Black or African American
25%
Minkovitz, C., Strobino, D., Hughart, N., Scharfstein, D., Guyer, B., & Healthy Steps Evaluation Team (2001). Early effects of the Healthy Steps for Young Children Program. Archives of Pediatrics & Adolescent Medicine, 155(4), 470–479.
Model(s) Reviewed
Navigate to model page for more information about the home visiting model.
Funding Sources
The Commonwealth Fund and local funders.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Not established on race/ethnicity or SES (i.e., maternal education). |
None |
Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1 |
In 2020, HomVEE updated this review to move the measures of whether the parent gave the baby cereal or water from the Positive Parenting Practice domain to the Child Health domain because ACF determined that HomVEE should place all child feeding outcomes under the Child Health domain.
Study presents unadjusted program and comparison group means (columns 5 and 6). Tests of statistical significance apply to adjusted results in column 7 (means difference or odds ratio).
The standard errors in Minkovitz et al. (2001) are adjusted for clustering by site.
Findings that rate moderate or high in this manuscript
Child health
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Continuing to breastfeed | 2-4 mo. | High | 0.08 | Not statistically significant, p ≥ 0.05 | 1987 mothers | The 6 RCT national evaluation sites | ||
| Gave baby water | 2-4 mo. | High | 0.14 | Statistically significant,p < 0.05 | 1987 mothers | The 6 RCT national evaluation sites | ||
| Gave baby cereal | 2-4 mo. | High | 0.08 | Not statistically significant, p ≥ 0.05 | 1987 mothers | The 6 RCT national evaluation sites |
Positive parenting practices
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| Used wrong sleep position | 2-4 mo. | High | 0.17 | Statistically significant,p < 0.05 | 1987 mothers | The 6 RCT national evaluation sites | ||
| Car seat in back seat | 2-4 mo. | High | 0.05 | Not statistically significant, p ≥ 0.05 | 1987 mothers | The 6 RCT national evaluation sites | ||
| Lowered water temperature | 2-4 mo. | High | 0.04 | Not statistically significant, p ≥ 0.05 | 1987 mothers | The 6 RCT national evaluation sites | ||
| Showed picture books daily | 2-4 mo. | High | 0.05 | Not statistically significant, p ≥ 0.05 | 1987 mothers | The 6 RCT national evaluation sites | ||
| Followed at least 2 routines | 2-4 mo. | High | 0.14 | Not statistically significant, p ≥ 0.05 | 1987 mothers | The 6 RCT national evaluation sites | ||
| Played with baby daily | 2-4 mo. | High | 0.01 | Not statistically significant, p ≥ 0.05 | 1987 mothers | The 6 RCT national evaluation sites |
Study Participants
The sample included 1,987 mothers with children ages 2 to 4 months at assessment. All women enrolled in Healthy Steps within four weeks of the child’s birth. Study enrollment occurred between September 1996 and November 1998. Most mothers had a high school degree (~85%) and one in four also had a college degree. Most study participants were white (~62%) or African American (~24%). The most common maternal age groups were 20-29 (~51%) and over 30 (~33%). Nearly two-thirds of mothers were married.
Setting
The six sites—Allentown, PA, Amarillo, TX, Florence, SC, Iowa City, IA, Pittsburgh, PA, and San Diego, CA—were randomly assigned as part of the national evaluation. (There were nine other sites that used quasi-experimental comparisons. These comparisons received a low rating, however. See Study Ratings for details.) Sites were group practices, hospital-based clinics, or pediatric practices in health maintenance organizations.
Home Visiting Services
Healthy Steps Specialists provided well-child care, home visits, a child development telephone information line, child development and family health checkups, written materials for parents that emphasize prevention, parent group meetings, and links to community resources. Home visits typically occurred at least once during the first month after birth and a total of six times by the time the children were age 3. Three in four mothers in the intervention group had received a home visit by the two- to four-month follow-up.
Model(s) Reviewed
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Comparison Conditions
Children in the control group received routine pediatric care but had no exposure to the Healthy Steps Specialist or to Healthy Steps materials.
This study included participants from the following locations:
- California
- Iowa
- Pennsylvania
- South Carolina
- Texas