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Study Detail

Caughy, M. O., Miller, T., Genevro, J. L., Huang, K., & Nautiyal, C. (2003). The effects of Healthy Steps on discipline strategies of parents of young children. Journal of Applied Developmental Psychology, 24(5), 517–534.

Program(s) Reviewed: Healthy Steps (National Evaluation 1996 Protocol)

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignAttritionBaseline EquivalenceReassignmentConfounding Factors
ModerateRCT (16-18 months)HighEstablished on race/ethnicity and SES (i.e., maternal education and Medicaid coverage). Equivalence on baseline measures is not feasible.NoneNone
ModerateRCT (34-37 months)HighNot established on SES (i.e., Medicaid coverage).NoneNone

Caughy et al. (2003) presents a statistically significant difference on maternal race that was shown to be not statistically significant in Caughy et al. (2004) and that was confirmed by HomVEE calculations.

Study Characteristics

Study Participants

The sample included 378 mothers with children ages 16 to 18 months at assessment. All women enrolled in Healthy Steps within four weeks of the child’s birth. Study enrollment occurred between September 1996 and November 1998. Most mothers had a high school degree (86%) and one in five also had a college degree. Most study participants were either white (62%) or African American (25%). The most common maternal age groups were 20-29 (57%) and over 30 (25%). Two-thirds of mothers were married.


The study used two of the six randomly assigned pediatric care sites that were part of the national evaluation of Healthy Steps (Amarillo, TX, and Florence, SC). Both sites served economically and racially/ethnically diverse populations.

Home Visiting Services

Healthy Steps Specialists provided well-child care, home visits, a child development telephone information line, child development and family health checkups, written materials for parents that emphasize prevention, parent group meetings, and links to community resources. The program offered families nine standard pediatric office visits and six home visits by the time the children were age 3. Healthy Steps families received, on average, two home visits.

Comparison Condition

Children in the control group received routine pediatric care but had no exposure to the Healthy Steps Specialist or to Healthy Steps materials.

Staff Characteristics and Training

Specialists were early childhood educators, nurses, nurse practitioners, social workers, or professionals with other relevant expertise. Each attended annual trainings conducted by the Boston University Healthy Steps team and administered services in cooperation with pediatricians and pediatric nurse practitioners. Sites also received program and training manuals and technical assistance through biweekly teleconferences. Implementation of written protocols was monitored by the Healthy Steps national program office. See Guyer et al. (2003) for more details.

Funding Source

William T. Grant Foundation; The Amarillo Area Foundation; The Duke Endowment; The Hogg Foundation; and The McLeod Foundation.

Author Affiliation

None of the study authors are developers of this program model.


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