Document Detail


Healthy steps in an integrated delivery system: child and parent outcomes at 30 months.
MedLine Citation:
PMID:  16894077     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To test the effects of the Healthy Steps for Young Children program (HS) (which supports parents managing children's developmental and behavioral issues)-with and without a prenatal component-on child health and development, parenting practices, and parental well-being. DESIGN: A concurrent comparison with clinic-level assignment to intervention or usual care status. Nested in the intervention arm, a randomized trial compared HS with and without a prenatal component. SETTING: Five primary care clinics in an integrated delivery system in the Pacific Northwest. PARTICIPANTS: A consecutive sample of 439 pregnant women (80% of eligible) were enrolled. Follow-up data were obtained for 78% when the child was 30 months old. Intervention Families in intervention clinics received HS services, including developmental and behavioral advice and risk factor screening. In addition, those randomized to prenatal services received 3 home visits during pregnancy. MAIN OUTCOME MEASURES: Assessed by telephone interview in the 3 domains of child health and development, parenting practices, and parental well-being. RESULTS: Intervention was associated with positive outcomes in timely well-child care, immunization rates, breastfeeding, television viewing, injury prevention, and discipline strategies. Prenatal initiation of services was associated with larger expressive vocabularies at age 24 months. Mothers who received the intervention reported more depressive symptoms, but there was no increase in the proportion with clinically significant depression. CONCLUSIONS: For members of an integrated delivery system, the HS intervention was associated with positive effects on children's health and parenting practices. There was little evidence of any additional benefit of HS services initiated during the prenatal period.
Authors:
Brian D Johnston; Colleen E Huebner; Melissa L Anderson; Lynda T Tyll; Robert S Thompson
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  160     ISSN:  1072-4710     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-08     Completed Date:  2006-08-24     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  793-800     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics and Maternal and Child Health Program, University of Washington, Seattle, WA 98104, USA. bdj@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Accident Prevention
Adult
Breast Feeding
Child Development*
Child Health Services / organization & administration*
Child Rearing*
Child, Preschool
Female
Follow-Up Studies
Health Education
Humans
Immunization Schedule
Infant
Infant, Newborn
Intervention Studies
Language Development
Outcome and Process Assessment (Health Care)
Parenting* / psychology
Pregnancy
Prenatal Care
Preventive Health Services / organization & administration*
Safety Management

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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