Promoting First Relationships®—Home Visiting Promotion Model

17

Manuscripts

Released in 1979 through 2020

0

Manuscripts

Impact studies rated high or moderate quality

Services intended at ages
12-23 months
24-35 months
36-47 months
48+ months
0-11 months (WILL BE REMOVED)
Favorable results from well-defined research
Not applicable

Skip to:  

Related Models:

Where to find out more

Address

University of Washington
1705 NE Pacific Street, Health Sciences Building F-346, Box 357231, Seattle, WA 98195

Phone
(206) 616-5380
(206) 543-8528
Email
rees@uw.edu
Website
https://pfrprogram.org/

Effectiveness

Does not meet criteria established by the U.S. Department of Health and Human Services for an evidence-based home visiting model.

Does not meet criteria for an evidence-based home visiting model for Indigenous peoples and communities.

Extent of Evidence

For more information about manuscripts, search the research database.

For more information on the criteria used to rate research, please see details of HomVEEʼs methods and standards.

17

Manuscripts

Released in 1979 through 2020

2

Manuscripts

Eligible for review

0

Manuscripts

Impact studies rated high or moderate quality

Note: When an individual manuscript reports findings from multiple studies, HomVEE reviews each study as a distinct manuscript. In these rare instances, HomVEE counts that manuscript multiple times in this table, once for each study identified, screened, and reviewed by HomVEE.

Summary of Findings

To see details on each manuscript HomVEE reviewed in well-designed research, click on the manuscript counts in the table.

Favorable:
A finding showing a statistically significant impact on an outcome measure in a direction that is beneficial for children and parents.

No effect:
Findings are not statistically significant.

Unfavorable:
A finding showing a statistically significant impact on an outcome measure in a direction that may indicate potential harm to children and/or parents.

Outcomes Manuscripts Favorable Findings No Effects Findings Unfavorable Findings
Child development and school readiness Not measured - - -
Child health Not measured - - -
Family economic self-sufficiency Not measured - - -
Linkages and referrals Not measured - - -
Maternal health Not measured - - -
Positive parenting practices Not measured - - -
Reductions in child maltreatment Not measured - - -
Reductions in juvenile delinquency, family violence, and crime Not measured - - -

Implementation

In this section:

Overview

Theoretical approach, intended population, and targeted outcomes.

Skip to section

Support Availability

Skip to section

Service Delivery

Model services, adaptions and enhancements, model intensity and length.

Skip to section

Requirements

Staffing and organizational requirements.

Skip to section

Overview

Theoretical approach

Promoting First Relationships® (PFR), based on attachment theory, posits that developing strong early relationships with parents and other caregivers* is the key to healthy social, emotional, behavioral, language, and cognitive development in children. The model aims to promote parent/caregiver-child relationships by helping parents/caregivers read and understand children’s cues and the unmet needs behind challenging behaviors, and by supporting parents’/caregivers’ use of sensitive and responsive caregiving behaviors.

PFR can be used in multiple settings. The PFR-Home Visiting Options include two versions of PFR that are used with parents in the home: (1) PFR-Home Visiting Promotion Model and (2) PFR-Home Visiting Intervention Model. The only difference between the versions is that in the PFR-Home Visiting Intervention Model, home visitors must have a master’s degree. The PFR-Early Learning Model is used with caregivers responsible for group child care. The PFR-Pediatric Primary Care Model can be used one-on-one with parents during pediatric well-child visits for children from birth through age 2 years. The information in this profile describes the PFR-Home Visiting Promotion Model, but the information also applies to the PFR-Home Visiting Intervention Model unless specified otherwise.

*In this profile, the term “caregiver” refers to child care providers.

Intended population

The PFR-Home Visiting Promotion Model serves parents of children from birth through age 5 years.

Targeted outcomes

The PFR-Home Visiting Promotion Model seeks to promote children’s social-emotional development by fostering secure and healthy parent-child relationships.

Highlights

Services intended at ages
12-23 months
24-35 months
36-47 months
48+ months
0-11 months (WILL BE REMOVED)

Support Availability

Implementation support availability

Parent-Child Relationship Programs (PCRP) at the Barnard Center for Infant Mental Health and Development at the University of Washington provides training and support to implement the PFR-Home Visiting Promotion Model. The Barnard Center for Infant Mental Health and Development developed the model.

On an as needed basis, PFR master trainers can provide agencies with 60- to 90-minute technical assistance sessions to address implementation issues.

Service Delivery

Model services

The PFR-Home Visiting Promotion Model involves home visitors providing feedback to parents based on video recordings of the parent’s interactions with the child. The home visitor makes video recordings of the parent interacting with the child at home, and the home visitor and parent view and reflect on the recordings. The home visitor highlights positive interactions observed and offers instructive comments to enhance caregiving. The home visitor also helps the parent reflect on their own behavior, feelings, and needs during the interaction, as well as on those of the child. In addition, the PFR-Home Visiting Promotion Model provides parents with information, including handouts, on the social and emotional needs of young children, and strategies to meet these needs. The home visitor and the parent discuss ways to handle challenging behaviors and explore the parent’s own social-emotional development and how that influences caregiving.

