Article Text

  1. K. D. Ramos,
  2. R. L. Brandt-Kreutz,
  3. K. Arreguin,
  4. J. Ache
  1. UCSF Fresno Pediatrics, California State University


Purpose Healthy Steps embeds a developmental specialist in medical primary care offices, offering information, screening, and a helping relationship for families with children aged 0 to 3 years. The purpose of this study is to assess the impact of Healthy Steps on early parenting outcomes in a clinic population.

Methods Healthy Steps participants surveyed during well-child office visits around child's age of 2 months. Identical survey administered during well-child office visit to comparison group of infants not enrolled in Healthy Steps, but seen in the same pediatric clinic. Survey was orally administered in either Spanish or English, and assessed demographic information in addition to outcome variables. Outcomes included parent report of safety practices, feeding practices, practices that promote development, and Emergency Room usage.

Results Healthy Steps participants (n=40) and comparison infants (n=25), all less than 4 months old, were largely Latino with low levels of income, education, and marriage. Healthy Steps participants were significantly more likely to be first-born babies and to have foreign-born mothers. There was a trend toward more babies being put to sleep on their backs and less exposure to cigarette smoke in the Healthy Steps group. Healthy Steps babies were more likely to have initiated breastfeeding, and among those who had ceased breastfeeding, it had lasted an average of one week longer in the Healthy Steps group. However, they were no more likely to be breastfeeding by the time of the survey. Healthy Steps infants were less likely to have already received water, juice, and cereal. Those who had received cereal did so an average of 7 weeks later in the Healthy Steps group. There were no differences in the frequency of reading to, talking to, or cuddling baby; very high percentages in both groups did these things very frequently. Healthy Steps infants were far less likely to have been to a hospital emergency department.

Conclusions The Healthy Steps program appears to have modest effects on some indicators of infant well-being. Small changes early in life have great potential to improve lives of those most in need.

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