Oklahoma’s Community-Based Family Resource and Support (CBFRS) Program

Oklahoma’s Community-Based Family Resource and Support (CBFRS) program, which targeted first-time mothers, was developed to improve maternal and child health and child development. Weekly or biweekly home visits beginning before 28 weeks gestation continued to the child’s first birthday. The frequency of the home visits varied based upon the program phase. Home visits followed a standardized curriculum that covered maternal and child health, child growth and development, and parenting skills.

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Oklahoma’s Community-Based Family Resource and Support (CBFRS) program was developed to improve the health and development outcomes of mothers and their infants. Based on research suggesting that home visiting provided by professionals as opposed to paraprofessionals might provide more positive impacts, the developers decided to use professionals in the field of child development to provide the home visits.

The Child Abuse Prevention and Treatment Act amendments of 1996 allocated funding for state CBFRS programs designed to reduce the incidence of child abuse and neglect through a wide range of services. Oklahoma used CBFRS funding to implement a home visiting program for first-time mothers.

Oklahoma’s CBFRS program served first-time mothers living in rural counties.

The program was designed to enhance maternal and child health and development. Specifically the program sought to positively affect mothers’ parenting knowledge and skill, use of community services, family planning, household safety, and child immunization. The program also aimed to increase mothers’ knowledge of the effects of second-hand smoke on their children and decrease the number of cigarettes smoked.

Oklahoma’s CBFRS program provided home visitation to participants. The content and the intensity of the program varied depending upon the stage of the intervention and the age of the child.

Oklahoma’s CBFRS program followed a standardized curriculum that covered (1) maternal and child health, (2) child growth and development, and (3) parenting. The parenting-related materials covered topics such as attachment, guidance, and play. The health portion of the curriculum focused on topics including maternal and child nutrition, substance use, labor and delivery, family planning, and immunizations. The content of the curriculum varied depending on the stage of the intervention. For example, during the prenatal period, the home visitors covered more maternal health-related topics, whereas the curriculum focused more on parenting following the child’s birth. All families received instruction covering the three general curriculum topics, but the home visitors could tailor the curriculum by selecting subtopics within the overarching categories that addressed families’ specific concerns or interests.

The program was designed to be initiated before 28 weeks gestation and continue to the child’s first birthday. The frequency of the home visits varied based upon the program phase. During pregnancy, participants were visited weekly the first month of the program, followed by biweekly visits until the child’s birth for a total of eight prenatal visits. After the child’s birth, home visits occurred weekly during the first three months of the child’s life and biweekly for the next three months, for a total of 18 visits. Between six months and one year, biweekly visits continued for the remainder of the program for a total of 12 visits. Each visit was about an hour in length.

Oklahoma’s CBFRS program was administered by the Oklahoma State Department of Health and implemented by county health departments.

No information was available about whether the model specified any fidelity guidelines that implementing programs or home visitors were required to meet on an ongoing basis.

The program was staffed by child development specialists under the supervision of master’s-level administrators.

The home visitors had a bachelor’s or master’s degree in child development or were attending college and had five years of experience working with children and families. The race and ethnicity of the home visitors mirrored the demographics of the counties in which they worked. The supervisors had at least a master’s degree in child development and a minimum of two years of supervisory experience.

The supervisors provided weekly supervision during which they reviewed the home visitor’s records from each visit to provide feedback and help ensure program fidelity.

Oklahoma’s CBFRS program provided the home visitors with more than 40 hours of pre-service training.

The home visitors received ongoing training, but no additional information on the training was available.

Sherie Trice, MS, CCPS
CBCAP Grant Coordinator
1000 NE 10th Street
Oklahoma City, OK 73117-1299

Phone: 405-271-7611
Fax: 405-271-1011
Email: sheriet@health.ok.gov