The effects of Healthy Steps on discipline strategies of
parents of young children
Margaret O’Brien Caughy
, Therese L. Miller
, Janice L. Genevro
, Charu Nautiyal
School of Public Health, Health Science Center, University of Texas Houston, TX, USA
Department of Population and Family Health Sciences, Johns Hopkins University, Baltimore, MD, USA
Department of Psychology, University of Maryland, Baltimore, MD, USA
The Healthy Steps Initiative is a national demonstration project to provide support for parents of
young children through the pediatrician’s office. We report data from 432 families who were visited in
their homes when the target child was between the ages of 16 and 18 months (Time 1), and 34 and 37
months (Time 2). Parents reported on their discipline strategies for the month prior to the interview.
The program showed significant effects in increasing inductive/authoritative forms of discipline when
the target child was a toddler. By the time of the pre-school-age assessment, the effect of Healthy Steps
participation on the use of inductive/authoritative discipline strategies was moderated by maternal
race/ethnicity. White mothers who participated in Healthy Steps reported higher use of inductive/
authoritative discipline strategies than white mothers who were in the control group, whereas black
mothers and Hispanic mothers reported lower use of inductive/authoritative discipline than their
control group counterparts. We also found that treatment effects were moderated by birth order as well
as family socioeconomic status. By the time the children were pre-school-age, the effects of Healthy
Steps on the use of inductive/authoritative discipline were more dramatic for families living near or
below poverty than for families in more secure economic circumstances. For the families with first
born children, Healthy Steps participation was associated with lower use of inductive/authoritative
discipline at preschool age, with an inverse association seen for families of later born children.
D 2003 Elsevier Inc. All rights reserved.
Keywords: Healthy Steps Initiative; Discipline strategies; Maternal race and ethnicity; Birth order; Socioeconomic
status; Pediatric care
0193-3973/$ – see front matter D 2003 Elsevier Inc. All rights reserved.
* Corresponding author. School of Public Health, MPH Program at University of Texas Southwestern Medical
Center at Dallas, 5323 Harry Hines Boulevard, V8.112, Dallas, TX 77390-9128, USA.
E-mail address: Margaret.Caughy@UTSouthwestern.edu (M. O’Brien Caughy).
Applied Developmental Psychology 24 (2003) 517–534