WWHV003737

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.
Citation Year
2006
Rating
Used in Implementation Reports
On
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.
Comparison Conditions
Women in the comparison group received the standard Healthy Steps program.
Staff Characteristics and Training
Healthy Steps Specialists (HSS) underwent a five-day Healthy Steps training at Boston University, followed by one additional day of training in Seattle on how PrePare relates to Healthy Steps. HS S also underwent an additional 21 hours of training on different modules subsequent to the initial training.

Author Affiliation
None of the study authors are developers of this 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.
Attrition
Low
Reassignment
None
Citation short

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

Confounding Factors
None
Baseline Equivalence
Established on race/ethnicity and SES (i.e., family income). Controls for baseline scores of outcomes collected at baseline.
Disposition
Not applicable
Screening Decision
Passes screens
Design Detail
RCT (30 months), Analysis of Healthy Steps plus PrePare supplement
General Effects Notes
Results for women receiving Healthy Steps plus PrePare.
General Outcome Notes
Outcomes measured for women receiving Healthy Steps plus PrePare.