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: 2011

Effects shown in research & outcome measure details

Maternal 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
Mother resumed smoking
FavorableUnfavorable or ambiguousNo Effect
2-4 months The 6 RCT national evaluation sites 1987 mothers Not reported Not reported OR = 1.20 HomeVEE calculated = -0.02 Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties Operations links

Mother resumed smoking

Percentage of mothers who resumed smoking after the birth of their child Parent/caregiver report

Not reported by author

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
CES-D scale
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 mothers Mean = 4.74 Mean = 3.80 Mean difference = 0.55 Not available Statistically significant,
p < 0.05
Any illicit drug use in past year
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 mothers Mean = 0.07 Mean = 0.05 OR = 1.02 HomeVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
Clinically significant depressive symptoms
FavorableUnfavorable or ambiguousNo Effect
30 months Healthy Steps sample 239 mothers Mean = 0.10 Mean = 0.07 OR = 0.93 HomeVEE calculated = -0.04 Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties Operations links

CES-D

A modified14-item version of the CES-D that assesses depressive symptoms. The researchers analyzed the modified total score ranging from 0 to 42 and a binary variable dividing the sample into those that were at or above the clinical cutoff (11) and those below it.

Parent/caregiver report

Cronbach’s α = .83

Any illicit drug use in past year

Percentage of parents who reported using illegal drugs during the past year

Parent/caregiver report

Not applicable

Clinically significant depressive symptoms

A modified14-item version of the CES-D that assesses depressive symptoms. The researchers analyzed the modified total score ranging from 0 to 42 and a binary variable dividing the sample into those that were at or above the clinical cutoff (11) and those below it.

Parent/caregiver report

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
CES-D score above clinical cutoff
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.06 Mean = 0.07 OR = 0.65 HomeVEE calculated = -0.26 Not statistically significant, p ≥ 0.05
Any CES-D mental health symptoms
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.14 Mean = 0.01 OR = 0.95 HomeVEE calculated = -0.03 Not statistically significant, p ≥ 0.05
Household drug/alcohol concern
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 0.10 Mean = 0.05 OR = 1.62 HomeVEE calculated = 0.29 Not statistically significant, p ≥ 0.05
Modified CES-D scale
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 4.18 Mean = 3.56 Mean difference = 0.33 Not available Not statistically significant, p ≥ 0.05
Psychosocial profile (Daily Hassles) score
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 15.85 Mean = 15.21 Mean difference = 0.38 Not available Not statistically significant, p ≥ 0.05
Support Behavior Inventory – Family
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 60.38 Mean = 60.43 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
Support Behavior Inventory – Partner
FavorableUnfavorable or ambiguousNo Effect
3 months Healthy Steps sample 275 mothers Mean = 58.71 Mean = 60.25 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
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Outcome measure Outcome measure description Collection method Properties Operations links

CES-D score above clinical cutoff

A modified 14-item version of the CES-D that assesses depressive symptoms. The researchers analyzed the modified total score ranging from 0 to 42 and a binary variable dividing the sample into those who were at or above the clinical cutoff and those below it.

Parent/caregiver report

Not applicable

PPP: Daily Hassles Scale

The Daily Hassles Scale of the PPP assesses stress.

Parent/caregiver report

Cronbach’s α = .67

SBI: PartnerSBI: Family

The SBI assesses satisfaction with levels of social and emotional support. The researchers examined the support received from family and from a partner.

Parent/caregiver report

Cronbach’s α = .96 (Partner) Cronbach’s a = .94 (Family)

Any mental health symptoms

Percentage of parents reporting that they have mental health symptoms

Parent/caregiver report

Not applicable

Household drug/alcohol concern

Percentage of parents who reported concern about alcohol or drug use by themselves or by, another household member

Parent/caregiver report

Not reported by author

Modified CES-D scale

A modified 14-item version of the CES-D that assesses depressive symptoms. The researchers analyzed the modified total score ranging from 0 to 42 and a binary variable dividing the sample into those who were at or above the clinical cutoff and those below it.

Parent/caregiver report

Cronbach’s α = .83

Self-efficacy (health care specific)

This scale measures parents’ self-efficacy in addressing child health problems.

Parent/caregiver report

Cronbach’s α = .82

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