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Practice-based intervention improves quality of care for young children

A practice-based intervention enhanced the quality of care for families of young children and improved selected parenting practices, according to an article in the December 17 issue of The Journal of the American Medical Association (JAMA).

There is growing evidence of deficiencies in the quality of health care for children, including low rates of preventive services, persistent disparities in health status, and lack of a usual source of care among ethnic and racial minorities and children in low-income families, according to background information in the article.

The Healthy Steps for Young Children Program was designed to meet the needs of families regarding their young children's early development and behavior by enhancing relationships between parents and their children, between families and the pediatric practice, and among practice members.

Cynthia S. Minkovitz, M.D., M.P.P., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues conducted a study to determine whether the Healthy Steps program increased quality of care related to developmental and behavioral services and affected parenting practices regarding discipline, perceptions of their children's behavior, and promotion of development when children were ages 30 to 33 months.

The controlled clinical trial was conducted between September 1996 and November 1998 at 6 randomization and 9 quasi-experimental sites across the United States. The study included 5,565 children enrolled at birth and followed up through age 3 years. The Healthy Steps program included incorporation of developmental specialists and enhanced developmental services into pediatric care.

Intervention families received the Healthy Steps program components, including contact with the Healthy Steps specialist, who were nurses, nurse practitioners, early childhood educators, and social workers with training and experience in child development. The specialist's main f
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Contact: Tim Parsons
410-955-7619
JAMA and Archives Journals
16-Dec-2003


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