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Healthy Steps (National Evaluation 1996 Protocol)

Meets DHHS criteria for an evidenced based model

Last Updated: July 2011

In Brief for Child Development and School Readiness Outcomes

Impact Studies Rated High


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.
Results for women receiving Healthy Steps plus PrePare.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
Child Behavior Checklist: Aggressive behavior subscale No Effect Healthy Steps sample 30 months 239 children Mean = 8.01
SD = 4.40
Mean = 7.46
SD = 4.49
MD = 0.54 Not statistically significant,
p > 0.05
Not available Primary
Child Behavior Checklist: Anxious or depressed mood subscale Unfavorable Healthy Steps sample 30 months 239 children Mean = 4.12
SD = 2.60
Mean = 3.71
SD = 2.08
MD = 0.40 Statistically significant,
p < 0.05
Not available Primary
Child Behavior Checklist: Sleep problems subscale No Effect Healthy Steps sample 30 months 239 children Mean = 3.35
SD = 2.77
Mean = 2.88
SD = 2.61
MD = 0.39 Not statistically significant,
p > 0.05
Not available Primary
MCDI combines two or more words (sometimes/often versus not yet) Favorable Healthy Steps sample 30 months 219 children Mean = 0.93 Mean = 0.89 OR = 1.05 Statistically significant,
p < 0.05
HomVEE = 0.03 Primary
MCDI use of two-word endings (three or more versus less than three) No Effect Healthy Steps sample 30 months 219 children Mean = 0.55 Mean = 0.55 OR = 1.09 Not statistically significant,
p > 0.05
HomVEE = 0.05 Primary
MCDI vocabulary checklist Favorable Healthy Steps sample 30 months 219 children Mean = 54.4
SD = 25.1
Mean = 52.3
SD = 24.2
MD = 4.08 Statistically significant,
p < 0.05
Not available Primary
MCDI word length of child’s 3 longest phrases No Effect Healthy Steps sample 30 months 219 children Mean = 4.29
SD = 2.10
Mean = 4.57
SD = 2.46
MD = -0.22 Not statistically significant,
p > 0.05
Not available Primary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
CBCL: Anxious or depressed mood subscale The CBCL is a questionnaire that assesses behavioral problems in young children. The researchers used three subscales, which used aggressive behavior (15 items with a subscale score range of 0 to 30), sleep problems (7 items with a subscale score range of 0 to 14), and symptoms related to an anxious or depressed mood (11 items with a subscale score range of 0 to 22). Parent/caregiver report Cronbach’s α = 0.68 Primary
CDI word length of child’s three longest phrases The CDI assesses language development in young children. A questionnaire that included elements of the short and long forms of the CDI evaluated single-word expressive vocabulary, word combining (two words or more), use of three or more word endings, and mean length (in morphemes) of the child’s three longest phrases. Parent/caregiver report Not reported by author Primary
CDI use of two-word endings (three or more versus less than three) The CDI assesses language development in young children. A questionnaire that included elements of the short and long forms of the CDI evaluated single-word expressive vocabulary, word combining (two words or more), use of three or more word endings, and mean length (in morphemes) of the child’s three longest phrases. Parent/caregiver report Not reported by author Primary
CDI vocabulary checklist The CDI assesses language development in young children. A questionnaire that included elements of the short and long forms of the CDI evaluated single-word expressive vocabulary, word combining (two words or more), use of three or more word endings, and mean length (in morphemes) of the child’s three longest phrases. Parent/caregiver report Not reported by author Primary
MacArthur CDI combines two or more words (sometimes/often versus not yet) The CDI assesses language development in young children. A questionnaire that included elements of the short and long forms of the CDI evaluated single-word expressive vocabulary, word combining (two words or more), use of three or more word endings, and mean length (in morphemes) of the child’s three longest phrases. Parent/caregiver report Not reported by author Primary
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Impact Studies Rated Moderate


Caughy, M. O., Huang, K., Miller, T., & Genevro, J. L. (2004). The effects of Healthy Steps for Young Children Program: Results from observations of parenting and child development. Early Childhood Research Quarterly, 19(4), 611–630.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
Attachment Q-sort scale No Effect 2 of the 6 RCT national evaluation sites 16-18 mo. 378 children Mean = 0.37
SE = 0.02
Mean = 0.36
SE = 0.02
MD = 0.01 Not statistically significant,
p > 0.05
Not available Primary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
Attachment Q-Sort scale The Attachment Q-Sort assesses security of attachment and dependency in young children. Each of the 90 items is a description of a specific behavior. Items are sorted by the mother/caregiver into nine piles of 10 cards each based on how likely or unlikely the item matches the behavior of her child. Parent/caregiver report with the assistance of a trained interviewer Not reported by author Primary

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.
Show Study Effects Details
Outcome Effect Sample Timing of Follow-Up Sample Size Program Group Comparison Group Mean Difference or Odds Ratio
Statistical Significance
Effect Size
Outcome Type
Clinical or borderline concern about child behavior No Effect The 6 RCT national evaluation sites 5.5 years 1,308 children Mean = 0.20 Mean = 0.17 OR = 1.26 Not statistically significant,
p > 0.05
HomVEE = 0.14 Primary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
CBCL: Clinical or borderline concern about child behavior The CBCL is a questionnaire that assesses behavioral problems in young children. Parent/caregiver report Not reported by author Primary
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