Healthy Steps (National Evaluation 1996 Protocol)
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 |