Black or African American
21%
Minkovitz, C. S., Strobino, D., Mistry, K. B., Scharfstein, D. O., Grason, H., Hou, W., Guyer, B. (2007). Healthy Steps for Young Children: Sustained results at 5.5 years. Pediatrics, 120(3), 658–668.
Study design characteristics contributing to rating
| Design | Attrition | Baseline equivalence | Confounding factors? | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | High |
Established on race/ethnicity and SES (i.e., family income). Equivalence on baseline measures is not feasible. |
None |
Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1 |
Notes from the review of this manuscript
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).
Child Development and School Readiness
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Clinical or borderline concern about child behavior | 5.5 years | Moderate | 0.14 | Not statistically significant, p ≥ 0.05 | 1308 children | The 6 RCT national evaluation sites |
Child Health
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Child hospitalized in past year | 5.5 years | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 1308 children | 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 |
|---|---|---|---|---|---|---|---|
| Ever slap in face/spank with object | 5.5 yrs | Moderate | 0.10 | Not statistically significant, p ≥ 0.05 | 1308 mothers | The 6 RCT national evaluation sites | |
| Looked at/read books in past week | 5.5 yrs | Moderate | 0.04 | Not statistically significant, p ≥ 0.05 | 1308 mothers | The 6 RCT national evaluation sites | |
| Often/almost always ignore misbehavior | 5.5 yrs | Moderate | 0.04 | Not statistically significant, p ≥ 0.05 | 1308 mothers | The 6 RCT national evaluation sites | |
| Often/almost always negotiate | 5.5 yrs | Moderate | 0.14 | Not statistically significant, p ≥ 0.05 | 1308 mothers | The 6 RCT national evaluation sites | |
| Routine/regular bedtime | 5.5 yrs | Moderate | 0.17 | Not statistically significant, p ≥ 0.05 | 1308 mothers | The 6 RCT national evaluation sites | |
| Use harsh discipline | 5.5 yrs | Moderate | 0.15 | Not statistically significant, p ≥ 0.05 | 1308 mothers | The 6 RCT national evaluation sites |
Reductions In Child Maltreatment
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description |
|---|---|---|---|---|---|---|---|
| Used emergency department in past year for injury | 5.5 years | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 1308 children | The 6 RCT national evaluation sites |
This study included participants from the following locations:
- California
- Iowa
- Pennsylvania
- South Carolina
- Texas
Study Participants
The sample included 1,308 mothers with children about 5.5 years old 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. Just over one in three parents had a college degree, and 40% had incomes above $50,000 at baseline. Most study participants were white (65%) or African American (21%). The most common maternal age groups were 20-29 (48%) and over 30 (42%).
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.
Intervention condition
Note: Navigate to the model page for more information about the home visiting model. See the source manuscript for more information about how the model was implemented in this study.
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.
Funding Sources
The Commonwealth Fund (grant 20010683) and the Agency for Healthcare Quality and Research (grant R01HS13086).