Description & Citation--Study No. 4049

• Bibliographic Description
• Scope of Study
• Methodology
• Access and Availability

Bibliographic Description

4049

Healthy Steps for Young Children Program National Evaluation, 1996-2001: [United States]

Guyer, Bernard, Johns Hopkins University. Bloomberg School of Public Health. Women's and Children's Health Policy Center

Commonwealth Fund (20020707)

Guyer, Bernard. HEALTHY STEPS FOR YOUNG CHILDREN PROGRAM NATIONAL EVALUATION, 1996-2001: [UNITED STATES] [Computer file]. ICPSR version. Baltimore, MD: Johns Hopkins University, Bloomberg School of Public Health, Women's and Children's Health Policy Center [producer], 2004. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2005. doi:10.3886/ICPSR04049.v1

Scope of Study

The Healthy Steps for Young Children program began in 1995 as a new approach to primary health care for young children, birth to age three. The program is intended to enhance early pediatric care by incorporating preventive developmental and behavioral services as part of a comprehensive, whole-child, whole-family model of health care and to help provide mothers and fathers with the childrearing information and guidance they seek.

The evaluation of Healthy Steps consisted of three components: the National Evaluation, the Affiliate Evaluation, and the Embedded Observational Study. All data contained in these public release data sets come from the National Evaluation. For additional information on the Affiliate Evaluation or the Embedded Observational Study, please visit http://www.jhsph.edu/WCHPC_/Projects/Healthy_Steps/index.html.

These data were gathered to assess whether the Healthy Steps program was successful in reorienting pediatric practice to emphasize child development issues in increasing parents' knowledge about early nurturing of infants and parents' involvement in their children's development and in promoting parents' practices that improve the health, safety, and health care utilization of their children.

The data are organized as follows:

• Parent Forms: Newborn

  The newborn form was used to gather data on the baby's characteristics, demographic characteristics of the mother, father, and family, prenatal utilization of services, health behaviors of the mother and father, and parents' decisions about a pediatric provider for their newborn.

• Parent Forms: 6 Month

  The 6 month form was used to gather information on selected family demographic characteristics, child's health, parenting practices, and health behaviors of the mother and father. Questions included the frequency of injuries, emergency department visits, and hospitalization in the past 6 months, use of safety devices, activities that promote learning and development, sources of information on speech development, child care arrangements, smoking practices, and mother's receipt of postpartum care.

• Parent Forms: 12 Month

  Like the 6 month form, the 12 month form was used to gather information on selected family demographic characteristics, child's health, parenting practices, and health behaviors of the mother and father. Questions included the frequency of injuries, emergency department visits, and hospitalization in the past 12 months, use of safety devices, activities that promote learning and development, sources of information on speech development, child care arrangements, smoking practices, and mother's receipt of postpartum care.

• Medical Record Abstraction: Vaccinations

  This file contains demographic and vaccination data, including gender, race/ethnicity, and insurance provider.

• Medical Record Abstraction: Medical Visits

  This file contains data abstracted from forms completed for every visit recorded in the medical record or other primary care files, including type visit and whether a physical assessment was conducted.

• Medical Record Abstraction: Referrals/Consultations

  These data are limited to information on any referrals or consultations noted in the child's medical record or other primary care files, including type of and reason for the referral.

• Medical Record Abstraction: Hospitalizations/ED Visits

  These data are limited to information on any hospitalization, emergency department visit, or urgent care visit recorded in the child's medical record or other primary care files, including the type of and reason for the visit.

• Healthy Steps Specialist Contact Logs

  Data contained in this file represent every interaction between Healthy Steps Specialists and the family, including home visits, office visits, telephone calls to or from the family, parent groups, mailings, and other types of contacts, such as hospital visits. Information collected on each contact included the date of contact, type of contact, person contacted, status of the contact, reason for the contact, whether a handout was given out or a referral made during the contact, the issues/ problems discussed during the contact, and any action taken by the Healthy Steps Specialist.

