The Commonwealth Fund and its partners actively recruited sites to participate in the HS national evaluation. To be considered for the national evaluation, sites were required to have a client base of 200 or more newborns within a six- to nine-month period, strong interest from the lead pediatrician and support from senior leadership at the site, a commitment of three years from the practice and a local funder, and the potential to support random assignment or help develop a comparison group.
Implementing 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.
Implementation last updated: 2015
The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the research reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Similarly, models described here may not all have impact studies, and those with impact studies may vary in their effectiveness. Please see the Effectiveness button on the left for more information about research on the effectiveness of the models discussed here.
Training to support implementation
Pre-service staff training
Key personnel from each site participated in three annual HS training institutes in Boston, Massachusetts. The training institutes had four goals:
- Translate new knowledge in child development, parenting, and women’s health into practical clinical strategies for clinicians
- Emphasize the importance of relationships between parent and child, and parent and professional
- Create multidisciplinary teams of pediatric clinicians and HS specialists
- Help participants transform their pediatric practices into HS practices
Training institutes typically included three to five sites, with two physicians, two HS specialists, and an administrator from each site. Training topics included early brain development, breastfeeding, newborn and child development assessment, maternal depression, early learning and reading, family health behaviors, and systems change in pediatric settings. Participants were trained to take advantage of teachable moments, or occasions when the clinician or HS specialist could explain to parents what they observe about a child’s behavior, development, or temperament.
Key personnel who attended the training were expected to orient all staff in their practice to the program.
In-service staff training
Key personnel, plus other site staff, participated in two additional annual training institutes after the initial training institute. In addition to topics covered during the first training, these trainings covered team processes and preschool development and clinical problems in the toddler years.
Training materials
Participants at the training institutes received a training manual that described the program in detail and reviewed, reinforced, and supplemented information presented in training sessions.
Qualified trainers
An interdisciplinary pediatric team from Boston University School of Medicine, Department of Pediatrics, trained site staff.
Technical assistance
HS specialists participated in biweekly technical assistance teleconference sessions with key training staff from the Boston University training team. Teleconferences provided a forum for answering questions, reinforcing training, and troubleshooting implementation issues. Teleconferences continued throughout the demonstration program period, but, over time, decreased in frequency and focused more on clinical concerns and less on implementation issues.
Implementation notes
The information contained on this page was last updated in August 2015.