Johnston, B. D., Huebner, C. E., Tyll, L. T., Barlow, W. E., & Thompson, R. S. (2004). Expanding developmental and behavioral services for newborns in primary care: Effects on parental well-being, practice, and satisfaction. American Journal of Preventative Medicine, 26(4), 356–366.
Model(s) Reviewed:
PrePare supplement relative to Healthy Steps only subgroup
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 1 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| High | Randomized controlled trial | Low | Established on race/ethnicity. A measure of at-risk status that included indicators of SES and some baseline maternal health measures was not equivalent, but was controlled for in the analysis. Controls for baseline scores of outcomes collected at baseline. | None | None | Not assessed in manuscripts reviewed before 2021 |
| Study participants | The sample included 275 mothers with children age 3 months at assessment. All women were receiving Healthy Steps services and had enrolled before 22 weeks of gestation. Study enrollment occurred between July 20, 1998 and September 29, 2000. Most mothers had some postsecondary schooling (92%), with about one in three also having graduate-level training. Study participants were predominately white (77%). Over 80% of mothers had family incomes above $40,000, with over one in three family incomes exceeding $75,000. |
|---|---|
| Setting | Two primary care clinics that are part of the Group Home Cooperative in the Pacific Northwest. |
| Intervention services | The study randomly assigned mothers to receive either Healthy Steps only or Healthy Steps plus the PrePare supplement. Those in the Healthy Steps plus PrePare group received three prenatal home visits in addition to standard Healthy Steps program services following the child’s birth. Healthy Steps Specialists provided prenatal home visiting services to help parents prepare for their newborn. Specialists also screened and provided interventions for smoking, depression, and domestic violence. Following birth, Healthy Steps Specialists provided home visits, developmental and behavioral advice, a child development telephone information line, and links to community resources. The typical frequency of home visits by three months after birth is five in the standard implementation and eight with PrePare supplemental visits included. |
| Comparison conditions | Women in the comparison group received the standard Healthy Steps program. |
| Subgroups examined |
This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). Subgroups are not listed for manuscripts reviewed before 2021. |
| Funding sources | Funder(s) not listed. |
| Author affiliation | None of the study authors are developers of this model. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Findings that rate moderate or high
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | Breastfeeding at 3 months | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.89 | Mean = 0.92 | OR = 0.98 | HomVEE calculated = -0.01 | Not statistically significant, p ≥ 0.05 | |
| High | Feels strongly supported to breastfeed | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.73 | Mean = 0.77 | OR = 0.98 | HomVEE calculated = -0.01 | Not statistically significant, p ≥ 0.05 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | CES-D score above clinical cutoff | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.06 | Mean = 0.07 | OR = 0.65 | HomVEE calculated = -0.26 | Not statistically significant, p ≥ 0.05 | |
| High | Any CES-D mental health symptoms | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.14 | Mean = 0.01 | OR = 0.95 | HomVEE calculated = -0.03 | Not statistically significant, p ≥ 0.05 | |
| High | Household drug/alcohol concern | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.10 | Mean = 0.05 | OR = 1.62 | HomVEE calculated = 0.29 | Not statistically significant, p ≥ 0.05 | |
| High | Modified CES-D scale | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 4.18 | Mean = 3.56 | Mean difference = 0.33 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Psychosocial profile (Daily Hassles) score | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 15.85 | Mean = 15.21 | Mean difference = 0.38 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Support Behavior Inventory – Family | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 60.38 | Mean = 60.43 | Mean difference = 0.30 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Support Behavior Inventory – Partner | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 58.71 | Mean = 60.25 | Mean difference = 0.30 | Not available | Not statistically significant, p ≥ 0.05 |
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| High | KIDI score | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.82 | Mean = 0.83 | Mean difference = 0.00 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Endorsed appropriate discipline | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.90 | Mean = 0.90 | OR = 1.01 | HomVEE calculated = 0.01 | Not statistically significant, p ≥ 0.05 | |
| High | Home Safety Index | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 6.29 | Mean = 6.27 | Mean difference = 0.03 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Knowledge of sleep positions | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.97 | Mean = 0.98 | OR = 0.60 | HomVEE calculated = -0.31 | Not statistically significant, p ≥ 0.05 |
|
| High | Parenting sense of competence | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 47.30 | Mean = 48.05 | Mean difference = -0.70 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Read with infant in past week | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.78 | Mean = 0.80 | OR = 0.98 | HomVEE calculated = -0.01 | Not statistically significant, p ≥ 0.05 | |
| High | Role satisfaction | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.98 | Mean = 0.98 | OR = 1.01 | HomVEE calculated = 0.01 | Not statistically significant, p ≥ 0.05 | |
| High | Safe-sleep practices | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.81 | Mean = 0.78 | OR = 1.05 | HomVEE calculated = 0.03 | Not statistically significant, p |
|
| High | Self-efficacy (health care specific) | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 16.54 | Mean = 16.73 | Mean difference = -0.17 | Not available | Not statistically significant, p ≥ 0.05 | |
| High | Tobacco-free household | FavorableUnfavorable or ambiguousNo Effect |
Healthy Steps sample | 3 months | 275 mothers | Mean = 0.90 | Mean = 0.91 | OR = 1.01 | HomVEE calculated = 0.01 | Not statistically significant, p ≥ 0.05 |