Healthy Steps for Young Children Program in Pediatric Residency Training: Impact on Primary Care Outcomes

Niederman, Leo G.; Schwartz, Alan; Connell, Karen J.; Silverman, Kathleen

doi:10.1542/peds.2005-3090

Cited by 12 publications

(19 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

“…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%

See 1 more Smart Citation

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

et al. 2013

View full text Add to dashboard Cite

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:

show abstract

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

View full text Add to dashboard Cite

show abstract

“…Two articles 35, 36 examined associations between implementing the Healthy Steps program and screening. Healthy Steps is designed for first-time parents and provides co-located developmental specialists to enhance well-child visits.…”

Section: Resultsmentioning

confidence: 99%

Interventions to Improve Screening and Follow-Up in Primary Care: A Systematic Review of the Evidence

Cleave

Kuhlthau

Bloom

et al. 2012

Academic Pediatrics

View full text Add to dashboard Cite

Background The American Academy of Pediatrics and other organizations recommend several screening tests as part of preventive care. The proportion of children who are appropriately screened and who receive follow-up care is low. Objective To conduct a systematic review of the evidence for practice-based interventions to increase the proportion of patients receiving recommended screening and follow-up services in pediatric primary care. Data source Medline database of journal citations. Study eligibility criteria, participants, and interventions We developed a strategy to search Medline to identify relevant articles. We selected search terms to capture categories of conditions (e.g., developmental disabilities, obesity), screening tests, specific interventions (e.g., quality improvement initiatives, electronic records enhancements), and primary care. We searched references of selected articles and reviewed articles suggested by experts. We included all studies with a distinct, primary care-based intervention and post-intervention screening data, and studies that focused on children and young adults (≤21 years of age). We excluded studies of newborn screening. Study appraisal and synthesis methods Abstracts were screened by 2 reviewers and articles with relevant abstracts received full text review and evaluated for inclusion critieria. A structured tool was used to abstract data from selected articles. Because of heterogeneous interventions and outcomes, we did not attempt a meta-analysis. Results From 2547 returned titles and abstracts, 23 articles were reviewed. Nine were pre-post comparisons, 5 were randomized trials, 3 were post-intervention comparisons with a control group, 3 were post-intervention cross-sectional analyses only, and 3 reported time series data. Of 14 articles with pre-intervention or control group data and significance testing, 12 reported increases in the proportion of patients appropriately screened. Interventions were heterogeneous and often multifaceted, and several types of interventions, such as provider/staff training, electronic medical record templates/prompts, and learning collaboratives, appeared effective in improving screening quality. Few articles described interventions to track screening results or referral completion for those with abnormal tests. Data were often limited by single-site, non-randomized design. Conclusions Several feasible, practice- and provider-level interventions appear to increase the quality of screening in pediatric primary care. Evidence for interventions to improve follow-up of screening tests is scant. Future research should focus on which specific interventions are most effective, whether effects are sustained over time, and what interventions improve follow-up of abnormal screening tests.

show abstract

“…[13][14][15][16] Previously, Niederman et al 17 have shown that HS can increase continuity of care in pediatric residency sites. In addition, a study by Kinzer et al 10 at a single program demonstrated that HS increased resident perception of their B/D counseling effectiveness.…”

Section: Discussionmentioning

confidence: 99%

A Modified Healthy Steps Model to Improve Resident Training in Behavioral and Developmental Care

Randolph¹,

Stenberg²,

Socolar³

et al. 2011

Journal of Developmental &Amp; Behavioral Pediatrics

View full text Add to dashboard Cite

show abstract

Healthy Steps for Young Children Program in Pediatric Residency Training: Impact on Primary Care Outcomes

Cited by 12 publications

References 23 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

Interventions to Improve Screening and Follow-Up in Primary Care: A Systematic Review of the Evidence

A Modified Healthy Steps Model to Improve Resident Training in Behavioral and Developmental Care

Contact Info

Product

Resources

About