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What Is HealthySteps?

Feb 15, 2017

After 21 years, the HealthySteps national network spans 109 pediatric and family practice sites in 15 states and the District of Columbia, serving more than 26,000 children a year.

HealthySteps is an evidence-based, interdisciplinary pediatric primary care program that ensures babies and toddlers receive nurturing parenting and have healthy development. A child development professional, known as a HealthySteps Specialist, connects with families during well-child visits as part of the primary care team. The HealthySteps Specialist offers screening and support for common and complex concerns that physicians often lack time to address, including feeding, behavior, sleep, attachment, depression, social determinants of health, and adapting to life with a baby or young child. Specialists are trained to provide families with parenting guidance, support between visits, referrals, and care coordination, all specific to their needs.

After 21 years, the HealthySteps national network spans 109 pediatric and family practice sites in 15 states, serving over 26,000 children a year. Study after study has shown significant impact on children, families, and practices at relatively low cost. In 2015, ZERO TO THREE reacquired HealthySteps to scale this impact.

An ongoing national evaluation has uncovered that HealthySteps sites nationwide:

  • incorporate educated child development professionals who have flexible credentials and provide families with comprehensive, preventive services from birth to minimum 3 years of age
  • administer validated screening for developmental, social-emotional, behavioral, and parental protective and risk factors in line with American Academy of Pediatrics recommendations
  • provide timely observation and behavior modeling, and tailored anticipatory guidance, counseling, and resources
  • uniquely focus on child and family strengths and parent-child and parent-provider relationships
  • help families navigate complex systems in order to fully address both child and parent needs
  • integrate new tools and resources, including novel in-clinic and community services

Achievable outcomes with HealthySteps appear to be:

  • universal early identification of and access to effective interventions for developmental delays
  • improved age-appropriate parent-child interactions and child social-emotional development
  • reductions in severe physical discipline, ER utilization, and delays in school readiness
  • improved well-child visit adherence, immunization rates, and parent and physician satisfaction
  • support for parental depression, domestic violence, substance abuse, food, housing, and other social determinants of health
  • improved residency training in child development and social determinants of health
  • optimal child development and family health through more supportive, integrated pediatric primary care and early childhood systems

HealthySteps core components form the backbone of connections that make a difference.

  1. Team-based well-child visits
  2. Child development, social-emotional, and behavior screening
  3. Family protective/risk factor and social determinants of health screening
  4. Access to HealthySteps Specialist support between visits (office, home, phone, text, email, etc.)
  5. Connections to community resources
  6. Care coordination/systems navigation
  7. Positive parenting guidance and information
  8. Early learning resources

Evidence-based outcomes that speak to doctors, health systems, and insurers:

“Healthy Steps…provides important evidence that by changing the structure and process of pediatric care, performance in the delivery of pediatric developmental services can be improved significantly.” – Neal Halfon, MPH, and Moira Inkelas, PhD, MPH

To learn more about HealthySteps, please visit


1 Guyer, B., Barth, M., Bishai, D., Caughy, M., Clark, B., Burkom, D., Genevro, J., Grason, H., Hou, W., Huang, K., Hughart, N., Jones, A.S., McLearn, K.T., Miller, T., Minkovitz, C., Scharfstein, D., Stacy, H., Strobino, D., Szanton, E., & Tang, C. (2003). Healthy Steps: The First Three years: The Healthy Steps for Young Children Program National Evaluation. Johns Hopkins Bloomberg School of Public Health, February 28, 2003. Retrieved May 5, 2016, from

2 Minkovitz, C.S., Strobino, D., Mistry, K.B., Scharfstein, D.O., Grason, H., Hou, W., Ialongo, N., & Guyer, B. (2007). Healthy Steps for Young Children: Sustained results at 5.5 years. Pediatrics, 120(3), e658-e668.

3 Johnston, B. D., Huebner, C. E., Tyll, L. T., Barlow, W. E., & Thompson, R. S. (2004). Expanding developmental and behavioral services for newborns in primary care: Effects on parental well-being, practice and satisfaction. American Journal of Preventative Medicine, 2004(26), 4th ser., 356-366.

4 Johnston, B. D., Huebner, C. E., Anderson, M. L., Tyll, L. T., & Thompson, R. S. (2006). Healthy Steps in an integrated delivery system. Archives of Pediatrics & Adolescent Medicine, 160(8), 793–800.

5 Buchholz, M., & Talmi, A. (2012). What we talked about at the pediatrician’s office: Exploring differences between Healthy Steps and traditional pediatric primary care visits. Infant Mental Health Journal, 33(4), 430–436.

6 Halfon, N., & Inkelas, M. (2003). Editorial: Optimizing the health and development of children. JAMA, 290(23), 3136-3138.

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