The evidence base

Well-Child Visits, Continuity of Care, and Vaccinations

Well-child visits and vaccinations are the bedrock of pediatric primary care. For babies and toddlers who are not yet enrolled in child care or early education, or are too young, it’s the one place to universally support their development and give life-saving immunizations.

This is why the American Academy of Pediatrics (AAP) recommends a schedule of well-child visits and vaccines to help ensure the optimal physical, mental, and social health of a child. Well-child care and vaccinations are also important areas for national initiatives including HealthyPeople 2030 and the National Committee for Quality Assurance Healthcare Effectiveness Data and Information Set.

However, gaps in timely and complete well-child visit attendance and vaccination persist, particularly for families experiencing disadvantage. [1] [2]

How HealthySteps Supports Well-Child Care, Continuity of Care and Vaccinations

HealthySteps is designed to close these gaps by supporting families at their already scheduled well-child visits (12-13 in the first 3 years), enhancing and promoting AAP guidelines among families and providers, and strengthening the relationship between families and the pediatric care team.

Selena Martinez sits on a park bench with her son Blake and her husband in Brooklyn, NY.

USA Today Profiles HealthySteps as a Critical to Well-Child Care amid Pandemic

Research on HealthySteps demonstrates that children receive more on-time well child visits, have better continuity of care, and are up to date on vaccinations.

  • Children were up to 2.4x more likely to receive timely well visits [3] [4] [5]
  • Children were more likely to attend all of the first 10 recommended well-child visits [6]
  • Continuity of care was significantly better for both total and well-child visits [7]
  • Families were nearly twice as likely to remain with the practice through 20 months [8]
  • Children were 1.4x more likely to be up to date on vaccinations by age 2 [3]
  • Children were up to 1.6x more likely to receive timely vaccinations [3] [4] [5]

[1]Wolf ER, Hochheimer CJ, Sabo RT, et al. (2018). Gaps in well-child care attendance among primary care clinics serving low-income families. Pediatrics, 142(5):e20174019. doi: 10.1542/peds.2017-4019.

[2]Leeds M, Muscoplat MH. Timeliness of Receipt of Early Childhood Vaccinations Among Children of Immigrants — Minnesota, 2016.  Morb Mortal Wkly Rep 2017;66:1125–1129. doi: 10.15585/mmwr.mm6642a1

[3]Guyer, B., Barth, M., Bishai, D., Caughy, M., Clark, B., Burkom, D., Genevro, J., Grason, H., Hou, W., Keng-Yen, H., Hughart, N., Snow Jones, A., McLearn, K.T., Miller, T., Minkovitz, C., Scharfstein, D., Stacy, H., Strobino, D., Szanton, E., & Tang, C. (2003). Healthy Steps: The first three years: The Healthy Steps for Young Children Program National Evaluation.

[4]Johnston, B.D., Huebner, C.E., Anderson, M.L., Tyll, L.T., & Thompson, R.S. (2006). Healthy Steps in an integrated delivery system: Child and parent outcomes at 30 months. Archives of Pediatrics & Adolescent Medicine, 160(8), 793–800. doi: 10.1001/archpedi.160.8.793.

[5]Buchholz, M., & Talmi, A. (2012). What we talked about at the pediatrician’s office: Exploring differences between Healthy Steps and traditional pediatric primary care visits. Infant Mental Health Journal, 33(4), 430–436. doi: 10.1002/imhj.21319

[6]Wolcott, C., Buchholz, M., Ehmer, A., Stein, R., & Talmi, A. (2017, Nov 29 – Dec 2) Adversity and well-child visit attendance: The role of a preventative primary care intervention [Poster Session]. ZERO TO THREE Annual Conference, San Diego, CA.

[7]Niederman, L.G., Schwartz, A., Connell, K.J., & Silverman, K. (2007). Healthy Steps for Young Children Program in pediatric residency training: Impact on primary care outcomes. Pediatrics, 120(3), e596–e603. doi: 10.1542/peds.2005-3090

[8]Minkovitz, C. S., Strobino, D., Mistry, K.B., Scharfstein, D.O., Grason, H., Hou, W., Ialongo, N., & Guyer, B. (2007). Healthy Steps for Young Children: Sustained results at 5.5 years. Pediatrics, 120(3), e658–e668. doi: 10.1542/peds.2006-1205