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

Child health

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
DTP1 vaccination
FavorableUnfavorable or ambiguousNo Effect
 2 months The 6 RCT national evaluation sites 1950 mothers = 0.92 = 0.88 OR = 1.50 HomVEE calculated = 0.25 Statistically significant,
p < 0.05
Hospitalization since birth
FavorableUnfavorable or ambiguousNo Effect
 2-4 months The 6 RCT national evaluation sites 1987 mothers Not reported Not reported OR = 0.71 HomVEE calculated = -0.21 Not statistically significant, p ≥ 0.05
One-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 1 month The 6 RCT national evaluation sites 2086 mothers = 0.97 = 0.95 OR = 1.85 HomVEE calculated = 0.37 Statistically significant,
p < 0.05
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
Continuing to breastfeed
FavorableUnfavorable or ambiguousNo Effect
 2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.56 Mean = 0.54 OR = 1.15 HomVEE calculated = 0.08 Not statistically significant, p ≥ 0.05
Gave baby cereal
FavorableUnfavorable or ambiguousNo Effect
 2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.30 Mean = 0.32 OR = 0.88 HomVEE calculated = -0.08 Not statistically significant, p ≥ 0.05
Gave baby water
FavorableUnfavorable or ambiguousNo Effect
 2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.38 Mean = 0.41 OR = 0.80 HomVEE calculated = -0.14 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
10-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.94 Mean = 0.93 OR = 1.01 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
15-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.88 Mean = 0.89 OR = 0.99 HomVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
2-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.93 Mean = 0.96 OR = 0.97 HomVEE calculated = -0.02 Not statistically significant, p ≥ 0.05
24-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.87 Mean = 0.76 OR = 1.17 HomVEE calculated = 0.10 Statistically significant,
p < 0.05
4-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.96 Mean = 0.98 OR = 0.97 HomVEE calculated = -0.02 Not statistically significant, p ≥ 0.05
6-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.94 Mean = 0.94 OR = 1.01 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
Breastfeeding duration (mo.)
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 232 mothers Mean = 13.00 Mean = 13.90 Mean difference = -0.64 Not available Statistically significant,
p < 0.05
Ever breastfed
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 232 mothers Mean = 0.95 Mean = 0.99 OR = 0.96 HomVEE calculated = -0.03 Statistically significant,
p < 0.05
Immunization status up-to-date at 24 mo.
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.92 Mean = 0.88 OR = 1.03 HomVEE calculated = 0.02 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
Breastfeeding at 3 months
FavorableUnfavorable or ambiguousNo Effect
 3 months Healthy Steps sample 275 mothers Mean = 0.89 Mean = 0.92 OR = 0.98 HomVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
Feels strongly supported to breastfeed
FavorableUnfavorable or ambiguousNo Effect
 3 months Healthy Steps sample 275 mothers Mean = 0.73 Mean = 0.77 OR = 0.98 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
Child hospitalized in past year
FavorableUnfavorable or ambiguousNo Effect
 5.5 years The 6 RCT national evaluation sites 1308 children Mean = 0.03 Mean = 0.04 OR = 0.96 HomVEE calculated = -0.02 Not statistically significant, p ≥ 0.05
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