likely to recommend transplantation for children whose parents had higher degrees of education in comparison to lower education levels, and for white rather than for black patients [14]. On the other hand, clinical support in providing primary health care in the Healthy Steps for Young Children program showed increasing satisfaction in families with lower income [15]. Intervention families were more satisfied with care received than control families [16].…”

Section: Influence Of Migration Background On Level Of Carementioning

confidence: 99%

Migration background and patient satisfaction in a pediatric nephrology outpatient clinic

et al. 2012

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“…25 Clinicians serving low-income families reported the greatest positive change in their perceptions about the quality of care provided to their clients. 28 In a separate study, the majority of pediatric residents at a participating site indicated HS increased the efficiency of wellchild visits, and did not detract from their role with parents. 29 When Healthy Steps was integrated as a core component of residency training, residents not only jointly conducted well-child visits with an HS specialist, but also made at least 3 home visits during the first year of their training.…”

Section: Quality Of Care Outcomesmentioning

confidence: 98%

Healthy Steps: A Systematic Review of a Preventive Practice-Based Model of Pediatric Care

Piotrowski¹,

Talavera²,

Mayer³

2009

Journal of Developmental &Amp; Behavioral Pediatrics

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The preventive role of anticipatory guidance in pediatric practice has gained increasing importance over the last two decades, resulting in the development of competing models of practice-based care. Our goal was to systematically evaluate and summarize the literature pertaining to the Healthy Steps Program for Young Children, a widely cited and utilized preventive model of care and anticipatory guidance, Medline and the bibliographies of review articles for relevant studies were searched using the keywords: Healthy Steps, preventive care, pediatric practice and others. Other sources included references of retrieved publications, review articles, and books; government documents; and Internet sources. Relevant sources were selected on the basis of their empirical evaluation of some component of care (e.g., child outcomes, parent outcomes, quality of care). From 21 identified articles, 13 met the inclusion criteria of empirical evaluation. These evaluations were summarized and compared. Results indicated that the Healthy Steps program has been rigorously evaluated and shown to be effective in preventing negative child and parent outcomes and enhancing positive outcomes. Despite limited information concerning cost effectiveness, the Healthy Steps Program provides clear benefit through early screening, family-centered care, and evidence-based anticipatory guidance. It is recommended that the Healthy Steps program be more widely disseminated to relevant stakeholders, and further enhanced by improved linguistic and cultural sensitivity and long term evaluation of cost effectiveness.

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

Cited by 6 publications

References 17 publications

Well-Child Care Clinical Practice Redesign for Young Children: A Systematic Review of Strategies and Tools

Well-Child Care Clinical Practice Redesign for Young Children: A Systematic Review of Strategies and Tools

Migration background and patient satisfaction in a pediatric nephrology outpatient clinic

Healthy Steps: A Systematic Review of a Preventive Practice-Based Model of Pediatric Care

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