Healthy Steps (National Evaluation 1996 Protocol) Meets HHS Criteria

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.

Last updated: July 2011

Effects Shown in Research & Outcome Measure Details

Positive Parenting Practices

Outcomes Rated High

Healthy Steps (National Evaluation 1996 Protocol)
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
Car seat in back seat
FavorableUnfavorableNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.90 Mean = 0.90 OR = 1.08 HomeVEE calculated = 0.05 Not statistically significant,
p > 0.05
Secondary
Followed at least 2 routines
FavorableUnfavorableNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.94 Mean = 0.93 OR = 1.27 HomeVEE calculated = 0.14 Not statistically significant,
p > 0.05
Secondary
Gave baby cereal
FavorableUnfavorableNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.30 Mean = 0.32 OR = 0.88 HomeVEE calculated = -0.08 Not statistically significant,
p > 0.05
Secondary
Gave baby water
FavorableUnfavorableNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.38 Mean = 0.41 OR = 0.80 HomeVEE calculated = -0.14 Statistically significant,
p < 0.05
Secondary
Lowered water temperature
FavorableUnfavorableNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.31 Mean = 0.33 OR = 0.93 HomeVEE calculated = -0.04 Not statistically significant,
p > 0.05
Secondary
Played with baby daily
FavorableUnfavorableNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.93 Mean = 0.93 OR = 1.02 HomeVEE calculated = 0.01 Not statistically significant,
p > 0.05
Secondary
Showed picture books daily
FavorableUnfavorableNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.28 Mean = 0.27 OR = 1.08 HomeVEE calculated = 0.05 Not statistically significant,
p > 0.05
Secondary
Used wrong sleep position
FavorableUnfavorableNo Effect
2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.11 Mean = 0.14 OR = 0.76 HomeVEE calculated = -0.17 Statistically significant,
p < 0.05
Secondary
Show Study Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Car seat in back seat

Percentage of mothers who placed the child’s car seat in the back seat Parent/caregiver report during telephone interview

Not applicable

Secondary

Followed at least two routines

Percentage of mothers who followed at least two routines at bedtime, naptime, or mealtime Parent/caregiver report during telephone interview

Not applicable

Secondary

Gave baby cereal

Percentage of mothers who fed their infant cereal Parent/caregiver report during telephone interview

Not applicable

Secondary

Gave baby water

Percentage of mothers who fed their infant water Parent/caregiver report during telephone interview

Not applicable

Secondary

Lowered water temperature

Percentage of mothers who lowered the temperature of the hot water heater at home Parent/caregiver report during telephone interview

Not applicable

Secondary

Played with baby daily

Percentage of mothers who played with their child at least once daily Parent/caregiver report during telephone interview

Not applicable

Secondary

Showed picture books daily

Percentage of mothers who showed their child picture books daily Parent/caregiver report during telephone interview

Not applicable

Secondary

Used wrong sleep position

Percentage of mothers who used the wrong sleep position at both nap and bedtime Parent/caregiver report during telephone interview

