Practice-based interventions enhance quality of care

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

Contact: Tim Parsons
Johns Hopkins University Bloomberg School of Public Health

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