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Healthy Steps (National Evaluation 1996 Protocol)

Meets DHHS criteria for an evidenced based model

This report focuses on Healthy Steps as implemented in the 1996 evaluation. HHS has determined that home visiting is not the primary service delivery strategy and the model does not meet current requirements for MIECHV program implementation.

In Brief

Last Updated

July 2011

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Evidence of Program Model Effectiveness

This program model meets the criteria established by the Department of Health and Human Services (DHHS) for an “evidence-based early childhood home visiting service delivery model” for the general population, but does not meet the criteria for tribal populations.

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Program Model Description

Healthy Steps (national evaluation 1996 protocol) was a universal parenting intervention implemented between 1996 and 2001 for parents of children from birth to age 3. The HomVEE review is based on Healthy Steps as implemented in the 1996 national evaluation, and referred to as Healthy Steps (national evaluation 1996 protocol), or HS (national evaluation). HS (national evaluation) was designed to promote (1) the clinical capacity and effectiveness of pediatric primary care to better meet the needs of families with young children; (2) the knowledge, skills, and confidence of parents in their child-rearing abilities; and (3) the health and development of young children. The program added a child development specialist to the pediatric care team. HS specialists delivered a minimum of six home visits, attended well-child care appointments, staffed a telephone line parents could call with any questions, conducted child development and family health assessments, led parent group meetings, disseminated written materials to parents, and connected parents to community resources. Home visits and other components focused on educating families about their children’s health, behavior, and development. For more information, please read the Program Model Overview.

This report also includes a review of an enhancement to Healthy Steps, called PrePare. PrePare was designed for sites that provide prenatal assistance only. PrePare has been studied as a supplement to Healthy Steps that added an average of three prenatal home visits by the HS specialist. Home visitors covered general topics on the transition to parenthood, as well as dealing with family-specific risk factors.

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Extent of Evidence

Results of Search and ReviewNumber of Studies for Healthy Steps OnlyNumber of Studies for Healthy Steps + PrePare
Released from 1979 to 2011 332
Eligible for review 72
     Rated high 22
     Rated moderate 30
     Rated low 20
     Additional sourcesa 00

aAdditional sources overlap with another study and are not rated.

For more information, see the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.

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Summary of Findings



Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 0
No effect: 2
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Child Health

Favorable: 2
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 3
Unfavorable or ambiguous: 0

Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Positive Parenting Practices

Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Favorable: 3
No effect: 13
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

PrePare supplement relative to Healthy Steps only subgroup
Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 2
No effect: 4
Unfavorable or ambiguous: 1

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Child Health

Favorable: 2
No effect: 5
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 2
Unfavorable or ambiguous: 2

Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 9
Unfavorable or ambiguous: 1

Positive Parenting Practices

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Favorable: 1
No effect: 20
Unfavorable or ambiguous: 3

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime

Favorable: 0
No effect: 1
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.

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Criteria Established by the Department of Health and Human Services

 Healthy Steps OnlyHealthy Steps + PrePare
Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study? YesYes
Across high- or moderate-quality studies, favorable impacts in…
 
   at least two outcome domains within one sample
 
   OR
 
   the same domain for at least two non-overlapping samples?
YesYes
Favorable impacts on full sample? YesYes
Any favorable impacts on outcome measures sustained at least 12 months after program enrollment?a YesYes
One or more favorable, statistically significant impact reported in a peer-reviewed journal?a YesYes

aThis information is reported for all program models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

Please read the DHHS Criteria for Evidence-Based Program Models for more information.

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