Home-Visiting Intervention for Reunified Families After Child Abuse/Neglect

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Washington

Disqualifiers: Acute crisis, Previous intervention, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 12

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial evaluates a home-visiting program designed to assist parents recently reunited with their young children after foster care. The main goals are to improve parenting skills, enhance child wellbeing, and reduce the likelihood of returning to foster care or experiencing child maltreatment. Participants will receive either a set of resources and referral services or a 12-session home-based program called Promoting First Relationships. The trial seeks birth parents who have reunited with children aged 1-5, are parenting them, and live in specific areas of Washington State, with home visits included. As an unphased trial, this study offers a unique opportunity to contribute to valuable research that could enhance family reunification support.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this home-visiting intervention is safe for reunified families?

Research has shown that Promoting First Relationships® (PFR) has been tested in several studies with families who have young children. These studies indicate that PFR is generally easy for families to use and helps improve family connections and children's well-being. For instance, one study with 247 families reported positive outcomes without major safety issues. Additionally, eight other studies found that the program helped families by making placements more stable and reducing the need for foster care.

Overall, the evidence suggests that PFR is a safe option for families wanting to strengthen their relationships after reuniting. Significant negative effects have not been reported, making it a promising choice for those interested in joining the program. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Promoting First Relationships (PFR) program because it offers a novel approach to supporting families reunified after foster care due to child abuse or neglect. Unlike traditional services that might focus on providing resources or counseling separately, PFR is a comprehensive, in-home intervention delivered over 12 sessions by trained providers, emphasizing the development of strong, positive interactions between parents and children. This hands-on, relationship-focused method is designed to directly strengthen the parent-child bond, which could lead to better long-term outcomes for these families. Additionally, the personalized resource and referral service offers an individualized plan for families, ensuring they receive tailored support and follow-up, which is often lacking in standard care. Researchers hope these approaches will lead to more successful family reunifications and improved child well-being.

What evidence suggests that this trial's treatments could be effective for reunified families after child abuse/neglect?

The Promoting First Relationships® (PFR) program, which participants in this trial may receive, has been shown in studies to effectively improve parenting skills and child wellbeing. Research indicates that PFR helps parents become more responsive and aware of their children's needs. Additionally, studies have found that PFR can help keep children in stable homes and reduce the chances of returning to foster care. These findings suggest that PFR can be a valuable tool for families reunited after foster care, helping to strengthen family bonds and prevent future separations. Another treatment arm in this trial involves the Resource & Referral service, which includes a needs assessment, personalized resource packet, referrals, and monthly check-in phone calls. ^{1 2 4 6 7}

Who Is on the Research Team?

Monica Oxford, PhD

Principal Investigator

University of Washington

Are You a Good Fit for This Trial?

This trial is for English-speaking birth parents aged 18 or older in Washington State who have recently been reunited with their child, aged 1-5, after foster care. They must be able to receive home visits and calls. Parents can't join if they're in crisis or have had certain previous interventions.

Inclusion Criteria

Housing situation allows for home visits

Conversant in English

Access to a telephone

Exclusion Criteria

Experiencing an acute crisis (e.g., hospitalization, incarceration)

You have already participated in the Promoting First Relationships® program or Child Parent Psychotherapy (CPP).

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Promoting First Relationships (PFR) program delivered in the home by trained providers over 12 sessions

12 weeks

12 home visits

Follow-up

Participants are monitored for changes in parenting knowledge, child behavior, and parental sensitivity

12 months

What Are the Treatments Tested in This Trial?

Interventions

• Promoting First Relationships ®
• Resource & Referral

Trial Overview

The study tests a home-visiting program called Promoting First Relationships ® to see if it helps improve parenting skills and child wellbeing while reducing the risk of further maltreatment and failed reunifications.

How Is the Trial Designed?

Group I: Resource & Referral Experimental Treatment 1 Intervention

The service consists of a needs assessment conducted by phone, followed by a personalized resource packet and referrals, and 3 monthly check-in phone calls.