Not applicable

Secondary
Healthy Steps - PrePare supplement relative to Healthy Steps only subgroup
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
Covers on electrical outlets
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.95 Mean = 0.91 OR = 1.06 HomeVEE calculated = 0.03 Statistically significant,
p < 0.05
Secondary
Discipline by ever slapping face or spanking with object
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.01 Mean = 0.03 OR = 0.20 HomeVEE calculated = -0.98 Not statistically significant,
p > 0.05
Secondary
Environment with tobacco smoke
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 239 mothers Mean = 0.10 Mean = 0.07 OR = 1.05 HomeVEE calculated = 0.03 Not statistically significant,
p > 0.05
Secondary
Followed 3 routines, 2 if no nap
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.80 Mean = 0.91 OR = 1.02 HomeVEE calculated = 0.01 Not statistically significant,
p > 0.05
Secondary
Has access to poison control center telephone number
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.96 Mean = 0.96 OR = 1.01 HomeVEE calculated = 0.01 Not statistically significant,
p > 0.05
Secondary
Health care self-efficacy
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 239 mothers Mean = 17.00 Mean = 17.00 Mean difference = -0.14 Not available Not statistically significant, p > 0.05 Secondary
Injury prevention index
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 239 mothers Mean = 4.86 Mean = 4.81 Mean difference = -0.02 Not available Not statistically significant,
p > 0.05
Secondary
Parenting Behavior Checklist: Nurturing subscale
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 239 mothers Mean = 58.70 Mean = 60.20 Mean difference = -1.35 Not available Not statistically significant,
p > 0.05
Secondary
Parenting sense of competence
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 239 mothers Mean = 47.10 Mean = 47.60 Mean difference = -0.69 Not available Not statistically significant,
p > 0.05
Secondary
Play with child at least daily
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.97 Mean = 0.99 OR = 0.98 HomeVEE calculated = -0.01 Not statistically significant,
p > 0.05
Secondary
Read to child at least daily
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.88 Mean = 0.95 OR = 0.92 HomeVEE calculated = -0.05 Statistically significant,
p < 0.05
Secondary
Safety latches on cabinets
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.63 Mean = 0.71 OR = 0.87 HomeVEE calculated = -0.08 Statistically significant,
p < 0.05
Secondary
Use stair gate
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.32 Mean = 0.34 OR = 0.99 HomeVEE calculated = -0.01 Not statistically significant,
p > 0.05
Secondary
Watch television more than one hr. per day
FavorableUnfavorableNo Effect
30 months Healthy Steps sample 232 mothers Mean = 0.39 Mean = 0.28 OR = 1.35 HomeVEE calculated = 0.18 Statistically significant,
p < 0.05
Secondary
Show Study Outcome Measure Summary
Healthy Steps - PrePare supplement relative to Healthy Steps only subgroup
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
KIDI score
FavorableUnfavorableNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.82 Mean = 0.83 Mean difference = 0.00 Not available Not statistically significant,
p > 0.05
Secondary
Endorsed appropriate discipline
FavorableUnfavorableNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.90 Mean = 0.90 OR = 1.01 HomeVEE calculated = 0.01 Not statistically significant,
p > 0.05
Secondary
Home Safety Index
FavorableUnfavorableNo Effect
3 months Healthy Steps sample 275 mothers Mean = 6.29 Mean = 6.27 Mean difference = 0.03 Not available Not statistically significant,
p > 0.05
Secondary
Knowledge of sleep positions
FavorableUnfavorableNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.97 Mean = 0.98 OR = 0.60 HomeVEE calculated = -0.31 Not statistically significant,
p < 0.05
Secondary
Parenting sense of competence
FavorableUnfavorableNo Effect
3 months Healthy Steps sample 275 mothers Mean = 47.30 Mean = 48.05 Mean difference = -0.70 Not available Not statistically significant,
p > 0.05
Secondary
Read with infant in past week
FavorableUnfavorableNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.78 Mean = 0.80 OR = 0.98 HomeVEE calculated = -0.01 Not statistically significant,
p > 0.05
Secondary
Role satisfaction
FavorableUnfavorableNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.98 Mean = 0.98 OR = 1.01 HomeVEE calculated = 0.01 Not statistically significant,
p > 0.05
Secondary
Safe-sleep practices
FavorableUnfavorableNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.81 Mean = 0.78 OR = 1.05 HomeVEE calculated = 0.03 Not statistically significant,
p
Secondary
Self-efficacy (health care specific)
FavorableUnfavorableNo Effect
3 months Healthy Steps sample 275 mothers Mean = 16.54 Mean = 16.73 Mean difference = -0.17 Not available Not statistically significant, p > 0.05 Secondary
Tobacco-free household
FavorableUnfavorableNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.90 Mean = 0.91 OR = 1.01 HomeVEE calculated = 0.01 Not statistically significant,
p > 0.05
Secondary
Show Study Outcome Measure Summary

