HealthySteps has significantly positive outcomes for children, their families, and the physicians and practices that serve them.
That was the conclusion, published in 2003, of a National Evaluation of HealthySteps conducted by the Johns Hopkins Bloomberg School of Public Health Women’s and Children’s Health Policy Center. The evaluation, which studied 15 clinics serving more than 5,500 children and their families across the country and the economic spectrum, included both a randomized controlled trial (RCT) and a quasi-experimental comparison study. An accompanying Affiliate Evaluation showed that HealthySteps could be effectively delivered to low-income and high-risk families.
RCT findings showed that by age two, HealthySteps children were:
- twice as likely as children in the control group to make timely well-child visits and receive recommended vaccinations,
- and visited the emergency room 23 percent less frequently for injuries.
By age three, HealthySteps children showed more secure attachment to their parents and less aggressive behavior in general.
HealthySteps parents were:
- nine times more likely than those in the control group to have discussed age-appropriate, preventive topics with clinic professionals,
- less likely to have used severe discipline such as a slap in the face or spanking with an object,
- given 25 percent more community resource information, and
- twice as satisfied with their pediatric care and more likely to remain at that practice.
The evaluations also found that HealthySteps families were more likely to:
- discuss important concerns, including nutrition, discipline, language development, child temperament, and maternal depression and anxiety, and
- read to and interact sensitively with their infants, and
- ensure they slept on their backs to prevent Sudden Infant Death Syndrome.
Overall, HealthySteps significantly reduced income disparities in access to preventive services.
It also enhanced the experiences of providers. Physicians were highly satisfied with the program and thought it:
- helped families,
- improved their own listening skills, and
- empowered their staff to support child development.
In 2007, the continuing RCT published findings showing sustained treatment effects when HealthySteps children were 5.5 years old.
Other research has shown additional outcomes:
- A clinical trial published in 2006 found that HealthySteps improved rates of breastfeeding and injury prevention, and reduced television viewing – three American Academy of Pediatrics recommendations.
- A quasi-experimental, longitudinal study published in 2014 in Clinical Practice in Pediatric Psychology found that HealthySteps moderated the deleterious effects that parents who experienced trauma during childhood can have on the social-emotional development of their children.
FUTURE EVALUATION PLANS
HealthySteps plans to complete in 2017 a third-party implementation study that will help capture various program innovations taking place throughout the nationwide network and codify the essential elements of the model.
It has formed an evaluation advisory committee that includes some of the original Johns Hopkins researchers. The committee is using inputs from the implementation study to position HealthySteps for additional rigorous evaluation in the near future.