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Promoting First Relationships®

In Brief

Last Updated

June 2015


Evidence of Model Effectiveness

This model does not meet the criteria established by the Department of Health and Human Services (HHS) for an “evidence-based early childhood home visiting service delivery model” for the general population or for tribal populations.


Model Description

Promoting First Relationships (PFR) is a caregiver-child relationship-building program that can be used one-on-one with parents, in the clinic or in home, and with child care providers and early childhood teachers responsible for group care. The Home Visiting Evidence of Effectiveness (HomVEE) review is based on PFR used with parents in the home. The program seeks to promote children’s social-emotional development by helping parents read and understand children’s cues and the unmet need behind challenging behaviors, and supporting parents’ use of sensitive and responsive caregiving behaviors. The program targets parents of children ages birth to 3 years. When PFR is implemented with parents in the home, a trained home visitor—such as a mental health specialist, public health nurse, or family service worker—video records the parent interacting with his or her child at home, and the home visitor and parent view and reflect on the recordings. In addition, PFR provides parents with information, including handouts, on the social and emotional needs of infants and toddlers, and strategies to meet these needs. The PFR home visiting program is designed to provide weekly hour-long home visits for 10 to 14 weeks but can be extended based on a family’s needs. For more information, please read the Model Overview.


Extent of Evidence

Results of Research and ReviewNumber of Studies
Released from 1979 to 2014 10
Eligible for review 4
     Rated high 0
     Rated moderate 0
     Rated low 4
     Additional sources1 0

1Additional sources overlap with another study and are not rated.

For more information, see the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.


Summary of Findings

HomVEE reports results from studies that meet the standards for the high or moderate ratings. No such studies were identified for this review of Promoting First Relationships.


Criteria Established by the Department of Health and Human Services

Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study? No
Across high- or moderate-quality studies, favorable impacts in…
   at least two outcome domains within one sample
   the same domain for at least two non-overlapping samples?
Favorable impacts on full sample? NA
Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?1 NA
One or more favorable, statistically significant impact reported in a peer-reviewed journal?1 NA

NA = not applicable.

1This information is reported for all models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

Please read the HHS Criteria for Evidence-Based Models for more information.