Healthy Steps (National Evaluation 1996 Protocol) Meets HHS Criteria

This report focuses on Healthy Steps as implemented in the 1996 evaluation. HHS has determined that home visiting is not the primary service delivery strategy and the model does not meet current requirements for MIECHV program implementation.

Model effectiveness research report last updated: 2011

Effects shown in research

Positive parenting practices

Findings rated high

Healthy Steps (National Evaluation 1996 Protocol)
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Car seat in back seat
FavorableUnfavorable or ambiguousNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.90 Mean = 0.90 OR = 1.08 HomVEE calculated = 0.05 Not statistically significant, p ≥ 0.05
Followed at least 2 routines
FavorableUnfavorable or ambiguousNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.94 Mean = 0.93 OR = 1.27 HomVEE calculated = 0.14 Not statistically significant, p ≥ 0.05
Lowered water temperature
FavorableUnfavorable or ambiguousNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.31 Mean = 0.33 OR = 0.93 HomVEE calculated = -0.04 Not statistically significant, p ≥ 0.05
Played with baby daily
FavorableUnfavorable or ambiguousNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.93 Mean = 0.93 OR = 1.02 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
Showed picture books daily
FavorableUnfavorable or ambiguousNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.28 Mean = 0.27 OR = 1.08 HomVEE calculated = 0.05 Not statistically significant, p ≥ 0.05
Used wrong sleep position
FavorableUnfavorable or ambiguousNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.11 Mean = 0.14 OR = 0.76 HomVEE calculated = -0.17 Statistically significant,
p < 0.05
Healthy Steps - PrePare supplement relative to Healthy Steps only subgroup
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Covers on electrical outlets
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.95 Mean = 0.91 OR = 1.06 HomVEE calculated = 0.03 Statistically significant,
p < 0.05
Discipline by ever slapping face or spanking with object
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.01 Mean = 0.03 OR = 0.20 HomVEE calculated = -0.98 Not statistically significant, p ≥ 0.05
Environment with tobacco smoke
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 mothers Mean = 0.10 Mean = 0.07 OR = 1.05 HomVEE calculated = 0.03 Not statistically significant, p ≥ 0.05
Followed 3 routines, 2 if no nap
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.80 Mean = 0.91 OR = 1.02 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
Has access to poison control center telephone number
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.96 Mean = 0.96 OR = 1.01 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
Health care self-efficacy
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 mothers Mean = 17.00 Mean = 17.00 Mean difference = -0.14 Not available Not statistically significant, p ≥ 0.05
Injury prevention index
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 mothers Mean = 4.86 Mean = 4.81 Mean difference = -0.02 Not available Not statistically significant, p ≥ 0.05
Parenting Behavior Checklist: Nurturing subscale
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 mothers Mean = 58.70 Mean = 60.20 Mean difference = -1.35 Not available Not statistically significant, p ≥ 0.05
Parenting sense of competence
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 mothers Mean = 47.10 Mean = 47.60 Mean difference = -0.69 Not available Not statistically significant, p ≥ 0.05
Play with child at least daily
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.97 Mean = 0.99 OR = 0.98 HomVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
Read to child at least daily
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.88 Mean = 0.95 OR = 0.92 HomVEE calculated = -0.05 Statistically significant,
p < 0.05
Safety latches on cabinets
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.63 Mean = 0.71 OR = 0.87 HomVEE calculated = -0.08 Statistically significant,
p < 0.05
Use stair gate
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.32 Mean = 0.34 OR = 0.99 HomVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
Watch television more than one hr. per day
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.39 Mean = 0.28 OR = 1.35 HomVEE calculated = 0.18 Statistically significant,
p < 0.05
Healthy Steps - PrePare supplement relative to Healthy Steps only subgroup
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
KIDI score
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.82 Mean = 0.83 Mean difference = 0.00 Not available Not statistically significant, p ≥ 0.05
Endorsed appropriate discipline
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.90 Mean = 0.90 OR = 1.01 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
Home Safety Index
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 6.29 Mean = 6.27 Mean difference = 0.03 Not available Not statistically significant, p ≥ 0.05
Knowledge of sleep positions
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.97 Mean = 0.98 OR = 0.60 HomVEE calculated = -0.31 Not statistically significant,
p ≥ 0.05
Parenting sense of competence
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 47.30 Mean = 48.05 Mean difference = -0.70 Not available Not statistically significant, p ≥ 0.05
Read with infant in past week
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.78 Mean = 0.80 OR = 0.98 HomVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
Role satisfaction
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.98 Mean = 0.98 OR = 1.01 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
Safe-sleep practices
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.81 Mean = 0.78 OR = 1.05 HomVEE calculated = 0.03 Not statistically significant,
p
Self-efficacy (health care specific)
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 16.54 Mean = 16.73 Mean difference = -0.17 Not available Not statistically significant, p ≥ 0.05
Tobacco-free household
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.90 Mean = 0.91 OR = 1.01 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05

Findings rated moderate

Healthy Steps (National Evaluation 1996 Protocol)
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Use of inductive/authoritative discipline
FavorableUnfavorable or ambiguousNo Effect
16-18 mo. 2 of the 6 RCT national evaluation sites 378 mothers Mean = 0.10 Mean = -0.12 Mean difference = 0.22 HomVEE calculated = 0.21 Statistically significant,
p < 0.05
Use of punitive/“high power” discipline
FavorableUnfavorable or ambiguousNo Effect
16-18 mo. 2 of the 6 RCT national evaluation sites 378 mothers Mean = -0.06 Mean = 0.13 Mean difference = -0.19 HomVEE calculated = 0.18 Not statistically significant, p ≥ 0.05
Healthy Steps (National Evaluation 1996 Protocol)
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Ever slap in face/spank with object
FavorableUnfavorable or ambiguousNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.11 Mean = 0.13 OR = 0.85 HomVEE calculated = -0.10 Not statistically significant, p ≥ 0.05
Looked at/read books in past week
FavorableUnfavorable or ambiguousNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.59 Mean = 0.57 OR = 1.07 HomVEE calculated = 0.04 Not statistically significant, p ≥ 0.05
Often/almost always ignore misbehavior
FavorableUnfavorable or ambiguousNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.09 Mean = 0.09 OR = 1.07 HomVEE calculated = 0.04 Not statistically significant, p ≥ 0.05
Often/almost always negotiate
FavorableUnfavorable or ambiguousNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.59 Mean = 0.54 OR = 1.25 HomVEE calculated = 0.14 Not statistically significant, p ≥ 0.05
Routine/regular bedtime
FavorableUnfavorable or ambiguousNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.85 Mean = 0.88 OR = 0.76 HomVEE calculated = -0.17 Not statistically significant, p ≥ 0.05
Use harsh discipline
FavorableUnfavorable or ambiguousNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.05 Mean = 0.07 OR = 0.78 HomVEE calculated = -0.15 Not statistically significant, p ≥ 0.05
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