The Healthy Steps for Young Children program began in 1995 as a new approach to primary health care for young children, birth to age three. The program is intended to enhance early pediatric care by incorporating preventive developmental and behavioral services as part of a comprehensive, whole-child, whole-family model of health care and to help provide mothers and fathers with the child-rearing information and guidance they seek.
The WCHPC at JHU has been charged with conducting three sets of evaluations of the Healthy Steps for Young Children Program:
- National Evaluation
- Embedded, Direct Observation Evaluation
- Affiliate Evaluation
Healthy Steps for Young Children: Sustained Results at 5.5 Years (2007). Pediatrics, 150(4), 658-668.
Fifteen of the original 24 sites were included in an independent national program evaluation. The national evaluation was charged with assessing the process, outcomes, costs, and sustainability of the program. The sample included 5,565 children and their parents (intervention and control) enrolled at birth and being followed through 5 1/2 years of age. At six sites, newborns were assigned randomly to the intervention or control group; at nine sites, a quasi-experimental design was used and a comparison location for the Healthy Steps practice was selected.
The practices and families included in the evaluation shared some important characteristics with all practices and families throughout the United States. Participating sites represented a range of organizational practice settings. Among them were community-based group practices, pediatric clinics located within academic medical centers, and staff model managed care organizations.
Two of the 15 sites also participated in an embedded, direct observation study. The embedded study assessed the program’s effect on the home environment, mother-child interaction, and child development.
Nine additional sites implemented Healthy Steps in the same way as the 15 national evaluation sites. They are referred to as affiliate sites. Six affiliate sites were involved in a more limited evaluation. Findings from the affiliate evaluation complement the larger evaluation. Two of the remaining affiliate sites implemented their own formal evaluations, which are not yet completed, and one affiliate site participated in a local evaluation.
More information about the Healthy Steps program is available on this website, and at the Program's website.