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.

Model effectiveness research report last updated: 2011

Effects shown in research & outcome measure details

Child health

Findings rated high

Healthy Steps (National Evaluation 1996 Protocol)
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Continuing to breastfeed
FavorableUnfavorable or ambiguousNo Effect
 2-4 mo. The 6 RCT national evaluation sites 1987 mothers Mean = 0.56 Mean = 0.54 OR = 1.15 HomeVEE calculated = 0.08 Not statistically significant, p ≥ 0.05
Gave baby cereal
FavorableUnfavorable or ambiguousNo 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
Gave baby water
FavorableUnfavorable or ambiguousNo 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
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Outcome measure Outcome measure description Collection method Properties

Continuing to breastfeed

 Percentage of mothers who were breastfeeding, including those that continued to breastfeed, among women who had initiated breastfeeding Parent/caregiver report

Not applicable

Gave baby cereal

Percentage of mothers who fed their infant cereal

Parent/caregiver report during telephone interview

Not applicable

Gave baby water

Percentage of mothers who fed their infant water

Parent/caregiver report during telephone interview

Not applicable
Healthy Steps (National Evaluation 1996 Protocol)
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
DTP1 vaccination
FavorableUnfavorable or ambiguousNo Effect
 2 months The 6 RCT national evaluation sites 1950 mothers = 0.92 = 0.88 OR = 1.50 HomeVEE calculated = 0.25 Statistically significant,
p < 0.05
Hospitalization since birth
FavorableUnfavorable or ambiguousNo Effect
 2-4 months The 6 RCT national evaluation sites 1987 mothers Not reported Not reported OR = 0.71 HomeVEE calculated = -0.21 Not statistically significant, p ≥ 0.05
One-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 1 month The 6 RCT national evaluation sites 2086 mothers = 0.97 = 0.95 OR = 1.85 HomeVEE calculated = 0.37 Statistically significant,
p < 0.05
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Outcome measure Outcome measure description Collection method Properties

DTP1 vaccination

 Percentage of children who had received the DTP1 vaccination between 42 and 92 days postpartum Review of medical records

Not applicable

Hospitalization since birth

 Number of child hospitalizations Parent/caregiver report

Not applicable

One-month well-child care visit

 Percentage of children who had attended a well-child care visit within 41 days of birth Review of medical records

Not applicable
Healthy Steps - PrePare supplement relative to Healthy Steps only subgroup
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
10-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.94 Mean = 0.93 OR = 1.01 HomeVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
15-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.88 Mean = 0.89 OR = 0.99 HomeVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
2-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.93 Mean = 0.96 OR = 0.97 HomeVEE calculated = -0.02 Not statistically significant, p ≥ 0.05
24-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.87 Mean = 0.76 OR = 1.17 HomeVEE calculated = 0.10 Statistically significant,
p < 0.05
4-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.96 Mean = 0.98 OR = 0.97 HomeVEE calculated = -0.02 Not statistically significant, p ≥ 0.05
6-month well-child care visit
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.94 Mean = 0.94 OR = 1.01 HomeVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
Breastfeeding duration (mo.)
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 232 mothers Mean = 13.00 Mean = 13.90 Mean difference = -0.64 Not available Statistically significant,
p < 0.05
Ever breastfed
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 232 mothers Mean = 0.95 Mean = 0.99 OR = 0.96 HomeVEE calculated = -0.03 Statistically significant,
p < 0.05
Immunization status up-to-date at 24 mo.
FavorableUnfavorable or ambiguousNo Effect
 30 months Healthy Steps sample 239 children Mean = 0.92 Mean = 0.88 OR = 1.03 HomeVEE calculated = 0.02 Statistically significant,
p < 0.05
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Outcome measure Outcome measure description Collection method Properties

Breastfeeding duration

Number of months the mother breasted her child

Parent/caregiver report

Not applicable

Ever breastfed

Percentage of mothers who had ever breastfed their child

Parent/caregiver report

Not applicable

Immunization status up-to-date at 24 months

Percentage of children who had up-to-date immunizations for their age

Review of the health plan’s standard Health Plan Employer Data and Information Set.

Not applicable

Well-child care visits at 2, 4, 6, 10, 15, 24 months of age.

Percentage of children who had a well-child visit at the reference month of age

Review of health plan records

Not applicable
Healthy Steps - PrePare supplement relative to Healthy Steps only subgroup
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Breastfeeding at 3 months
FavorableUnfavorable or ambiguousNo Effect
 3 months Healthy Steps sample 275 mothers Mean = 0.89 Mean = 0.92 OR = 0.98 HomeVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
Feels strongly supported to breastfeed
FavorableUnfavorable or ambiguousNo Effect
 3 months Healthy Steps sample 275 mothers Mean = 0.73 Mean = 0.77 OR = 0.98 HomeVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties

Breastfeeding at 3 months

Percentage of mothers who had been breastfeeding at the child’s 3rd month of age

Parent/caregiver report

Not applicable

Feels strongly supported to breastfeed

Percentage of mothers who felt supported by their partner and extended family to breastfeed their child

Parent/caregiver report

Not applicable

Findings rated moderate

Healthy Steps (National Evaluation 1996 Protocol)
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Child hospitalized in past year
FavorableUnfavorable or ambiguousNo Effect
 5.5 years The 6 RCT national evaluation sites 1308 children Mean = 0.03 Mean = 0.04 OR = 0.96 HomeVEE calculated = -0.02 Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties

Child hospitalized in past year

 Percentage of children who had been hospitalized during the previous year Parent/caregiver report

Not applicable
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