SC ETV Features Game-Changing Healthy Steps Program

By Amy Williams, DNP, APRN, CPNPPC, Associate Professor, DNP program
Lifelines, Summer 2022

In April, South Carolina Educational Television (SC ETV) highlighted Healthy Steps, an innovative national program growing throughout the state that provides early childhood development support to families in the pediatric primary care office. A certified pediatric nurse practitioner who has been a primary care provider at MUSC Children’s Health University Pediatrics North Charleston clinic for the past 14 years, Dr. Amy Williams, Class of '00, '06 ,'14, has been instrumental in bringing the dynamic Health Steps program to MUSC and championing the initiative’s impact and growth.

I feel compelled to work in the early childhood space because it coincides with where the most sensitive and rapid brain development occurs in a person’s life. I intently focus on developmental and behavioral promotion in these first five years by building community-based systems that aid parents and caregivers in fostering their child’s development, including early intervention when necessary. MUSC Children’s Health University Pediatrics is a patient-centered medical home where families seek care for their children from the newborn period through their 18th birthdays. The clinic is unique in that it serves a majority of first generation Latin American population, and I, along with most of the clinic staff, speak Spanish in the practice.

Prior to establishing the Healthy Steps program at the clinic, I first piloted a home-visitation program, funded by the Duke Endowment, for children ages zero to five in Spanish-speaking households. Tailored to serve a need in the community where there were no existing programs, it was designed to combat the staggering statistic that Latin American children are diagnosed with developmental delays, including pervasive developmental disorders like autism spectrum disorders, later as well as less often than their English-speaking peers. Proven successful, the program has been implemented in other parts of South Carolina and is now sustained by federal preschool development grant funding.

However, I recognized the high potential for impactful work to be done directly with my patients and their families in the clinical setting. Currently, I am a principal investigator on a grant that delivers Healthy Steps, an evidenced-based national model from Zero to Three, an early childhood advocacy and policy organization based in the science of childhood development and headquartered in Washington, D.C. An evidence-based program that occurs concurrently during well child care in pediatric clinics, Healthy Steps is for patients ages zero to three. This model partners patients and families with a Healthy Steps specialist who is trained in early childhood development, behavioral challenges or behavioral needs during that age group and then also offers connections to resources that families may need during those early years of their child’s life.

Healthy Steps is a tiered system, with some patients receiving more high intensity services. For example, these families have a Healthy Steps specialist present during every well child visit with their primary care provider for the first three years of life. In addition, by virtue of being a Healthy Steps site, each child, ages zero to three, receives routine and structured developmental screenings, and mothers receive routine and structured postpartum depression screenings after giving birth and through the first six months of their child’s life. Finally, families receive needs assessments, where we’re looking at things like housing insecurity, food insecurity and other social determinants of health that can affect a child’s health care.

A typical week in my life blends teaching, practice, grant-based work and my family. I like my work because I get the privilege of hearing every family’s unique story, including what virtues and what things they may feel are important to pass along to their children. It’s really a bonus when I get to work alongside a family to help them understand what programs might be available, like Healthy Steps, that can help them put their child on a path to successful development and work hand in hand with that individual family.

As a primary care provider, I precept College of Nursing Accelerated BSN students at my clinical site when they are in their community health rotation and serve as a primary clinical preceptor for students enrolled in the Pediatric Nurse Practitioner track of the DNP program. They see patients from birth after hospital discharge to 18 years of age for well visits, health promotion, vaccinations or episodic visits, in addition to managing children with complex and chronic illness from the primary care standpoint and in conjunction with subspecialists and allied health professionals.

To serve populations within a state or community, as a health care provider, you must engage and uplift those same populations through a service commitment. In addition to my scholarship and subsequent grant funding, totaling 3.3 million dollars in secured funding mapped to the early childhood years of zero to five, I am also active in health care policy at the state level. I hold two Governor’s appointments as the medical provider to the state boards that conduct early childhood activities for the state of South Carolina, First Steps to School Readiness and the Early Childhood Advisory Council. By concurrently serving on the board of PASOs of South Carolina, a statewide Latinx advocacy organization that is a part of the Arnold School of Public Health at the University of South Carolina, I engage in grassroots advocacy work that is done in communities across the state and that gains attention from and is tested by researchers providing new evidence-based programs.

Being able to witness firsthand the impact of a program such as Healthy Steps has only increased my passion for advocacy work, and I eagerly anticipate where the next step will lead.

To watch SC ETV’s feature on Healthy Steps, visit scetv.org/watch/carolinaclassrooms (First Five SC video, April 21, 2022).

Did You Know?

Last July, the South Carolina Department of Education chose Healthy Steps as one of several South Carolina First Steps to School Readiness early childhood education and parenting support initiatives to share over three years $14.7 million in funding from the American Rescue Plan’s Elementary and Secondary School Emergency Relief Fund. Choosing to include Healthy Steps in this award was a significant distinction that recognized the important role health education programs play in creating school readiness, especially during the pandemic. The funding will help expand the Healthy Steps program to other sites in South Carolina and ensure they are able to recruit and retain qualified individuals.