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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 Maternal Health Outcomes

Impact Studies Rated High


Guyer, B., Barth, M., Bishai, D., Caughy, M., Clark, B., Burkom, D., Tang, C. (2003). The Healthy Steps for Young Children Program National Evaluation. Baltimore: Women’s and Children’s Health Policy Center, Department of Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health.
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
Mother resumed smoking No Effect The 6 RCT national evaluation sites 2-4 months 1,987 mothers Not reported Not reported OR = 1.20 Not statistically significant, p > 0.05 HomVEE = -0.02 Secondary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
Mother resumed smoking Percentage of mothers who resumed smoking after the birth of their child Parent/caregiver report Not reported by author Secondary

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
Any illicit drug use in past year No Effect Healthy Steps sample 30 months 239 mothers Mean = 0.07 Mean = 0.05 OR = 1.02 Not statistically significant,
p > 0.05
HomVEE = 0.01 Secondary
CES-D scale Unfavorable Healthy Steps sample 30 months 239 mothers Mean = 4.74
SD = 4.49
Mean = 3.80
SD = 4.42
MD = 0.55 Statistically significant,
p < 0.05
Not available Secondary
Clinically significant depressive symptoms No Effect Healthy Steps sample 30 months 239 mothers Mean = 0.10 Mean = 0.07 OR = 0.93 Not statistically significant,
p > 0.05
HomVEE = -0.04 Secondary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
Any illicit drug use in past year Percentage of parents who reported using illegal drugs during the past year Parent/caregiver report Not applicable Secondary
CES-D A modified14-item version of the CES-D that assesses depressive symptoms. The researchers analyzed the modified total score ranging from 0 to 42 and a binary variable dividing the sample into those that were at or above the clinical cutoff (11) and those below it. Parent/caregiver report Cronbach’s α = .83 Secondary
Clinically significant depressive symptoms A modified14-item version of the CES-D that assesses depressive symptoms. The researchers analyzed the modified total score ranging from 0 to 42 and a binary variable dividing the sample into those that were at or above the clinical cutoff (11) and those below it. Parent/caregiver report Not applicable Secondary
Environment with tobacco smoke Percentage of households with current smokers Parent/caregiver report Not applicable Secondary

Johnston, B. D., Huebner, C. E., Tyll, L. T., Barlow, W. E., & Thompson, R. S. (2004). Expanding developmental and behavioral services for newborns in primary care: Effects on parental well-being, practice, and satisfaction. American Journal of Preventative Medicine, 26(4), 356–366.
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
Any CES-D mental health symptoms No Effect Healthy Steps sample 3 months 275 mothers Mean = 0.14 Mean = .014 OR = 0.95 Not statistically significant,
p > 0.05
HomVEE = -0.03 Secondary
CES-D score above clinical cutoff No Effect Healthy Steps sample 3 months 275 mothers Mean = 0.06 Mean = 0.07 OR = 0.65 Not statistically significant,
p > 0.05
HomVEE = -0.26 Secondary
Household drug/alcohol concern No Effect Healthy Steps sample 3 months 275 mothers Mean = 0.10 Mean = 0.05 OR = 1.62 Not statistically significant,
p > 0.05
HomVEE = 0.29 Secondary
Modified CES-D scale No Effect Healthy Steps sample 3 months 275 mothers Mean = 4.18
SD = 4.54
Mean = 3.56
SD = 4.36
MD = 0.33 Not statistically significant,
p > 0.05
Not available Secondary
Psychosocial profile (Daily Hassles) score No Effect Healthy Steps sample 3 months 275 mothers Mean = 15.85
SD = 3.51
Mean = 15.21
SD = 3.25
MD = 0.38 Not statistically significant,
p > 0.05
Not available Secondary
Support Behavior Inventory – Family No Effect Healthy Steps sample 3 months 275 mothers Mean = 60.38
SD = 8.78
Mean = 60.43
SD = 5.84
MD = 0.30 Not statistically significant,
p > 0.05
Not available Secondary
Support Behavior Inventory – Partner No Effect Healthy Steps sample 3 months 275 mothers Mean = 58.71
SD = 11.15
Mean = 60.25
SD = 8.58
MD = 0.30 Not statistically significant,
p > 0.05
Not available Secondary
Show Study Outcome Measure Summary
Outcome Description of Measure Data Collection Method Properties of the Outcome Measure Outcome Type
Any mental health symptoms Percentage of parents reporting that they have mental health symptoms Parent/caregiver report Not applicable Secondary
CES-D score above clinical cutoff A modified 14-item version of the CES-D that assesses depressive symptoms. The researchers analyzed the modified total score ranging from 0 to 42 and a binary variable dividing the sample into those who were at or above the clinical cutoff and those below it. Parent/caregiver report Not applicable Secondary
Household drug/alcohol concern Percentage of parents who reported concern about alcohol or drug use by themselves or by, another household member Parent/caregiver report Not reported by author Secondary
Modified CES-D scale A modified 14-item version of the CES-D that assesses depressive symptoms. The researchers analyzed the modified total score ranging from 0 to 42 and a binary variable dividing the sample into those who were at or above the clinical cutoff and those below it. Parent/caregiver report Cronbach’s α = .83 Secondary
PPP: Daily Hassles Scale The Daily Hassles Scale of the PPP assesses stress. Parent/caregiver report Cronbach’s α = .67 Secondary

SBI: Partner

SBI: Family

TheSBI assesses satisfaction with levels of social and emotional support. The researchers examined the support received from family and from a partner. Parent/caregiver report Cronbach’s α = .96 (Partner)
Cronbach’s a = .94 (Family)
Secondary
Self-efficacy (health care specific) This scale measures parents’ self-efficacy in addressing child health problems. Parent/caregiver report Cronbach’s α = .82 Secondary
Tobacco-free household Percentage of households without smokers Parent/caregiver report Not applicable Secondary
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