What we talked about at the pediatrician's office: Exploring differences between healthy steps and traditional pediatric primary care visits.

Healthy Steps for Young Children (HS) is a program designed to enhance pediatric primary care experiences for children birth to 3 years and their families by pairing a developmental specialist with a pediatric provider during well-child visits. This study examined the impact of HS on content discussed during well-child visits by providers, HS Specialists, and families. The impact of HS on pediatric outcomes, including timeliness of well-child visits and immunizations, also was examined. Using retrospective medical review, records of 40 children enrolled in HS were compared with records of 36 demographically matched controls. A developmental topics checklist was used to analyze content of well-child visits. Attendance at well-child visits, receipt of immunizations, and healthcare utilization also was evaluated. Important developmental topics were discussed more often during well-child visits of children enrolled in HS than for children who were not enrolled. Children enrolled in HS received timelier well-child visits and immunizations. No differences between groups were found in the number of sick or emergency room visits. Integrating HS Specialists into pediatric primary care well-child visits allows for discussion of important developmental topics while also impacting pediatric health outcomes.