Implementing Early Start (New Zealand) Meets HHS Criteria

Model implementation summary last updated: 2015

The information in this implementation report reflects feedback, if provided, from this model’s developer as of the above date. 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. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Please see the Effectiveness button on the left for more information about any research on the effectiveness of the model, including any version(s) of the model with effectiveness research. Versions of the model that are described in the Adaptations and enhancements section of this implementation report may include (1) versions that were identified by the model’s developer and (2) versions that have been implemented by researchers and have manuscripts that HomVEE rated high or moderate, but that are not supported by the model’s developer.

Model overview

Theoretical approach

Early Start aims to create a collaborative, problem-solving partnership between the home visitor and family to maximize child health, increase child and family well-being, build strengths, and eliminate deficiencies. Early Start recognizes that child well-being can occur only through the more general health and well-being of the family, although the target child is treated as the primary focus of services.

Early Start was designed to be a mainstream program. However, the developers took steps to ensure that the model would be relevant to the Māori, an indigenous population of New Zealand. During the development phase, the Early Start team consulted with Māori representatives on the design of the program. The developers established an Early Start board, half of whose members were Māori, to oversee implementation of the program and to foster an organizational culture that was respectful and sensitive to the needs and perspectives of Māori families. The Māori board members provided a Māori cultural training to all Early Start staff and Māori home visitors were hired to work with Māori families. These efforts aimed to create a universal model that can be delivered to both Māori and non-Māori families in a culturally responsive way.

View Revisions

Implementation support

Early Start Project Ltd., a charitable non-governmental organization based in New Zealand, provides implementation support.

View Revisions

Intended population

Early Start targets at-risk families with newborn children up to age 5. Although it was designed as a mainstream program, the developers took steps to ensure that the model would be culturally responsive to the Māori, an indigenous population of New Zealand.

Early Start uses a three-stage eligibility determination process. First, Early Start administers a short risk assessment containing items on maternal age, extent of family support, whether the pregnancy was planned or unplanned, substance abuse, family violence, and child abuse and neglect. Any family with two or more risk factors continues to the next stage of the process. Second, families enroll in Early Start for a one-month assessment period to become acquainted with the program and so Early Start can learn about the family. Third, families complete an in-depth needs assessment based on a modified version of the Kempe Family Stress Checklist and are fully enrolled in the program for longer-term services.

View Revisions

Targeted outcomes

Early Start is designed to improve child health; reduce child abuse; improve parenting skills; support parental physical and mental health; encourage family economic well-being; and encourage stable, positive partner relationships.

View Revisions

Model services

Early Start provides services through home visitation. All Early Start families receive services based on four established curricula:

  1. Partnership in Parenting Education (PIPE) “Listen, Love, Play,” which focuses on listening, trust, language, problem solving, feelings, and how babies learn
  2. Triple P (Positive Parenting Program), which focuses on positive parenting practices and means to address childhood behavior problems
  3. Getting Ready for School focused on 4 year olds
  4. Incredible Years


Families are offered several additional services based on need:

  • Infant and child safety awareness
  • Linkages to supportive services in the community, including budget, health, and relationship services
  • Advice and support concerning healthy lifestyle choices, including family and child nutrition
  • Household and time management
View Revisions

Model intensity and length

Early Start includes four levels of service intensity:

  • Level 1 - High need: Up to three hours of client contact per week, which includes direct contact (via home visits) and indirect contact (such as reviewing client case notes and health recordings, planning, and discussing cases)
  • Level 2 - Moderate need: Up to three hours of home visiting per two-week period
  • Level 3 - Low need: Up to one hour of home visiting per month
  • Level 4 - Graduate: Up to one hour of contact (phone/home visitation) per three months

All families enter the program at Level 1 and move to higher levels over time based on their progress. Level changes are determined by home visitors in consultation with their supervisors.

Families can continue to receive services until the child reaches age 5.

View Revisions


Early Start is offered to families in the Christchurch area of New Zealand.

View Revisions

Adaptations and enhancements

Both a breastfeeding support group for young parents and services focused on the early years are available through Early Start Project Ltd.

View Revisions

Implementation notes

The information contained on this page was last updated in July 2015. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Early Start Project Ltd. in April 2015. HomVEE reserves the right to edit the profile for clarity and consistency.

View Revisions