Practice-based interventions enhance quality of care

December 16, 2003

Adding behavior and development services to the pediatric health care practice dramatically improved the quality of care of young children and the parenting practices of families, according to a scientific evaluation of the Healthy Steps for Young Children Program conducted by researchers from the Johns Hopkins Bloomberg School of Public Health. The findings are published in the December 17, 2003, edition of the Journal of the American Medical Association (JAMA).

The Healthy Steps for Young Children Program was designed to meet the early development and behavior needs of young children by enhancing the relationships between parents and children, families and the pediatric practice, and among physicians and staff. The program, which is sponsored by the Commonwealth Fund, places trained behavioral specialists in the pediatric practice to provide enhanced behavior and development services during the first three years of a child's life. The enhanced services provided by Healthy Steps were available to all children, regardless of socioeconomic status. They included home visits from developmental specialists, a telephone help line, educational materials and support groups to aid parents with developmental concerns.

"Our evaluation found that participation in the Healthy Steps Program significantly improved the effectiveness, patient-centeredness, timeliness and efficiency of care provided to children," said Cynthia Minkovitz, MD, MPP, lead author of the study and associate professor with the School's Department of Population and Family Health Sciences. "These improvements included marked parental satisfaction with the Healthy Steps Program; timelier preventive care, including timely immunizations; and the receipt of more developmentally-oriented services."

For the evaluation, Dr. Minkovitz and her colleagues followed 5,565 children from 15 Healthy Steps sites across the United States. The participants were monitored from birth to age three. All of the children received standard pediatric care. Some families received additional enhanced behavioral and developmental services provided as part of the Healthy Steps Program, while others did not.

According to the study, families who participated in the Healthy Steps Program were more likely to receive Healthy Steps-related services compared to families who did not receive enhanced services. These services included office visits about child's development, telephone line for non emergent concerns, written materials and special health booklets. Families who received enhanced services were more likely to discuss problems and issues with their care providers and were more satisfied with their care than families who did not. In addition, families who received enhanced care were less like to use severe disciplinary tactics with their children, such as slapping the face or spanking with an object, compared to parents who did not receive additional services.

"There is a growing concern in this country regarding the quality of health care for children, particularly in the area of early childhood behavior and development," said co-author Bernard Guyer, MD, MPH, Zanvyl Krieger Professor of Children's Health and chair of the Department of Population and Family Health Sciences at the School of Public Health. "Our evaluation shows that universally applied behavioral and developmental services, like those provided by the Healthy Steps Program, can dramatically improve the quality of care for children."
-end-
"A Practice-Based Intervention to Enhance Quality of Care in the First 3 Years of Life: The Healthy Steps for Young Children Program" was written by Cynthia Minkovitz, MD, MPP; Nancy Hughart, BSN, MPH; Donna Strobino, PhD; Dan Scharfstein, ScD; Holly Grason, MA; William Hou, MS; Tess Miller, DrPH; David Bishai, MD, PhD; Marilyn Augustyn, MD; Kathryn Taaffe McLearn, PhD; and Bernard Guyer, MD, MPH.

The evaluation was funded by the Commonwealth Fund.

News releases from the Johns Hopkins Bloomberg School of Public Health are available online at www.jhsph.edu/Press_Room.

Johns Hopkins University Bloomberg School of Public Health

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.