Home visiting intervention and prevention efforts to prevent child maltreatment have gained popularity and national funding support. However, little is known about the ability of existing prevention programs to intervene with birth parents reunified with their infants or toddlers who were once placed in the child welfare foster care system. One important reason for this lack of information is that evidence from existing programs do not represent the higher risk population of reunified birth parents (Lee, Aos, & Miller, 2008). Birth parents of young children who have been placed into foster care are a highly vulnerable population of caregivers. They are more likely to have been foster children themselves and survivors of childhood maltreatment (Marcenko, Newby, Mienko, & Courtney, 2011). They are at a much higher risk for co-morbidities, including mental health disorders, substance abuse, poverty, low education, and homelessness (Marcenko, Lyons, & Courtney, 2011). Their infants and toddlers, similarly, are not only at risk for serious emotional, behavioral, neurological and physiological health problems, they are also at risk for continued relationship disruptions throughout their life course with multiple placements (Fuller, 2005). In this application we will evaluate the effectiveness of a community based, home visiting intervention program with a population of birth parents recently reunified with their child under the age of five after a foster care placement. In order to do this, we will first adapt the program by adding material relevant to reunified birth families and adapt the material for older children. We will evaluate the effectiveness of Promoting First Relationships (PFR; Kelly et al., 2008) to meet the parenting needs of this vulnerable population. Promoting First Relationships was originally designed for children birth to three, and we will expand the curriculum to meet the needs of children aged birth to five. Through a strong, established community partnership between the state, a community mental health agency, and the University of Washington, we will 1) adapt Promoting First Relationships (PFR) for reunified birth families and older children; 2) test the effectiveness of PFR to improve parental quality and parent-child interaction as compared to a Resource and Referral service; 3) test the effectiveness of PFR on reducing social, emotional, and behavioral problems in a population of children at risk for elevated emotional and behavioral disorders; 4) test the effectiveness of PFR in reducing referrals to CPS and re-entry into foster care; and 5) test a proposed PFR theoretical model, linking the PFR intervention to improved parental insightfulness and emotional competence, which then contributes to parental sensitivity and improved child outcomes.

Public Health Relevance

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 five. 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.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD090176-03
Application #
9624799
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Esposito, Layla E
Project Start
2017-05-12
Project End
2022-01-31
Budget Start
2019-02-01
Budget End
2020-01-31
Support Year
3
Fiscal Year
2019
Total Cost
Indirect Cost
Name
University of Washington
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195