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

In brief

Evidence of model effectiveness

This model meets the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model” for the general population, but does not meet the criteria for tribal populations.

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Model description

Healthy Steps (national evaluation 1996 protocol) was a universal parenting intervention implemented between 1996 and 2001 for parents of children from birth to age 3. 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). HS (national evaluation) was designed to promote (1) the clinical capacity and effectiveness of pediatric primary care to better meet the needs of families with young children; (2) the knowledge, skills, and confidence of parents in their child-rearing abilities; and (3) the health and development of young children. The program added a child development specialist to the pediatric care team. HS specialists delivered a minimum of six home visits, attended well-child care appointments, staffed a telephone line parents could call with any questions, conducted child development and family health assessments, led parent group meetings, disseminated written materials to parents, and connected parents to community resources. Home visits and other components focused on educating families about their children’s health, behavior, and development. For more information, please read the Model Overview.

This report also includes a review of an enhancement to Healthy Steps, called PrePare. PrePare was designed for sites that provide prenatal assistance only. PrePare has been studied as a supplement to Healthy Steps that added an average of three prenatal home visits by the HS specialist. Home visitors covered general topics on the transition to parenthood, as well as dealing with family-specific risk factors.

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Extent of evidence

Healthy Steps (National Evaluation 1996 Protocol)
Results of search and review
Number of manuscripts
At least one finding was eligible for review…
7
  …and at least one finding rated high
2
  …and at least one finding rated moderate (but none rated high)
3
  …and all findings that were eligible for review rated low
2
  …but manuscript is additional source1
0
Healthy Steps - PrePare supplement relative to Healthy Steps only subgroup
Results of search and review
Number of manuscripts
At least one finding was eligible for review…
2
  …and at least one finding rated high
2
  …and at least one finding rated moderate
0
  …and all findings that were eligible for review rated low
0
  …but manuscript is additional source1
0

For more information, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.

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Summary of findings

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Criteria established by the U.S. Department of Health and Human Services

Information based on comprehensive review of all high- and moderate-rated manuscripts
Healthy Steps (National Evaluation 1996 Protocol)
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across high- or moderate-quality studies, favorable impacts in at least two outcome domains within one sample OR the same domain for at least two non-overlapping samples?Yes
3Favorable impacts on full sample?Yes
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.
Yes
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.
Yes
Healthy Steps - PrePare supplement relative to Healthy Steps only subgroup
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across high- or moderate-quality studies, favorable impacts in at least two outcome domains within one sample OR the same domain for at least two non-overlapping samples?Yes
3Favorable impacts on full sample?Yes
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.
Yes
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.
Yes

Notes: If the model does not meet criterion 3 but meets criteria 1 and 2 based on findings from subgroups, the impacts must be replicated in the same domain in two or more studies using non-overlapping analytic study samples. HomVEE assesses and reports criteria 4 and 5 for all models that have well-designed research, but meeting those two criteria is only required of models for which all findings are from randomized controlled trials. Please read the HHS criteria for evidence-based models for more information.

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