White
79%
Johnston, B. D., Huebner, C. E., Anderson, M. L., Tyll, L. T., & Thompson, R. S. (2006). Healthy Steps in an integrated delivery system: Child and parent outcomes at 30 months. Archives of Pediatrics & Adolescent Medicine, 160(8), 793–800.
Model(s) Reviewed
Navigate to model page for more information about the home visiting model.
Funding Sources
The Kaiser Foundation Health Plan; the Group Health Community Foundation; the Nesholm Family Foundation; and the Group Health Administration Employees Community Fund of Boeing, Puget Sound.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Established on race/ethnicity and SES (i.e., family income). Controls for baseline scores of outcomes collected at baseline. |
None |
Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1 |
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 Johnston et al. (2006) are adjusted for clustering within clinic.
Findings that rate moderate or high in this manuscript
No findings found that rate moderate or high.
Study Participants
The sample included 239 mothers with children age 30 months at assessment. All women were receiving Healthy Steps services and had enrolled before 22 weeks of gestation. Study enrollment occurred between July 1998 and September 2000. Most mothers had some college experience (>90%), with over one in three also having graduate-level training. Study participants were predominately white (>75%). Over 80% of mothers had family incomes above $40,000, with over one in three family incomes exceeding $75,000.
Setting
Three primary care clinics that are part of the Group Home Cooperative in the Pacific Northwest.
Home Visiting 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.
Model(s) Reviewed
Navigate to model page for more information about the home visiting model.
Comparison Conditions
Women in the comparison group received the standard Healthy Steps program.
Were any subgroups examined?
No