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

Model overview

Theoretical approach

Healthy Steps was a universal parenting intervention implemented between 1996 and 2001. The HomVEE review is based on Healthy Steps as implemented in the 1996 national evaluation, and referred to as Healthy Steps (national evaluation 1996 protocol), or HS (national evaluation). Sites enrolled in the national evaluation followed a protocol that incorporated home visits. However, home visiting is not the primary method of service delivery in the current model guidelines, and implementation of the HS (national evaluation) is no longer supported.

HS national evaluation) was designed to enhance pediatric primary care for children from birth to age 3 and their families by incorporating preventive developmental and behavioral services into routine practice. The model strived to enhance the knowledge and confidence of caregivers as a means of promoting children’s well-being. It focused on aspects of the caregiving environment amenable to change. Infancy is a suitable period for intervention because it is a time of rapid child development and high stress for parents, and parents are likely to be open to new ideas. The model was designed to be universal, with services offered to all families in participating practices, in recognition that all parents have concerns and questions about their children’s health, behavior, and development. Operating through pediatric practices allowed the program to periodically reach children and parents during the developmentally critical first few years of children’s lives.

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Model services

The HS (national evaluation) had seven major elements. Parents were offered:
  • Home visits from HS specialists, timed to reach parents at children’s key developmental junctures during the first three years. For example, a home visit conducted in a newborn’s first few weeks of life encouraged continued breastfeeding and supported parents as they established their caregiving patterns. A home visit when a baby was about 9 months old and becoming mobile focused on safety hazards and childproofing.
  • Enhanced well-child care appointments before, after, or during well-child appointments, during which HS specialists answered questions about child development and encouraged early reading to children.
  • Child development telephone information line, staffed by HS specialists, for parents to ask questions about day-to-day worries and developmental concerns.
  • Child development and family health check-ups, to detect developmental or behavioral problems and identify family health risks.
  • Written materials that emphasized prevention and health promotion on medical, developmental, and practical topics. For example, parents received a Child Health and Development Record that chronicled immunizations, physical growth, developmental milestones, and parental concerns through age 18.
  • Parent group meetings, facilitated by the HS specialists, for social support and opportunities for interactive learning.
  • Linkages to community resources, consisting primarily of a list of community resources compiled by HS specialists.
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Intended population

HS (national evaluation) was designed for parents with children from birth to age 3. For the evaluation, enrollment was limited to families with newborns less than 4 weeks old. Any such family served by a practice that participated in the national evaluation could enroll in the program, except for families that (1) planned to move or change pediatric practices within six months, (2) did not speak fluent English or Spanish, (3) planned to put their child up for adoption or in foster care, or (4) had a child who was too ill for an office visit within the first four weeks of life. View Revisions

Where to find out more

Healthy Steps (national evaluation 1996 protocol) is no longer supported. For information about the current Healthy Steps model, contact:

Margot Kaplan-Sanoff
Healthy Steps National Network Director
1255 23rd Street, NW
Suite 350
Washington, DC 20037
Telephone: 202-857-2283
Toll-free line for Healthy Steps: 1-844-464-9811
Website: exit disclaimer

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