Promoting First Relationships®—Home Visiting Options

Model effectiveness research report last updated: 2021

Effects shown in research

Positive parenting practices

Findings rated high

Hash, J. B., Oxford, M. L., Fleming, C. B., Ward, T. M., Spieker, S. J., & Lohr, M. J. (2019). Impact of a home visiting program on sleep problems among young children experiencing adversity. Child Abuse & Neglect, 89, 143–154.

Promoting First Relationships^®—Home Visiting Intervention Model

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Parent sensitivity- Nursing Child Assessment Teaching Scale (NCATS)	FavorableUnfavorable or ambiguousNo Effect	3 months post-intervention	PFR vs. R&R, Washington state 2011-2014	213 parent/child dyads	Unadjusted mean = 36.46	Unadjusted mean = 36.04	Mean difference = 0.42	Study reported = 0.09	Not statistically significant, p = 0.53	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Parent sensitivity- Nursing Child Assessment Teaching Scale (NCATS)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. R&R, Washington state 2011-2014	222 parent/child dyads	Unadjusted mean = 35.65	Unadjusted mean = 35.07	Mean difference = 0.58	Study reported = 0.12	Not statistically significant, p = 0.39	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.

Oxford, M. L., Hash, J. B., Lohr, M. J., Bleil, M., Unützer, J., & Spieker, S. J. (2020). Randomized trial of Promoting First Relationships® for new mothers who received community mental health services in pregnancy. Unpublished manuscript submitted to HomVEE.

