Implementing Promoting First Relationships®—Home Visiting Options

Entries in this row combine information across all versions of Promoting First Relationships that are used with parents in the home.

Model implementation summary last updated: 2021

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

Promoting First Relationships® (PFR), based on attachment theory, posits that developing strong early relationships with parents and other caregivers* is the key to healthy social, emotional, behavioral, language, and cognitive development in children. The model aims to promote parent/caregiver-child relationships by helping parents/caregivers read and understand children’s cues and the unmet needs behind challenging behaviors, and by supporting parents’/caregivers’ use of sensitive and responsive caregiving behaviors.

PFR can be used in multiple settings. The PFR-Home Visiting Options include two versions of PFR that are used with parents in the home: (1) PFR-Home Visiting Promotion Model and (2) PFR-Home Visiting Intervention Model. The only difference between the versions is that in the PFR-Home Visiting Intervention Model, home visitors must have a master’s degree. The PFR-Early Learning Model is used with caregivers responsible for group child care. The PFR-Pediatric Primary Care Model can be used one-on-one with parents during pediatric well-child visits for children from birth through age 2 years. The information in this profile describes the PFR-Home Visiting Promotion Model, but the information also applies to the PFR-Home Visiting Intervention Model unless specified otherwise.

*In this profile, the term “caregiver” refers to child care providers.

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Implementation support

Parent-Child Relationship Programs (PCRP) at the Barnard Center for Infant Mental Health and Development at the University of Washington provides training and support to implement the PFR-Home Visiting Promotion Model. The Barnard Center for Infant Mental Health and Development developed the model.

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Intended population

The PFR-Home Visiting Promotion Model serves parents of children from birth through age 5 years.

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Targeted outcomes

The PFR-Home Visiting Promotion Model seeks to promote children’s social-emotional development by fostering secure and healthy parent-child relationships.

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Model services

The PFR-Home Visiting Promotion Model involves home visitors providing feedback to parents based on video recordings of the parent’s interactions with the child. The home visitor makes video recordings of the parent interacting with the child at home, and the home visitor and parent view and reflect on the recordings. The home visitor highlights positive interactions observed and offers instructive comments to enhance caregiving. The home visitor also helps the parent reflect on their own behavior, feelings, and needs during the interaction, as well as on those of the child. In addition, the PFR-Home Visiting Promotion Model provides parents with information, including handouts, on the social and emotional needs of young children, and strategies to meet these needs. The home visitor and the parent discuss ways to handle challenging behaviors and explore the parent’s own social-emotional development and how that influences caregiving.

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Model intensity and length

The PFR-Home Visiting Promotion Model is designed to provide weekly hour-long home visits for 10 to 14 weeks. The model can be extended based on a family’s needs.

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Agencies deliver the PFR-Home Visiting Promotion Model in 11 states—California, Delaware, Florida, Idaho, Montana, New Mexico, North Carolina, Oregon, Rhode Island, South Dakota, and Washington—and internationally in Australia and Canada.

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Adaptations and enhancements

The PFR-Home Visiting Promotion Model has been adapted for use with American Indian families.

PCRP oversees all adaptations and enhancements to the PFR-Home Visiting Options.

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Implementation notes

The information contained on this page was last updated in April 2021. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the Barnard Center in April 2021. HomVEE reserves the right to edit the profile for clarity and consistency.

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