Promoting First Relationships^®

Abstract

We conducted a community-based randomized control trial with intent-to-treat analysis on Promoting First Relationships® (PFR), a 10-week home visiting program. The study included 247 families with 10–24-month-old children who had a recent, open Child Protective Services investigation of child maltreatment. Families were randomly assigned to receive either the 10-week, home visiting PFR service or a telephone-based, 3-call resource and referral (R&R) service. Across post-intervention time points, parents in the PFR condition scored higher than families in the R&R condition in parent understanding of toddlers’ social emotional needs (d = .35) and observed parental sensitivity (d = .20). Children in the PFR condition scored lower than children in the comparison condition on an observational measure of atypical affective communication (d = .19) and were less likely than children in the comparison group to be placed into foster care through one year post-intervention (6% vs. 13%, p = .042). No significant differences were found on measures of parenting stress or child social-emotional competence, behavior problems, or secure base behavior. Overall, the results show support for the promise of PFR as an intervention for enhancing parent sensitivity and preventing child removals for families in the child welfare system.

What evidence is there that parenting interventions reduce child abuse and neglect among maltreating families? A systematic review

“…Seven of the nine studies were randomized controlled trials (Chaffin et al, 2004(Chaffin et al, , 2011(Chaffin et al, , 2012Jonson-Reid et al, 2018;Jouriles et al, 2010;MacMillan et al, 2005;Oxford et al, 2016). One study, the first SafeCare trial, used a matched comparison group with no randomization to condition (Gershater-Molko et al, 2002), and Study 6 (NPP) was a state-wide pre-post trial with no comparison group (Maher et al, 2011).…”

“…Participant numbers ranged from 35 in the Project Support RCT (Jouriles et al, 2010) to 2,175 in the state-wide SafeCare trial (Chaffin, Hecht, Bard, Silovsky, & Beasley, 2012), with a total of 3,615 participants across nine studies (see Online Appendix 1). In all studies, the participants had previous or current CPS involvement (Chaffin et al, 2004;Gershater-Molko, Lutzker, & Wesch, 2002;Jouriles et al, 2010;Maher, Marcynyszyn, Corwin, & Hodnett, 2011), were reported as being an "open case" with CPS (Oxford, Spieker, Lohr, & Fleming, 2016), and/or were referred for intervention by CPS (Chaffin et al, 2011(Chaffin et al, , 2012Jonson-Reid et al, 2018). Five of the nine studies reported mean number of prior CPS reports among the study's sample.…”

“…Where reported, recruitment rates varied from 23% of the initial sample in the study of promoting first relationships (PFRs) to 91% of the referred families in NPP (Maher et al, 2011;Oxford et al, 2016). Recruitment methods varied considerably across studies, with most having participants referred for treatment from CPS.…”

“…Most studies used simple count data of CPS reports. Further examination or differentiation of CPS records was made in some studies: researchers checked records for duplicated events in Study 2 (Chaffin et al, 2011), differentiated between reported and substantiated maltreatment in Study 6 (Maher et al, 2011), and looked at both maltreatment rates and child removals during follow-up in Study 7 (Oxford et al, 2016). Follow-up periods in all studies commenced from the gathering of baseline data prior to the intervention and ranged from 12 months for Study 7 of PFRs to 72 months in Study 9, the second SafeCare trial (Chaffin et al, 2012).…”

“…Developmental Child Welfare 1(4) MacMillan et al, 2005). Three studies excluded parents who did not speak English (Jouriles et al, 2010;MacMillan et al, 2005;Oxford et al, 2016), and one study excluded parents who did not have a home (Oxford et al, 2016). Studies 4 and 6 excluded parents for substance use (Jouriles et al, 2010;Maher et al, 2011), and Study 4 also excluded parents with severe psychopathology such as suicidality or active psychosis.…”