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Caughy, M. O., Miller, T., Genevro, J. L., Huang, K., & Nautiyal, C. (2003). The effects of Healthy Steps on discipline strategies of parents of young children. Journal of Applied Developmental Psychology, 24(5), 517–534.

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)
Moderate Randomized controlled trial High Established on race/ethnicity and SES (i.e., maternal education and Medicaid coverage). Equivalence on baseline measures is not feasible. None None Not assessed in manuscripts reviewed before 2021
Notes:

Information on baseline equivalence for race/ethnicity was obtained from Caughy et al. (2004). In addition to the outcomes assessed at the 16-18 month follow-up period, outcomes were assessed at a 34-37 month follow-up period. The outcomes assessed at 34-37 months received a low rating because they had high attrition and baseline equivalence was not established on SES.

Study characteristics
Study participants The sample included 378 mothers with children ages 16 to 18 months at assessment. All women enrolled in Healthy Steps within four weeks of the child’s birth. Study enrollment occurred between September 1996 and November 1998. Most mothers had a high school degree (86%) and one in five also had a college degree. Most study participants were either white (62%) or African American (25%). The most common maternal age groups were 20-29 (57%) and over 30 (25%). Two-thirds of mothers were married.
Setting The study used two of the six randomly assigned pediatric care sites that were part of the national evaluation of Healthy Steps (Amarillo, TX, and Florence, SC). Both sites served economically and racially/ethnically diverse populations.
Intervention services Healthy Steps Specialists provided well-child care, home visits, a child development telephone information line, child development and family health checkups, written materials for parents that emphasize prevention, parent group meetings, and links to community resources. The program offered families nine standard pediatric office visits and six home visits by the time the children were age 3. Healthy Steps families received, on average, two home visits.
Comparison conditions Children in the control group received routine pediatric care but had no exposure to the Healthy Steps Specialist or to Healthy Steps materials.
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.
Staff characteristics and training Specialists were early childhood educators, nurses, nurse practitioners, social workers, or professionals with other relevant expertise. Each attended annual trainings conducted by the Boston University Healthy Steps team and administered services in cooperation with pediatricians and pediatric nurse practitioners. Sites also received program and training manuals and technical assistance through biweekly teleconferences. Implementation of written protocols was monitored by the Healthy Steps national program office. See Guyer et al. (2003) for more details.
Funding sources William T. Grant Foundation; The Amarillo Area Foundation; The Duke Endowment; The Hogg Foundation; and The McLeod Foundation.
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 details

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
Moderate Use of inductive/authoritative discipline
FavorableUnfavorable or ambiguousNo Effect
2 of the 6 RCT national evaluation sites 16-18 mo. 378 mothers Mean = 0.10 Mean = -0.12 Mean difference = 0.22 HomeVEE calculated = 0.21 Statistically significant,
p < 0.05
Moderate Use of punitive/“high power” discipline
FavorableUnfavorable or ambiguousNo Effect
2 of the 6 RCT national evaluation sites 16-18 mo. 378 mothers Mean = -0.06 Mean = 0.13 Mean difference = -0.19 HomeVEE calculated = 0.18 Not statistically significant, p ≥ 0.05

Outcome measure summary

Positive parenting practices
Outcome measure Description of measure Data collection method Properties of measure

Use of inductive/authoritative discipline

A modified version of the Parental Responses to Child Misbehavior was administered to parents who were asked to report how frequently in an average week in the previous month they used 12 discipline strategies. Authors conducted confirmatory factor analysis on a two-factor model: inductive/authoritative behavior and punitive/high-power behavior. Parent/caregiver report

Not reported by author

Use of punitive/“high-power” discipline

A modified version of the Parental Responses to Child Misbehavior was administered to parents who were asked to report how frequently in an average week in the previous month they used 12 discipline strategies. Authors conducted confirmatory factor analysis on a two-factor model: inductive/authoritative behavior and punitive/high-power behavior. Parent/caregiver report

Not reported by author