The Healthy Steps for Young Children program, which
added behavior and development services
to pediatric practices, continued to benefit families more
than two years after the intervention
ended, according to a study by researchers from the Johns
Hopkins Bloomberg School
of Public
Health.
The sustained benefits from participation in Healthy
Steps included greater satisfaction among
parents with their child's health care, greater odds that
parents will report a child's serious
behavioral issue to the pediatrician and greater odds of
children's reading books. Parents also were
less likely to use severe discipline such as spanking with
an object or slapping in the face. The findings
are published in the September edition of Pediatrics.
"Incorporating developmental specialists into
pediatric practices seems to be an effective
strategy to meet families' needs regarding their children's
behavior and development," said Cynthia
Minkovitz, lead author of the study and associate professor
with the school's
Department of
Population, Family and Reproductive Health. Minkovitz
noted that this universal practice-based
intervention had favorable, sustained effects on
"experiences seeking health care and other parenting
behaviors that are critical to children's development."
Healthy Steps for Young Children was initially
designed by Boston University and the
Commonwealth Fund to meet the early development and
behavior needs of young children by enhancing
the relationships between parents and children, families
and the pediatric practice, and among
physicians and staff. The program placed trained
developmental specialists in pediatric practices to
provide enhanced behavior and development services during
the first three years of a child's life.
Healthy Steps services included enhanced well-child care,
home visits from developmental specialists,
a telephone help line, developmental assessments,
educational materials, support groups to aid parents
with developmental concerns and linkages to community
resources.
To determine whether Healthy Steps had any sustained
effect, Minkovitz and her colleagues
conducted follow-up phone interviews with 3,165 families
enrolled in a national evaluation. Some
families received the additional enhanced services provided
as part of Healthy Steps, while others did
not. The interviews were conducted when the children
reached 5.5 years of age, which was 2.5 years
after intervention services were discontinued.
Previous studies by Minkovitz and her colleagues found
that families who participated in
Healthy Steps received higher quality of care and had more
favorable parenting practices. This study
shows sustained treatment effects even after the
intervention ended.
Additional authors are Donna Strobino, Kamila B.
Mistry, Daniel O. Scharfstein, Holly Grason,
William Hou, Nicholas Ialongo and Bernard Guyer.
The research was funded by grants from the
Commonwealth Fund and the Agency for
Healthcare Quality and Research.