Group II: Promoting First Relationships Experimental Treatment 1 Intervention

The PFR program designed for birth families being reunited after foster care placement consists of a manualized 12-session intervention delivered in the home by trained providers.

Who Is Running the Clinical Trial?

University of Washington

Lead Sponsor

Trials

1,858

Recruited

2,023,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Published Research Related to This Trial

The Promoting First Relationships® (PFR) program, a 10-week home visiting intervention, significantly improved parents' understanding of their toddlers' social-emotional needs and increased parental sensitivity compared to a resource and referral service, based on a study of 247 families.

Children in the PFR group were less likely to be placed into foster care (6% vs. 13%) within a year after the intervention, indicating that PFR may effectively prevent child removals in families involved with child protective services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting First Relationships®: Randomized Trial of a 10-Week Home Visiting Program With Families Referred to Child Protective Services. Oxford, ML., Spieker, SJ., Lohr, MJ., et al.[2019]

In a study of 643 high-risk families, home visiting programs did not show significant differences in short- and long-term outcomes for mothers compared to control groups, indicating that the overall effectiveness may be limited.

However, maternal relationship security played a crucial role; mothers with high relationship anxiety but low avoidance benefited the most from home visiting, while those with high anxiety and avoidance experienced negative effects, suggesting the need for tailored approaches in home visiting services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maternal relationship security as a moderator of home visiting impacts on maternal psychosocial functioning. McFarlane, E., Burrell, L., Crowne, S., et al.[2021]

Interventions for child maltreatment are most effective when they focus on improving parent-child interactions in home-based settings during early childhood.

Multicomponent programs that are delivered by professionals to enhance parenting skills yield stronger recovery outcomes, especially for families with higher-risk children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Characteristics of evidence-based child maltreatment interventions. Thomlison, B.[2019]

The Promoting First Relationships® (PFR) program, a 10-week home visiting intervention, did not show overall differences in placement stability or permanency for toddlers with recent placement disruptions, involving 210 participants.

However, foster/kin caregivers who participated in the PFR program were more likely to provide stable care and achieve legal guardianship or adoption of the toddlers compared to those in the comparison group, highlighting the program's potential benefits for this specific caregiver type.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Permanency Outcomes for Toddlers in Child Welfare Two Years After a Randomized Trial of a Parenting Intervention. Spieker, SJ., Oxford, ML., Fleming, CB.[2021]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC5357588/

Promoting First Relationships®: Randomized Trial of a 10 ...

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 ...

2.

pfrprogram.org

pfrprogram.org/research/nih-funded-randomized-trials/

Randomized Controlled Trials

PFR has been evaluated through eight randomized controlled trials, showing improved placement stability and reduced foster care placements.

3.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S0190740915301183

Promoting birth parents' relationships with their toddlers ...

This study reports on the findings from a randomized control trial of a 10-week home visiting program, Promoting First Relationships®

4.

cebc4cw.org

cebc4cw.org/program/promoting-first-relationships/detailed

CEBC » Promoting First Relationships › Program › Detailed

The purpose of the study was to test the efficacy of the Promoting First Relationships® (PFR) program in American Indian families living on a rural reservation.

5.

pfrprogram.org

pfrprogram.org/wp-content/uploads/2025/04/Promoting-First-Relationships-Research-Summary-APR-2025.pdf

SUMMARY OF RESEARCH

Our REFLECTIVE PARENTING STRATEGY helps parents gain insights to transform their relationship with their child. HOW DOES PFR WORK? • We use video observations ...

6.

withpower.com

withpower.com/trial/phase-11-2017-aa4d1

Home-Visiting Intervention for Reunified Families After ...

Promoting First Relationships® is unique because it is a home-visiting program specifically designed to strengthen the bond between parents and children after ...

7.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC3867131/

Maltreatment following Reunification: Predictors ...

This study examined risk of maltreatment among children exiting foster care using a statewide sample of children reunified between 2001 and 2004 in Rhode ...