Healthy Steps for Young Children: Sustained Results at 5.5 Years

Minkovitz, Cynthia S.; Strobino, Donna M.; Mistry, Kamila B.; Scharfstein, Daniel O.; Grason, Holly; Hou, William; Ialongo, Nicholas S.; Guyer, Bernard

doi:10.1542/peds.2006-1205

Cited by 127 publications

(122 citation statements)

References 32 publications

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“…13,[36][37][38] In a recent review of tools and strategies to improve WCC, we found evidence suggesting that inclusion of nonphysician providers into a health care team could improve receipt of anticipatory guidance and developmental and behavioral services. 16,17,[39][40][41][42] In Healthy Steps, a physician and child developmental specialist (typically a nurse, social worker, or early childhood educator) provide WCC in partnership. In a large, national, 3-year trial, intervention parents reported receiving more anticipatory guidance and more family-centered care and were more likely to be up-to-date on WCC.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,[12][13][14][15] Various tools and strategies to redesign the structure of WCC have been proposed and studied; however, there are few evidencebased comprehensive models of care to serve as feasible and sustainable alternatives to the current WCC structure in most small community practices. 16,17 Our comprehensive model (ie, the Parentfocused Redesign for Encounters, Newborns to Toddlers [PARENT]) was developed to address these key structural deficiencies in our current WCC system by decreasing reliance on the physician for routine WCC and shifting many WCC services to a health educator. 18 Our objective was to test the effectiveness of the PARENT intervention in providing comprehensive, nationally recommended WCC services, while optimizing WCC, urgent care, and emergency department (ED) utilization among low-income families.…”

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confidence: 99%

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A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial

et al. 2016

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OBJECTIVE: The goal of this study was to examine the effects of a new model for well-child care (WCC), the Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT), on WCC quality and health care utilization among low-income families. METHODS:PARENT includes 4 elements designed by using a stakeholder-engaged process:(1) a parent coach (ie, health educator) to provide anticipatory guidance, psychosocial screening and referral, and developmental/behavioral guidance and screening at each wellvisit; (2) a Web-based tool for previsit screening; (3) an automated text message service to provide periodic, age-specific health messages to families; and (4) a brief, problem-focused encounter with the pediatric clinician. The Promoting Healthy Development Survey-PLUS was used to assess receipt of recommended WCC services at 12 months' postenrollment. Intervention effects were examined by using bivariate analyses. RESULTS:A total of 251 parents with a child aged ≤12 months were randomized to receive either the control (usual WCC) or the intervention (PARENT); 90% completed the 12-month assessment. Mean child age at enrollment was 4.5 months; 64% had an annual household income less than $20 000. Baseline characteristics for the intervention and control groups were similar. Intervention parents scored higher on all preventive care measures (anticipatory guidance, health information, psychosocial assessment, developmental screening, and parental developmental/behavioral concerns addressed) and experiences of care measures (family-centeredness, helpfulness, and overall rating of care). Fiftytwo percent fewer intervention children had ≥2 emergency department visits over the 12-month period. There were no significant differences in WCC or sick visits/urgent care utilization. CONCLUSIONS:A parent coach-led model for WCC may improve the receipt of comprehensive WCC for low-income families, and it may potentially lead to cost savings by reducing emergency department utilization.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial

et al. 2016

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“…Reach Out and Read, Video Interaction Project, and Healthy Steps are innovative examples of existing programs that have shown promise in leveraging the primary care office to support positive parenting practices. [40][41][42][43][44][45] Additional strategies that increase interactive parenting practices in vulnerable families that are brief and workable into a busy pediatric clinic will be an important area for future research and public health initiatives.…”

Section: Discussionmentioning

confidence: 99%

Positive Parenting Practices, Health Disparities, and Developmental Progress

Shah¹,

Sobotka

Chen

et al. 2015

Pediatrics

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“…Healthy Steps for Young Children, a manual-based primary care strategy, and programs such as Incredible Years and Triple P, which integrate behavioral health into primary care, have been shown to promote responsive parenting and address common behavioral and developmental concerns. [69][70][71][72][73] Early literacy promotion in the medical home with programs such as Reach Out and Read advances reading readiness by approximately 6 months when compared with controls. 74 In addition, parents in Reach Out and Read practices are 4 times as likely to read to their children and more likely to spend time with their children in interactive play 75 than are families who are not in Reach Out and Read.…”

Section: Family and Parenting Support In The Medical Homementioning

confidence: 99%

Poverty and Child Health in the United States

Gitterman¹,

Flanagan²,

Cotton³

et al. 2016

Pediatrics

497

171

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Almost half of young children in the United States live in poverty or near poverty. The American Academy of Pediatrics is committed to reducing and ultimately eliminating child poverty in the United States. Poverty and related social determinants of health can lead to adverse health outcomes in childhood and across the life course, negatively affecting physical health, socioemotional development, and educational achievement. The American Academy of Pediatrics advocates for programs and policies that have been shown to improve the quality of life and health outcomes for children and families living in poverty. With an awareness and understanding of the effects of poverty on children, pediatricians and other pediatric health practitioners in a family-centered medical home can assess the financial stability of families, link families to resources, and coordinate care with community partners. Further research, advocacy, and continuing education will improve the ability of pediatricians to address the social determinants of health when caring for children who live in poverty. Accompanying this policy statement is a technical report that describes current knowledge on child poverty and the mechanisms by which poverty influences the health and well-being of children.

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Healthy Steps for Young Children: Sustained Results at 5.5 Years

Abstract: Sustained treatment effects, albeit modest, are consistent with early findings. Universal, practice-based interventions can enhance quality of care for families with young children and can improve selected parenting practices beyond the duration of the intervention.

Cited by 127 publications

References 32 publications

A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial

A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial

Positive Parenting Practices, Health Disparities, and Developmental Progress

Poverty and Child Health in the United States

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