The PFR-Home Visiting Promotion Model uses the PFR curriculum, which is available for purchase from PCRP. The curriculum includes an outline of activities and discussions and covers the following topics:

  • Elements of a healthy relationship;
  • Attachment theory and secure relationships;
  • Reflective capacity building;
  • Development of self for infants and toddlers;
  • Challenging behaviors;
  • Strategies for working with parents/caregivers; and
  • Intervention planning.

The curriculum package includes a manual and 20 reproducible handouts for parents and caregivers.

Model intensity and length

The PFR-Home Visiting Promotion Model is designed to provide weekly hour-long home visits for 10 to 14 weeks. The model can be extended based on a family’s needs.

Adaptations and enhancements

The PFR-Home Visiting Promotion Model has been adapted for use with American Indian families.

PCRP oversees all adaptations and enhancements to the PFR-Home Visiting Options.

Related Models:

Requirements

Staffing requirements

Staff with backgrounds in a range of areas—including infant mental health, public health, early intervention, early education, and social work—can deliver the PFR-Home Visiting Promotion Model. Agencies must have at least two trained home visitors who receive reflective supervision regularly in order to deliver the PFR-Home Visiting Promotion Model.

For the PFR-Home Visiting Promotion Model, PCRP requires that home visitors have at least a two-year degree, and prefers that they have a bachelor’s degree. For the PFR-Home Visiting Intervention Model, home visitors must have a master’s degree. All home visitors must have prior experience working with children and their parents from birth through age 5 years and should have strong parent-child observation and parent engagement skills. Supervisors must have at least a bachelor’s degree, and experience both working with children and their parents from birth through age 5 years and providing reflective supervision.

Agencies must provide home visitors with reflective supervision at least once per month. PFR agency trainers (home visitors who participate in the agency train-the trainer process) and PFR master trainers do not supervise home visitors per se, but they do provide reflective consultation. In agencies with an agency PFR trainer, the agency PFR trainer provides monthly reflective consultation to the home visitors. For agencies without an agency PFR trainer, PCRP offers monthly group reflective consultation to home visitors. PFR master trainers lead small-group meetings during which the trainer provides consultation on PFR skills and concepts and provides reflective consultation, offering space and time for home visitors to engage in reflective practice. PCRP strongly recommends, but does not require, this monthly consultation with the PFR master trainer for agencies that do not have an agency trainer. PCRP requires agency PFR trainers to participate in monthly reflective practice consultation with a master PFR trainer from PCRP. The master PFR trainer provides consultation on PFR skills and concepts, and space and time for agency trainers to reflect on their own delivery of PFR and the PFR training they provide.

PCRP requires home visitors to participate in a two-day Learner workshop (Level 1 training). During the workshop, home visitors watch and discuss videos of caregiver-child interactions, review and discuss case studies, role play, and practice reflective dialogue.* On-site and online workshops are available. PCRP recommends that supervisors also attend the Level 1 training to supervise and support their staff who are implementing the model. Please contact the model developer for additional information about the pre-service training requirement.

After completing the Level 1 training, home visitors begin serving families and participating in a 4-month Skill-Building Certified Mentored training (Level 2 training).** During the first 5 weeks, home visitors watch recorded PFR sessions of parent-child interactions and discuss the sessions weekly with a PFR master trainer. During the following 10 weeks, home visitors receive weekly online mentoring from their PFR master trainer while they implement the curriculum with a parent-child dyad at their own site. During this period, home visitors also record themselves delivering PFR sessions, and the PFR master trainer provides feedback. Please contact the model developer for additional information about the ongoing professional development requirement.

*For all PFR model versions, practitioners receive the same Level 1 training regardless of the delivery setting or population with whom they plan to work. There is not a separate Level 1 training for the PFR-Home Visiting Promotion Model.

**There is not a separate Level 2 training for home visitors. The Certified Mentored training is offered to practitioners who work with parents in the home and with caregivers.

Organizational requirements

The PFR-Home Visiting Promotion Model can be implemented by a variety of agencies, including child welfare, early intervention, public health, early education, and mental health.

PCRP requires home visitors to meet a set of ongoing fidelity guidelines. Please contact the model developer for additional information about these guidelines.

HomVEE requests input and feedback from the model developers on their profiles. The information in this implementation profile reflects feedback, if provided, from this model’s developer as of the above date. HomVEE reserves the right to edit the profile for clarity and consistency. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the manuscripts reviewed to determine this model’s evidence of effectiveness. Model developers are encouraged to notify HomVEE of any changes to their contact information on this page.