Early effects of the healthy steps for young children program

Objective: The Healthy Steps for Young Children Program (HS) incorporates e arly child development specialists and enhanced developmental services into routine pediatric care. An evaluation of HS is being conducted at 6 random ization and 9 quasi-experimental sites. Services received, satisfaction wit h services, and parent practices were assessed when infants were aged 2 to 4 months. Methods: Telephone interviews with mothers were conducted for 2631 interven tion (response rate, 89%) and 2265 control (response rate, 87%) families. A nalyses were conducted separately for randomization and quasi-experimental sites and adjusted for baseline differences between intervention and contro l groups. Hierarchical linear models assessed overall adjusted effects, whi le accounting for within-site correlation of outcomes. Results: Intervention families were considerably more likely than controls to report receiving 4 or more developmental services and home visits and di scussing 5 infant development topics. Thc) also were more likely to be sati sfied and less likely to be dissatisfied with care from their pediatric pro vider and were less likely to place babies in the prone sleep position or f eed them water. The program did not affect breast-feeding continuation. Dif ferences in the percentage of parents who showed picture books to their inf ants, fed them cereal, followed routines, and played with them daily were f ound only at the quasi-experimental sites and may reflect Factors unrelated to PIS. Conclusions: intervention families received more developmental services dur ing the first 2 to 4 months of their child's life and were happier with car e received than were control families. Future surveys and medical record re views H ill address whether these findings persist and translate into impro ved language development, better utilization of well-child care, and an eff ect on costs.