Healthy Steps for Young Children: Family Focused Prevention of Behavioral Health Problems in Pediatric Primary Care Settings

Primary care pediatrics/family medicine offers a window of opportunity for parents of infants and young children to learn about their children’s behavior and development, to identify and consider changes to their behaviors which might negatively impact their children such as smoking/substance abuse, depression, and intimate partner violence, and to gain information and access to additional services. A pediatric practice can provide important continuity of care at a time of critical importance in the life of a young child and new family; pediatric primary care is universal, timely, and, due in part to the Affordable Care Act, accessible.  Parents tend to trust their child’s pediatrician and that trust makes pediatric care non-stigmatizing, providing a supportive service delivery system for all communities. Pediatric primary care has the potential to serve as a portal to other community-based early childhood and family-focused programs.

This presentation will explore Healthy Steps for Young Children, a family focused intervention for preventing behavioral health problems in primary care settings. Healthy Steps for Young Children offers parents of children from birth through age 3 the opportunity to interact with a Healthy Steps team consisting of their child’s pediatrician and a child and family development specialist, called a Healthy Steps Specialist, at each well child visit.  Together the team responds to both health and behavioral concerns and offers home visits, developmental screening for the child and risk and protective factor screening for the parent, a telephone/text line for asking questions about their child’s behavior and development, written materials to support parents and facilitated referrals to insure access to needed community programs.

Healthy Steps is currently providing services in over 70 sites nationwide in both urban and rural settings, including private pediatric and family medicine practices, hospital-based clinics, residency training programs, Indian Health Service and through early childhood systems of care such as Healthy Babies.  Robust research evidence on the effectiveness of the Healthy Steps has been well documented; Healthy Steps is cited as a evidence-based practice for both the Affordable Care Act Maternal Infant Early Childhood Home Visiting program and through SAMSHA’s LAUNCH  program. Healthy Steps has the potential to serve as a powerful evidence-based model for pediatric patient centered medical homes for very young children. This presentation will explore the considerable opportunities, as well as the challenges, in scaling and sustaining Healthy Steps in pediatrics and family medicine practices.