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

240 Participants Needed

Trial Summary

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 data supports the effectiveness of the treatment Promoting First Relationships® for reunified families after child abuse/neglect?

Research shows that the Promoting First Relationships® program, a 10-week home visiting service, may help improve parenting sensitivity and child behaviors, and reduce child behavior problems in reunified families. Another study found that families receiving this program had better parent understanding of children's social-emotional needs and were less likely to have children placed back into foster care. ^{1 2 3 4 5}

Is the Promoting First Relationships® home-visiting program safe for families?

The Promoting First Relationships® program has been studied in various settings and has not shown any significant safety concerns. It is designed to support families and improve parent-child relationships, and no adverse effects have been reported in the research available. ^{1 2 6 7 8}

How is the treatment Promoting First Relationships® unique for reunified families after child abuse/neglect?

Promoting First Relationships® is unique because it is a home-visiting program specifically designed to strengthen the bond between parents and children after reunification, focusing on improving parenting sensitivity and child social-emotional outcomes. Unlike other treatments, it provides in-home support soon after reunification, which may help prevent reoccurrence of maltreatment and improve child well-being. ^{1 2 3 9 10}

What is the purpose of this trial?

Birth parents of young children who have been placed into foster care are a highly vulnerable population of caregivers. Little is known about the ability of existing prevention programs to intervene with birth parents who have recently been reunified with their children under the age of six. This project aims to evaluate a brief, home-visiting intervention model with a sample of reunified birth parents, examining its effectiveness to improve parenting and child wellbeing, and reduce reoccurrence of maltreatment and reunification failure.

Research Team

Monica Oxford, PhD

Principal Investigator

University of Washington

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Promoting Birth Parents' Relationships with their Toddlers upon Reunification: Results from Promoting First Relationships® Home Visiting Program. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Promoting First Relationships®: Randomized Trial of a 10-Week Home Visiting Program With Families Referred to Child Protective Services. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Maternal relationship security as a moderator of home visiting impacts on maternal psychosocial functioning. [2021]

4. Korea (South) pubmed.ncbi.nlm.nih.gov

The effectiveness of home visiting programs for the prevention of child maltreatment recurrence at home: a systematic review and meta-analysis. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

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

6. United States pubmed.ncbi.nlm.nih.gov

Is the Families First Home Visiting Program Effective in Reducing Child Maltreatment and Improving Child Development? [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Impact of a Child Abuse Primary Prevention Strategy for New Mothers. [2020]

8. England pubmed.ncbi.nlm.nih.gov

Permanency Outcomes for Toddlers in Child Welfare Two Years After a Randomized Trial of a Parenting Intervention. [2021]

9. England pubmed.ncbi.nlm.nih.gov

Randomized trial of a statewide home visiting program: impact in preventing child abuse and neglect. [2022]

10. England pubmed.ncbi.nlm.nih.gov

Trying to bridge the worlds of home visitation and child welfare: Lessons learned from a formative evaluation. [2019]