Promoting First Relationships^®—Home Visiting Intervention Model

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Dyadic synchronicity	FavorableUnfavorable or ambiguousNo Effect	12 months of age	PFR vs. comparison, Washington 2015-2020, full sample	225 mother/child dyads	Unadjusted mean = 6.45	Unadjusted mean = 5.98	Mean difference = 0.47	Study reported = 0.21	Not statistically significant, p = 0.12	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations. Unadjusted mean.
Dyadic synchronicity	FavorableUnfavorable or ambiguousNo Effect	12 months of age	PFR vs. comparison, Washington 2015-2020, full sample	252 mother/child dyads	Adjusted mean = 6.45	Adjusted mean = 5.98	Difference = 0.43	Study reported = 0.19	Not statistically significant, p= 0.15	Adjusted to control for preferred language and baseline measure.
Dyadic synchronicity	FavorableUnfavorable or ambiguousNo Effect	6 months of age	PFR vs. comparison, Washington 2015-2020, full sample	239 mother/child dyads	Unadjusted mean = 5.43	Unadjusted mean = 5.31	Mean difference = 0.12	Study reported = 0.05	Not statistically significant, p = 0.68	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations. Unadjusted mean.
Dyadic synchronicity	FavorableUnfavorable or ambiguousNo Effect	6 months of age	PFR vs. comparison, Washington 2015-2020, full sample	252 mother/child dyads	Adjusted mean = 5.43	Adjusted mean = 5.31	Difference = 0.01	Study reported = 0.00	Not statistically significant, p= 0.98	Adjusted to control for preferred language and baseline measure.
Maternal confidence	FavorableUnfavorable or ambiguousNo Effect	12 months of age	PFR vs. comparison, Washington 2015-2020, full sample	252 mothers	Adjusted mean = 4.40	Adjusted mean = 4.36	Difference = 0.02	Study reported = 0.05	Not statistically significant, p= 0.52	Adjusted to control for preferred language and baseline measure.
Maternal confidence	FavorableUnfavorable or ambiguousNo Effect	12 months of age	PFR vs. comparison, Washington 2015-2020, full sample	243 mothers	Unadjusted mean = 4.40	Unadjusted mean = 4.36	Mean difference = 0.04	Study reported = 0.11	Not statistically significant, p = 0.38	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations. Unadjusted mean.
Maternal confidence	FavorableUnfavorable or ambiguousNo Effect	6 months of age	PFR vs. comparison, Washington 2015-2020, full sample	252 mothers	Adjusted mean = 4.44	Adjusted mean = 4.36	Difference = 0.05	Study reported = 0.12	Not statistically significant, p= 0.10	Adjusted to control for preferred language and baseline measure.
Maternal confidence	FavorableUnfavorable or ambiguousNo Effect	6 months of age	PFR vs. comparison, Washington 2015-2020, full sample	244 mothers	Unadjusted mean = 4.44	Unadjusted mean = 4.36	Mean difference = 0.08	Study reported = 0.23	Not statistically significant, p = 0.07	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations. Unadjusted mean.
Parenting sensitivity	FavorableUnfavorable or ambiguousNo Effect	12 months of age	PFR vs. comparison, Washington 2015-2020, full sample	252 mothers	Adjusted mean = 36.73	Adjusted mean = 35.32	Difference = 1.28	Study reported = 0.26	Statistically significant, p= 0.03	Adjusted to control for preferred language and baseline measure.
Parenting sensitivity	FavorableUnfavorable or ambiguousNo Effect	12 months of age	PFR vs. comparison, Washington 2015-2020, full sample	225 mothers	Unadjusted mean = 36.73	Unadjusted mean = 35.32	Mean difference = 1.41	Study reported = 0.32	Statistically significant, p = 0.02	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations. Unadjusted mean.
Parenting sensitivity	FavorableUnfavorable or ambiguousNo Effect	6 months of age	PFR vs. comparison, Washington 2015-2020, full sample	252 mothers	Adjusted mean = 33.86	Adjusted mean = 32.38	Difference = 1.24	Study reported = 0.25	Statistically significant, p= 0.05	Adjusted to control for preferred language and baseline measure.
Parenting sensitivity	FavorableUnfavorable or ambiguousNo Effect	6 months of age	PFR vs. comparison, Washington 2015-2020, full sample	238 mothers	Unadjusted mean = 33.86	Unadjusted mean = 32.38	Mean difference = 1.48	Study reported = 0.30	Statistically significant, p = 0.02	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations. Unadjusted mean.
Understanding of toddlers	FavorableUnfavorable or ambiguousNo Effect	12 months of age	PFR vs. comparison, Washington 2015-2020, full sample	252 mothers	Adjusted mean = 51.84	Adjusted mean = 48.67	Difference = 2.32	Study reported = 0.45	Statistically significant, p <0.001	Adjusted to control for preferred language and baseline measure.
Understanding of toddlers	FavorableUnfavorable or ambiguousNo Effect	12 months of age	PFR vs. comparison, Washington 2015-2020, full sample	243 mothers	Unadjusted mean = 51.84	Unadjusted mean = 48.67	Mean difference = 3.17	Study reported = 0.64	Statistically significant, p = 0.00	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations. Unadjusted mean.
Understanding of toddlers	FavorableUnfavorable or ambiguousNo Effect	6 months of age	PFR vs. comparison, Washington 2015-2020, full sample	244 mothers	Unadjusted mean = 52.07	Unadjusted mean = 50.17	Mean difference = 1.90	Study reported = 0.38	Statistically significant, p = 0.00	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations. Unadjusted mean.
Understanding of toddlers	FavorableUnfavorable or ambiguousNo Effect	6 months of age	PFR vs. comparison, Washington 2015-2020, full sample	252 mothers	Adjusted mean = 52.07	Adjusted mean = 50.17	Difference = 1.06	Study reported = 0.21	Statistically significant, p= 0.03	Adjusted to control for preferred language and baseline measure.

Oxford, M. L., Spieker, S. J., Lohr, M. J., & Fleming, C. B. (2016). Promoting First Relationships®: Randomized trial of a 10-week home visiting program with families referred to child protective services. Child Maltreatment, 21(4), 267–277.

Promoting First Relationships^®—Home Visiting Intervention Model

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Parent sensitivity- Nursing Child Assessment Teaching Scale (NCATS)	FavorableUnfavorable or ambiguousNo Effect	3 months post-intervention	PFR vs. R&R, Washington state 2011-2014	215 parent/child dyads	Unadjusted mean = 27.77	Unadjusted mean = 27.39	Mean difference = 0.38	HomVEE = 0.08	Not statistically significant, p = 0.55
Parent sensitivity- Nursing Child Assessment Teaching Scale (NCATS)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. R&R, Washington state 2011-2014	225 parent/child dyads	Unadjusted mean = 27.34	Unadjusted mean = 26.70	Mean difference = 0.64	HomVEE = 0.13	Not statistically significant, p = 0.32
Parent understanding of toddler - Raising a Baby Scale	FavorableUnfavorable or ambiguousNo Effect	6 months post-intervention	PFR vs. R&R, Washington state 2011-2014	211 parent/child dyads	Unadjusted mean = 52.40	Unadjusted mean = 50.81	Mean difference = 1.59	HomVEE = 0.31	Statistically significant, p = 0.03	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.
Parent understanding of toddler - Raising a Baby Scale	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. R&R, Washington state 2011-2014	225 parent/child dyads	Unadjusted mean = 52.09	Unadjusted mean = 50.04	Mean difference = 2.05	Study reported = 0.42	Statistically significant, p < 0.01	HomVEE calculated significance Submitted by nwu on Fri, 04/12/2019 - 18:31 Statistical significance is based on HomVEE calculations.

