HealthySteps is an evidence-based, interdisciplinary pediatric primary care program designed to promote nurturing parenting and healthy development for babies and toddlers particularly in areas where there are persistent inequities for families of color or with low incomes. The HealthySteps (HS) approach means the entire practice works as a team to implement eight core components that strengthen the relationship between families and the practice and support strong parent/child attachment. A child development professional, known as a HS Specialist, connects with and guides families during and between well-child visits as part of the primary care team. The HS Specialist offers support for common and complex concerns that physicians often lack time to address, including feeding, behavior, sleep, attachment, parental depression, social determinants of health, and adapting to life with a baby or young child. HS Specialists are trained to provide families with parenting guidance, support between visits, referrals, and care coordination, all specific to their needs.

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Fast Facts

Relevant Actions
State or Local? State
CountiesCumberland, Durham, Guilford
Lead Agency Zero to Three
Type of Agency


Racial Equity Lens
  • HealthySteps advances health equity by focusing implementation in areas with persistent inequities for families of color or with low incomes. HS has improved outcomes in areas where there are persistent inequities such as breastfeeding, early intervention, maternal depression, early nutrition, social-emotional development, and Autism screening and diagnosis.  
  • HealthySteps’ national network has received professional development to enhance their culturally responsive work with children and families, such as Screening for Social Determinants of Health and Providing Parenting Recommendations in Culturally Diverse Patient Populations: Strategies for Pediatric Clinicians.
  • In 2022, the HS National Office released HealthySteps Specialist Competencies. The principals and concepts of diversity, equity, inclusion, access and belonging are intentionally woven into all aspects of a HS Specialist’s professional practice, and are included as a separate competency area.
Community Voice
  • In 2021, HealthySteps initiated the Family Advisory Group, a new effort to engage a small group of HS caregivers for feedback on the program and our resources. Family Advisors provide their unique insights and feedback to the HS National Office to improve and refine the program for all families, and they will help to shape the mission, vision, & direction of this newly formed group.
  • HealthySteps has grown from 7 Specialists at 4 sites in 2018 to 18 Specialists at 13 sites across NC in 2022. HS is reaching over 22,000 children birth to three across NC currently, across a variety of practices including pediatrics, family medicine, and federally qualified health centers.
  • HealthySteps connects families to early intervention services, ensuring well-coordinated systems of care with the family at the center. One HS site in Washington, D.C., with a dedicated family services coordinator working closely with HS Specialists, quadrupled its early intervention successful referral rate.
  • HealthySteps ensures frequent maternal depression screenings, creating opportunities for prevention and treatment. A case study in a HS practice with integrated maternal mental health treatment demonstrated a reversal of concerning infant weight loss.
Next Steps
  • Continue to expand the HealthySteps footprint in NC and nationally.
  • Continue to work with federal, state and local partners to build support for expanding social-emotional support for families and spread access to preventive dyadic services.
  • We continue to partner with other organizations and stakeholders on broader research initiatives such as an evaluation of Ready for School Ready for Life that seeks to understand the collective impact of multiple evidence-based programs, including HealthySteps, at the community level in Guilford and Durham Counties.
Primary Partners
  • Ready for School Ready for Life
  • Children’s Home Society of NC
Primary Funders
  • The Duke Endowment
Contact Natalie Tackitt

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