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Study Detail

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.

Program(s) Reviewed: PrePare supplement relative to Healthy Steps only subgroup

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignAttritionBaseline EquivalenceReassignmentConfounding Factors
HighRCT (30 months), Analysis of Healthy Steps plus PrePare supplementLowEstablished on race/ethnicity and SES (i.e., family income). Controls for baseline scores of outcomes collected at baseline.NoneNone

Study Characteristics

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 Condition 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.

Funding Source 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.
Author Affiliation None of the study authors are developers of this program model.


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