Pasalich, D. S., Fleming, C. B., Spieker, S. J. Lohr, M. J., & Oxford, M. L. (2019). Does parents' own history of child abuse moderate the effectiveness of the Promoting First Relationships® intervention in child welfare? Child Maltreatment, 24(1), 56-65.

Promoting First Relationships^®—Home Visiting Intervention Model

Show findings details

Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Parent sensitivity- Nursing Child Assessment Teaching Scale (NCATS)	FavorableUnfavorable or ambiguousNo Effect	Post- intervention	PFR vs. R&R, Washington state 2011-2014	247 mother/child dyads	Adjusted mean = 36.21	Adjusted mean = 35.07	Difference = 1.14	Study reported = 0.23	Statistically significant, p= 0.01	The finding is adjusted for child age, months between baseline and postintervention assessment, and baseline measures of parenting sensitivity and secure base behavior.

Spieker, S. J., Oxford, M. L., Kelly, J. F., Nelson, E. M., & Fleming, C. B. (2012). Promoting First Relationships: Randomized trial of a relationship-based intervention for toddlers in child welfare. Child Maltreatment, 17(4), 271-286.

Promoting First Relationships^®—Home Visiting Intervention Model

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Outcome measure	Effect	Follow-up timing	Sample	Sample size	Intervention group	Comparison group	Group difference	Effect size	Statistical significance	Notes
Commitment: This Is My Baby (TIMB)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. EES, one county in Washington state, 2007-2010, full sample	169 caregivers	Not reported	Not reported	Not reported	Not available	Not statistically significant, p= >0.10	Finding estimated with hierarchical linear model (HLM).
Commitment: This Is My Baby (TIMB)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. EES, one county in Washington state, 2007-2010, full sample	169 caregivers	Adjusted mean = 4.10	Adjusted mean = 4.21	Mean difference = -0.11	Study reported = -0.17	Not statistically significant, p= 0.35
Engagement: Indicator of Parent-Child Interaction (IPCI, 9 item subscale)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. EES, one county in Washington state, 2007-2010, full sample	173 children	Not reported	Not reported	Not reported	Not available	Not statistically significant, p= >0.10	Finding estimated with hierarchical linear model (HLM).
Engagement: Indicator of Parent-Child Interaction (IPCI, 9 item subscale)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. EES, one county in Washington state, 2007-2010, full sample	173 children	Adjusted mean = 2.08	Adjusted mean = 2.15	Mean difference = -0.07	Study reported = -0.15	Not statistically significant, p= 0.39
Sensitivity: Nursing Child Assessment Teaching Scale (NCATS, without 6 items on child distress)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. EES, one county in Washington state, 2007-2010, full sample	167 caregivers	Adjusted mean = 13.26	Adjusted mean = 11.76	Mean difference = 1.50	Study reported = 0.41	Statistically significant, p= 0.02
Support: Indicator of Parent-Child Interaction (IPCI, 15 items)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. EES, one county in Washington state, 2007-2010, full sample	173 caregivers	Adjusted mean = 2.18	Adjusted mean = 2.14	Mean difference = 0.04	Study reported = 0.11	Not statistically significant, p= 0.49
Support: Indicator of Parent-Child Interaction (IPCI, 15 items)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. EES, one county in Washington state, 2007-2010, full sample	173 caregivers	Not reported	Not reported	Not reported	Not available	Not statistically significant, p= >0.10	Finding estimated with hierarchical linear model (HLM).
Understanding of toddlers: Raising a Baby (RAB, 16 items)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. EES, one county in Washington state, 2007-2010, full sample	175 caregivers	Adjusted mean = 52.16	Adjusted mean = 50.92	Mean difference = 1.24	Study reported = 0.36	Statistically significant, p= 0.04
Understanding of toddlers: Raising a Baby (RAB, 16 items)	FavorableUnfavorable or ambiguousNo Effect	Post-intervention	PFR vs. EES, one county in Washington state, 2007-2010, full sample	175 caregivers	Not reported	Not reported	Not reported	Not available	Statistically significant, p= <0.01	Finding estimated with hierarchical linear model (HLM).

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