Outcomes Rated Moderate

Healthy Steps (National Evaluation 1996 Protocol)
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
Use of inductive/authoritative discipline
FavorableUnfavorableNo Effect
16-18 mo. 2 of the 6 RCT national evaluation sites 378 mothers Mean = 0.10 Mean = -0.12 Mean difference = 0.22 HomeVEE calculated = 0.21 Statistically significant,
p < 0.05
Secondary
Use of punitive/“high power” discipline
FavorableUnfavorableNo Effect
16-18 mo. 2 of the 6 RCT national evaluation sites 378 mothers Mean = -0.06 Mean = 0.13 Mean difference = -0.19 HomeVEE calculated = 0.18 Not statistically significant,
p > 0.05
Secondary
Show Study Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Use of inductive/authoritative discipline

A modified version of the Parental Responses to Child Misbehavior was administered to parents who were asked to report how frequently in an average week in the previous month they used 12 discipline strategies. Authors conducted confirmatory factor analysis on a two-factor model: inductive/authoritative behavior and punitive/high-power behavior. Parent/caregiver report

Not reported by author

Secondary

Use of punitive/“high-power” discipline

A modified version of the Parental Responses to Child Misbehavior was administered to parents who were asked to report how frequently in an average week in the previous month they used 12 discipline strategies. Authors conducted confirmatory factor analysis on a two-factor model: inductive/authoritative behavior and punitive/high-power behavior. Parent/caregiver report

Not reported by author

Secondary
Healthy Steps (National Evaluation 1996 Protocol)
Show Study Effects Details
Outcome measure Effect Follow-up Timing Sample Sample Size Program Group Comparison Group Group Difference Effect size Statistical significance Outcome Type
Ever slap in face/spank with object
FavorableUnfavorableNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.11 Mean = 0.13 OR = 0.85 HomeVEE calculated = -0.10 Not statistically significant,
p > 0.05
Secondary
Looked at/read books in past week
FavorableUnfavorableNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.59 Mean = 0.57 OR = 1.07 HomeVEE calculated = 0.04 Not statistically significant,
p > 0.05
Secondary
Often/almost always ignore misbehavior
FavorableUnfavorableNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.09 Mean = 0.09 OR = 1.07 HomeVEE calculated = 0.04 Not statistically significant,
p > 0.05
Secondary
Often/almost always negotiate
FavorableUnfavorableNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.59 Mean = 0.54 OR = 1.25 HomeVEE calculated = 0.14 Not statistically significant,
p > 0.05
Secondary
Routine/regular bedtime
FavorableUnfavorableNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.85 Mean = 0.88 OR = 0.76 HomeVEE calculated = -0.17 Not statistically significant,
p > 0.05
Secondary
Use harsh discipline
FavorableUnfavorableNo Effect
5.5 yrs The 6 RCT national evaluation sites 1308 mothers Mean = 0.05 Mean = 0.07 OR = 0.78 HomeVEE calculated = -0.15 Not statistically significant,
p > 0.05
Secondary
Show Study Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection method Properties Outcome Type Operations links

Ever slapped in face/spanked with object

Percentage of mothers who had ever slapped their child in the face or spanked their child with an object during the last 12 months Parent/caregiver report during telephone interview

Not applicable

Secondary

Looked at/read books in past week

Percentage of mothers whose child looked at or read books outside of school in the past week once or twice per week or more Parent/caregiver report during telephone interview

Not applicable

Secondary

Often/almost always ignored misbehavior

Percentage of mothers who often or almost always ignored their child in response to their child’s misbehavior during the last 12 months Parent/caregiver report during telephone interview

Not applicable

Secondary

Often/almost always negotiated

Percentage of mothers who often or almost always used negotiation as a response to their child’s misbehavior during the last 12 months Parent/caregiver report during telephone interview

Not applicable

Secondary

Routine/regular bedtime

Percentage of mothers whose child usually went to bed at about the same time each night on weeknights during the school year Parent/caregiver report during telephone interview

Not applicable

Secondary

Used harsh discipline

A dichotomous variable indicating harsh discipline was formed from a constructed scale that included responses to misbehavior such as yelling in anger or threatening during the last 12 months. The respondent’s total score on the scale was summed and divided by the number of items and was interpreted in relation to the response categories for the items. Parent/caregiver report during telephone interview

Cronbach’s α = 0.59

Secondary
View Revisions