Healthy Steps for Young ChildrenSM

E-UPDATE

Special Issue: Healthy Steps National Evaluation
December 17, 2003

Stories


Drum Roll Please…

Healthy Steps National Evaluation Released!

Results are in! And the prognosis is very good. On December 17, 2003, The Women’s and Children’s Health Policy Center of the Johns Hopkins (JHU) Bloomberg School of Public Health released the Healthy Steps National Evaluation.

Findings provide strong arguments for the value of Healthy Steps. Results showed that Healthy Steps families were more likely than non-participating families to:

In addition, Healthy Steps children, compared with children who did not receive Healthy Steps services, were more likely to receive:

In addition to the program’s impact on families, the evaluation found that Healthy Steps provided significant benefits to Clinicians. Physicians reported that the program helped them better understand families’ needs and helped them effectively combine child development with preventive care. For complete information on the evaluation, please go to www.healthysteps.org, “The Healthy Steps Evaluations.”
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A Winning Formula: National Evaluation Research Methods

Since JHU began the National Evaluation in 1995, countless hours have been spent conducting surveys, reviewing records, crunching numbers and more. And although this was a rigorous and elaborate task, there was certainly a method to the madness in fact, there were several.

The National Evaluation was implemented at 15 Healthy Steps sites and followed nearly 5,600 families over three years. JHU collected the evaluation data using:
JHU is continuing to follow up with the families who participated in the initial evaluation phase. As the children turn 5½ years old, JHU will study changes in parenting attitudes and practices related to children’s health and development as they reach school age.
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The Journal of the American Medical Association Publishes National Evaluation Results & Related Editorial

The Journal of the American Medical Association, the nation’s leading medical journal, published on December 17, 2003, “A Practice-Based Intervention to Enhance Quality of Care in the First Three Years of Life: Results from the Healthy Steps for Young Children Program.” This prestigious achievement acknowledges the quality of research used in the National Evaluation study and reinforces the importance of Healthy Steps’ achievements in early childhood health care. As lead author Cynthia Minkovitz, M.D. put it, “For all children, not just those at high-risk, the quality of pediatric care in the first three years of life was dramatically improved because of this intervention.”

The article is accompanied by an editorial by the distinguished pediatrician, Neal Halfon, MD, and his UCLA colleague Moira Inkelas, Ph.D. The editorial says that “What is important about Healthy Steps…is that it provides important evidence that by changing the structure and process of pediatric care, performance in the delivery of pediatric developmental services can be improved significantly.”
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Busy Woman on Campus: A Profile of National Evaluation Lead Author, Cynthia Minkovitz, MD
Among the many titles Cynthia Minkovitz, MD, has on her roster of accomplishments, she can now add distinguished master of multitasking. In addition to her role as lead National Evaluation author, Dr. Minkovitz is managing the long-term follow-up of Healthy Steps families. She is an Associate Professor in the Department of Population and Family Health Sciences at Johns Hopkins Bloomberg School of Public Health. She received her MD and MPP from Harvard University and completed residency and chief residency at Washington University and a General Pediatrics fellowship at Johns Hopkins. Her research emphasizes enhancing the quality of preventive services for children; impacting health care provider behavior; and understanding how women’s health and multiple roles in society impact their children’s receipt of health care services.

Dr. Minkovitz also cares for individual families and teaches medical students at the Harriet Lane Pediatric Primary Care Clinic in Baltimore, Maryland. Her involvement at the clinic reinforces her interest in practice-based interventions, like Healthy Steps, that both support parents and contribute to training the next generation of clinicians. When not practicing medicine and writing important journal articles, Cynthia enjoys music and the arts.
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Healthy Steps Affiliate Evaluation Released

Initially, Healthy Steps for Young Children was implemented at 24 sites around the country. Fifteen participated in the National Evaluation, described above. The nine additional sites are called Affiliate sites. Of these, six participated in the JHU Affiliate Evaluation, accounting for nearly 1,100 families.

Affiliate Evaluation results support National Evaluation findings, affirming that Healthy Steps enhances the quality of care while improving satisfaction among parents and clinicians. The Affiliate Evaluation showed that Healthy Steps:

The evaluation reports that levels of positive parenting practices were high among affiliate families. The majority of families reported using safety devices, establishing routines and talking to and playing with their children.

The Affiliate Evaluation was particularly significant because five of the six sites consisted of predominantly low-income families. Results found that the sites successfully provided Healthy Steps services to communities that are generally difficult to reach. Ultimately, the Affiliate Evaluation proved that the program was valuable to families of all income levels.

Data for the Affiliate Evaluation was collected using parent telephone interviews when the child was 18 months old, parent surveys during office visits every six months, and interviews and surveys with clinicians and practice staff. In addition, JHU reviewed children’s medical records and compared findings to a sample of children enrolled in the practice prior to the beginning of Healthy Steps.

As noted, six of the nine Affiliate sites participated in the JHU Affiliate Evaluation. Two sites are performing their own controlled evaluations, and the last site participated in a local evaluation.
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A Personal Note from the Director

It is difficult to believe that nine years ago I began work on Healthy Steps. There was no program, no training curriculum, no evaluation, no network of sites, no staff, not even a name. Healthy Steps quickly became "we." The marvelous national staff was created and the wonderful partnerships with funders and health care organizations across the country began to form. Inadequate as it seems, I want to thank all of the hundreds of talented and committed individuals who made all this happen.

Please accept my best wishes for a happy and healthy 2004.

Mike Barth

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For More Information

For more information on the Healthy Steps National Evaluation or the Healthy Steps Affiliate Evaluation please visit www.healthysteps.org. Click “The Healthy Steps Evaluations” to find, the following documents:

For additional information on Healthy Steps for Young Children, contact Michael C. Barth, Healthy Steps Program Director, at mbarth@icfi.com.
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