• Parent Interviews: 2-4 Month

  The 2-4 month interview included questions about the respondent's knowledge of child development, his/her sense of competence about childrearing, his/her perception of support for childrearing activities from both formal and informal sources, and his/her engagement in activities with the child that promote health, learning, and development. The interview also gathered information on the socio- demographic characteristics of the family, including the mother's and father's education, marital status, employment, income, and household composition.

• Parent Interviews: 30-33 Month

  The 30-33 month interview is the source of data on parent and child outcomes and assessed the extent to which families received the Healthy Steps intervention. Specifically, parents were asked about utilization of health-related services and about the child's health and progress in reaching age-appropriate developmental milestones, concerns the parent had about the child's development or behavior, and whether the child was referred to services for a behavior or developmentally-related problem. Additional questions addressed parenting activities that promote development, family routines, engagement in safety activities, the mother's general health status, use of substances, use of mental health services, and use of the child's doctor or her obstetrician/gynecologist as a source for discussing problems with depression and use of preventive health care.

child care, child development, child health, child rearing, families, infants, parent child relationship, parenting skills

United States

• 1996-09--2001-11

• 1996-09--2002-02

Children and families

All possible cases of children born at 15 selected sites within the United States between September 1996 and November 1998

survey data and administrative records data

The user manuals are provided by the principal investigator as Portable Document Format (PDF) files. The PDF file format was developed by Adobe Systems Incorporated and can be accessed using PDF reader software, such as the Adobe Acrobat Reader. Information on how to obtain a copy of the Acrobat Reader is provided on the ICPSR Web site.

Methodology

Fifteen primary pediatric practices across the country were selected to participate in the National Evaluation. Six of the sites featured a randomized, case/control model for evaluation in which families attending the same clinic were randomly assigned to receive Healthy Steps services (cases) or to receive the standard care provided by the practice (control). The remaining nine sites used a quasi-experimental design in which one practice delivered Healthy Steps services to all its patients and a comparison practice was selected in the same community or nearby community that served a population similar to that at the Healthy Steps practice where families received the standard pediatric practice care provided by the practice. To be eligible for enrollment in the evaluation, the newborn had to be less than four weeks of age and a patient at the Healthy Steps practice. Children were not eligible to participate if their parents expected to move from the area or change site of care within six months, their mother (or custodial parent) did not speak English or Spanish fluently, they were to be adopted (hospital only) or placed in foster care, or they were too ill to make an office visit within the first 28 days of life.

personal interviews, self-administered interviews, telephone interviews, and medical record abstractions

All archived data undergo a confidentiality review and are altered when necessary to limit the risk of disclosure. The archive also routinely creates ready-to-go data files along with setups in the major statistical software formats as well as standard codebooks to accompany the data. In addition to these procedures, the archive performed the following processing steps for this data collection:

• Performed consistency checks.
• Checked for undocumented or out-of-range codes.

Access and Availability

Detailed file-level information (such as record length, case count, and variable count) is listed in the file manifest.

2005-01-24

• 2006-03-30 File UG4049V2.ALL.PDF was removed from any previous datasets and flagged as a study-level file, so that it will accompany all downloads.

• 2006-03-30 File UG4049V1.ALL.PDF was removed from any previous datasets and flagged as a study-level file, so that it will accompany all downloads.

• DS1: Parent Forms: Newborn
• DS2: Parent Forms: 6 Month
• DS3: Parent Forms: 12 Month
• DS4: Medical Record Abstraction: Vaccinations
• DS5: Medical Record Abstraction: Medical Visits
• DS6: Medical Record Abstraction: Referrals/Consultations
• DS7: Medical Record Abstraction: Hospitalizations/ED Visits
• DS8: Healthy Steps Specialist Contact Logs
• DS9: Parent Interviews: 2-4 Month
• DS10: Parent Interviews: 30-33 Month