'Healthy Steps': A Program That Works for Parent and Child

(HealthDay News) – There are hundreds, if not thousands, of organizations claiming to assist in obtaining proper health care information and programs.

Some of them are actually worthwhile. The really good ones eventually achieve peer recognition. That’s what has happened to Healthy Steps, a 13-year-old parent information program, designed to provide increased access to health-care professionals. Healthy Steps also works to improve parenting skills and the well-being of their children.

Healthy Steps was started by The Commonwealth Fund in 1994. The Commonwealth fund, which was begun in 1918 by Anna Harkness, the wife of oil millionaire Stephen Harkness, is a not-for-profit foundation with an emphasis on promoting “a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable…” according to the Fund’s literature.

Healthy Steps focuses on the first three years of a child's life. It seeks to build stronger relationships between health experts and young parents by offering them support on how best to rear their children, and in 2003 the program received a favorable review in the Journal of the American Medical Association.

"We have known for over a decade that families' needs about how best to care for their children and to learn more about behavior and development have gone largely unmet," says Dr. Cynthia S. Minkovitz. She is lead author of the study and an associate professor of population and family health sciences at the Johns Hopkins Bloomberg School of Public Health.

"Families across the U.S. have argued that they would like to have more support for how best to rear their children and this comes at a time when families are receiving less support from extended families and more families of young children are in the work force earlier," Minkovitz continues.

Specifically, parents have indicated they would like to know more about structuring routines, how to deal with sleep problems, what language milestones to expect, how best to toilet train, constructive ways to discipline, how to deal with sibling rivalry, how to safety-proof their home and how to interpret their child's behaviors, Minkovitz says.

Previous research found that for children aged 2 to 4 months, Healthy Steps helped parents when it came to such issues as proper sleep position for an infant and feeding.

The current evaluation focused on children between 30 and 33 months old when they were interviewed by the study authors.

The trial was conducted between September 1996 and November 1998 at 15 sites across the United States and included 5,565 children.

The participants were divided into two groups -- one that received "usual care," and the other that received usual care plus the enhanced Healthy Steps program components.

Those components included more contact with specialists such as nurses, nurse practitioners, early childhood educators and social workers. Seven services were provided: enhanced child care (through visits with a doctor and specialists); six home visits in the first three years of the child's life; a specialist-staffed child development telephone line; developmental assessments; brochures on various topics; parent support groups; and referrals to community resources.

Not only were the services offered, but also parents used them. "We know through our study methods that not only were these services available but parents took advantage of them," Minkovitz says.

Families who participated in the Healthy Steps Program were more likely to receive four or more Healthy Steps-related services; were twice as likely to be highly satisfied with the care provided; received timely well-child visits and vaccinations; and remained with the program for 20 months or longer.

These families were also 20 percent less likely to engage in severe discipline such as slapping a child in the face or spanking him or her with an object.

"With results emerging from this study and others, we know how to improve quality of care and we know at the same time that we will see improvement in parenting practices," Minkovitz says. "If we want to improve effectiveness of care, we need to be more family-centered, more timely and more efficient."

On the Web

The American Academy of Pediatrics has a wealth of information on different topics relating to children's health.

SOURCES: Cynthia S. Minkovitz, M.D., associate professor, population and family health sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore; Dec. 17, 2003, Journal of the American Medical Association
Publication date: March 12, 2007
Author: Amanda Gardner, HealthDay Reporter
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