Healthy Steps for Young ChildrenSM

E-UPDATE

October 2007 Issue
(Printable Version)

Stories


Healthy Steps Delivers Sustained Benefits for Children and Families

Recently published research by scientists at The Johns Hopkins University shows that Healthy Steps continues to benefit families more than two years after the intervention ends.

The distinguished journal Pediatrics published in its September 2007 issue a follow-up of the Healthy Steps National Evaluation cohort to age 5½ years. The key findings from the study show that important benefits of Healthy Steps shown at age 30 months in the National Evaluation (JAMA, 12/17/03) persist well beyond active participation in the program. These benefits include greater satisfaction among parents with their child’s health care, improved odds that parents will report serious behavioral issues to a pediatrician, increased likelihood that the child will receive anticipatory guidance, and greater odds of children reading books. Further, the study found that parents are less likely to use severe discipline such as spanking with an object or slapping in the face. They also are more likely to remain with the same pediatric practice. These findings show what Healthy Steps pediatric providers around the nation already know from their daily interaction with patients: Healthy Steps improves the quality of care and the satisfaction of those receiving and providing it.

The Johns Hopkins findings are impressive in their own right but also may presage significant benefits to participants and society over time. Studies that have followed other early childhood interventions into participants’ adulthoods have measured significant gains in employment and earnings, as well as reduced government outlays for special education, unemployment compensation, and prison.

See Cynthia Minkovitz, et al., “Healthy Steps for Young Children: Sustained Results at 5.5 Years,” Pediatrics, Vol. 120, No 3, September 2007, e658–e668.

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Residency Training Improved by Healthy Steps

Healthy Steps now operates in 19 residency training programs, and evidence of the great success of these programs continues to accumulate. The latest report, published in the September 2007 issue of Pediatrics, comes from one of the pioneers of Healthy Steps in residency training, Jerry Niederman, and his colleagues at the University of Illinois at Chicago, Department of Pediatrics. Through chart audits, the researchers compared families receiving Healthy Steps services with families at the same site who did not receive these services, as well as with families receiving services at another non-Healthy Steps site. The data were used to assess the outcomes of resident education, especially the performance of residents who had experience with Healthy Steps compared with those who did not.

The study revealed the following insights: As yet unpublished research on outcomes for resident education and patient health at the Pediatrics Residency at the University of San Francisco at Fresno and the University of North Carolina–Chapel Hill shows even stronger and more positive results. (Other partners in the UNC research include the Carolinas Medical Center in Charlotte, Duke University Medical Center, and Wake Forest Baptist Medical Center.)

For the full study, see L.G. Niederman, et al., “Healthy Steps for Young Children Program in Pediatric Residency Training: Impact on Primary Care Outcomes,” Pediatrics, Vol. 120, No 3, September 2007, e596–e603.

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Healthy Steps Growth Continues

In the last few months, three new Healthy Steps sites kicked into operation. We welcome Borrego Community Health Foundation, a community health center with five branches in and around Borrego Springs, CA; Greenwood Community Children’s Center in Greenwood, SC; and the pediatrics residency training program at Loyola University Medical Center in Maywood, IL. Soon, the University of Miami will be implementing Healthy Steps in its pediatrics residency training program and training is scheduled for two practices in Evansville, IN.

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Innovative Partnerships Expand Reach of Healthy Steps

A central element of Healthy Steps is creating linkages to the community and ensuring quality referrals for care beyond the medical practice. Below are updates on three partnerships—two active and one in the planning stage—that will extend Healthy Steps.

First, the pediatrics department at Swope Health Care in Kansas City, MO, a Healthy Steps site, has partnered with Head Start to provide a medical home to some 90 young children. Led by Healthy Steps director Carol Dietzschold and lead pediatrician Warren Johnson, III, Swope signed a memorandum of understanding (MOU) to provide Head Start children with pediatric care, including dental and vision care. The partners recently re-signed the MOU for the coming year, ensuring that scores of children and families will see a physician, receive the broad gamut of services that Swope provides, and obtain the necessary referrals.

As an early example of the partnership in action, three-year-old twin boys were recently brought to Swope’s Pediatrics Department for their Head Start physical and related screenings. As part of the linked visit with Dr. Johnson, the Healthy Steps Specialist noted significant developmental concerns. During discussions, the parents reported that no one had ever talked to them about their sons’ lack of speech or their behavioral concerns. Subsequently, Head Start targeted the boys for speech and language services, and the twins are scheduled for a full developmental evaluation for autism. This collaboration among Head Start, Swope, and Healthy Steps should serve as a model for other communities and help to achieve the national Head Start goal of providing a medical home for all children.

The second active partnership emerged in Kansas City, KS. For several years, Parents as Teachers (PAT) has cross-trained and funded PAT Parent Educators and Healthy Steps Specialists, providing partial funding for the Specialist. As a result, the PAT curriculum is cross-pollinated with Healthy Steps to provide these complementary services in a medical setting.

The success of this effort recently led the national PAT and Healthy Steps programs to agree to expand the partnership in Kansas, and hopefully beyond. The brainchild of Juliet Hawley, Healthy Steps coordinator for Blue Cross Blue Shield of Kansas City, the partnership currently supports three Healthy Steps Specialists in Kansas City.

The third innovative partnership, now in the planning stage, aims to adapt Healthy Steps methods and materials for use by public health nurses. In partnership with the Public Health Nursing and Maternal and Child Health Sections of the American Public Health Association (APHA), Healthy Steps is combining forces with public health nurses who work in health departments, community health centers, schools, and nonprofit organizations. These nurses assess health needs, develop programs, coordinate resources, and deliver clinical services—all with a focus on children and families in greatest need. What better way to spread the clinically proven, evidence-based Healthy Steps approach?

At the November 2007 APHA meeting, Healthy Steps program director Mike Barth, together with APHA colleagues Marjorie Buchanan and Joyce Edmonds, presented the outline for the burgeoning partnership. The plan is to adapt the Healthy Steps approach, engage public health program partners to pilot test it in several locations, and then assess and evaluate the operations and results. And then, of course, sit back and watch Healthy Steps grow!

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