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Johnston, B. D., Huebner, C. E., Tyll, L. T., Barlow, W. E., & Thompson, R. S. (2004). Expanding developmental and behavioral services for newborns in primary care: Effects on parental well-being, practice, and satisfaction. American Journal of Preventative Medicine, 26(4), 356–366.

Manuscript screening details
Screening decision Screening conclusion HomVEE procedures and standards version
Passes screens Eligible for review Version 1
Study design details
Rating Design Attrition Baseline equivalence Compromised randomization Confounding factors Valid, reliable measure(s)
High Randomized controlled trial Low Established on race/ethnicity. A measure of at-risk status that included indicators of SES and some baseline maternal health measures was not equivalent, but was controlled for in the analysis. Controls for baseline scores of outcomes collected at baseline. None None Not assessed in manuscripts reviewed before 2021
Study characteristics
Study participants The sample included 275 mothers with children age 3 months at assessment. All women were receiving Healthy Steps services and had enrolled before 22 weeks of gestation. Study enrollment occurred between July 20, 1998 and September 29, 2000. Most mothers had some postsecondary schooling (92%), with about one in three also having graduate-level training. Study participants were predominately white (77%). Over 80% of mothers had family incomes above $40,000, with over one in three family incomes exceeding $75,000.
Setting Two primary care clinics that are part of the Group Home Cooperative in the Pacific Northwest.
Intervention services The study randomly assigned mothers to receive either Healthy Steps only or Healthy Steps plus the PrePare supplement. Those in the Healthy Steps plus PrePare group received three prenatal home visits in addition to standard Healthy Steps program services following the child’s birth. Healthy Steps Specialists provided prenatal home visiting services to help parents prepare for their newborn. Specialists also screened and provided interventions for smoking, depression, and domestic violence. Following birth, Healthy Steps Specialists provided home visits, developmental and behavioral advice, a child development telephone information line, and links to community resources. The typical frequency of home visits by three months after birth is five in the standard implementation and eight with PrePare supplemental visits included.
Comparison conditions Women in the comparison group received the standard Healthy Steps program.
Subgroups examined This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report).
Subgroups are not listed for manuscripts reviewed before 2021.
Funding sources Funder(s) not listed.
Author affiliation None of the study authors are developers of this model.
Peer reviewed Peer reviewed status is not listed for manuscripts reviewed before 2021.

Findings that rate moderate or high

Child health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High Breastfeeding at 3 months
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.89 Mean = 0.92 OR = 0.98 HomVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
High Feels strongly supported to breastfeed
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.73 Mean = 0.77 OR = 0.98 HomVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
Maternal health
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High CES-D score above clinical cutoff
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.06 Mean = 0.07 OR = 0.65 HomVEE calculated = -0.26 Not statistically significant, p ≥ 0.05
High Any CES-D mental health symptoms
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.14 Mean = 0.01 OR = 0.95 HomVEE calculated = -0.03 Not statistically significant, p ≥ 0.05
High Household drug/alcohol concern
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.10 Mean = 0.05 OR = 1.62 HomVEE calculated = 0.29 Not statistically significant, p ≥ 0.05
High Modified CES-D scale
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 4.18 Mean = 3.56 Mean difference = 0.33 Not available Not statistically significant, p ≥ 0.05
High Psychosocial profile (Daily Hassles) score
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 15.85 Mean = 15.21 Mean difference = 0.38 Not available Not statistically significant, p ≥ 0.05
High Support Behavior Inventory – Family
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 60.38 Mean = 60.43 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
High Support Behavior Inventory – Partner
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 58.71 Mean = 60.25 Mean difference = 0.30 Not available Not statistically significant, p ≥ 0.05
Positive parenting practices
Rating Outcome measure Effect Sample Timing of follow-up Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
High KIDI score
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.82 Mean = 0.83 Mean difference = 0.00 Not available Not statistically significant, p ≥ 0.05
High Endorsed appropriate discipline
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.90 Mean = 0.90 OR = 1.01 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
High Home Safety Index
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 6.29 Mean = 6.27 Mean difference = 0.03 Not available Not statistically significant, p ≥ 0.05
High Knowledge of sleep positions
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.97 Mean = 0.98 OR = 0.60 HomVEE calculated = -0.31 Not statistically significant,
p ≥ 0.05
High Parenting sense of competence
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 47.30 Mean = 48.05 Mean difference = -0.70 Not available Not statistically significant, p ≥ 0.05
High Read with infant in past week
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.78 Mean = 0.80 OR = 0.98 HomVEE calculated = -0.01 Not statistically significant, p ≥ 0.05
High Role satisfaction
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.98 Mean = 0.98 OR = 1.01 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05
High Safe-sleep practices
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.81 Mean = 0.78 OR = 1.05 HomVEE calculated = 0.03 Not statistically significant,
p
High Self-efficacy (health care specific)
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 16.54 Mean = 16.73 Mean difference = -0.17 Not available Not statistically significant, p ≥ 0.05
High Tobacco-free household
FavorableUnfavorable or ambiguousNo Effect
Healthy Steps sample 3 months 275 mothers Mean = 0.90 Mean = 0.91 OR = 1.01 HomVEE calculated = 0.01 Not statistically significant, p ≥ 0.05