The program, called Healthy Steps, resulted in “higher levels of
parental satisfaction with pregnancy and newborn well-child care,” compared
to those getting regular care, say Robert S. Thompson, M.D., director
of preventive care at Group Health Cooperative's Center for Health Studies,
and colleagues from the University of Washington in the American Journal of Preventive
Medicine.
Getting added assistance was associated with positive effects on breastfeeding,
maternal depressive symptoms, family support, discipline, reading with
the child, knowledge of infant development and satisfaction with parenting,
he says. Parental stress levels were similar among both the usual care
and the Healthy Steps families.
Whether the additional care started during pregnancy or after birth made
no difference in the health benefits for parents and children.
“Beneficial effects of the intervention affected all families,” Thompson
and colleagues say.
Their findings held true beyond the high-risk families usually targeted
by such programs. Experienced and low-risk parents who are often excluded
from this type of parenting support program benefited as well, Thompson
says. The results suggest that all parents should get similar help, not
just disadvantaged or at-risk families.
Parents with previous children reported improved social support and felt
Group Health Cooperative cared more about them, while first-time parents
emphasized gaining useful knowledge about things like breastfeeding and
discipline.
Thompson’s group studied 439 families, about one-third of whom were
assigned to the usual standard of care. Families at other medical centers
took part in the Healthy Steps program, starting either at four or five
months into the pregnancy or shortly after birth.
Each family in the program was assigned a Healthy Steps Specialist who
made home visits, helped solve problems or informed parents about developmental
and behavioral questions and provided telephone support when needed. Healthy
Steps care was integrated with routine pediatric well-child care. The researchers
surveyed the parents before birth, one week after birth, and after three
months to record the effects of the program.
Parents in the Healthy Steps program assigned to special care before their
babies were born showed a greater willingness to remain enrolled in the
health plan during the first three months after birth, Thompson says.
“Attention to patient/member satisfaction is especially important
for health care organizations because patient satisfaction is an important
determinant of enrollment and disenrollment,” he says. “It
is also being increasingly linked to better health outcomes.”
