First Born and More
Category
Child & Family Health
Child's Age
Prenatal, 0-1 years, 1-2 years, 2-3 years
Participant
Children, Parents/Guardian
Languages
English, Spanish
Brief Description
First Born and More is a multi-generational, relationship-based, culturally sensitive, and family-centered home visiting program designed to support families during pregnancy and in the early years of a child’s life by helping parents/caregivers create a nurturing, safe, and stimulating environment for their child. This program’s approach provides relevant, practical, and reflective resources that support families learning in the areas of health, wellness, development, safety, and overall family stability.
Expected Impact
- Decrease in families' trips to the emergency department
- Decrease in the number of families that see their primary care manager 9 or more times in the first year of life
- Increase in positive parenting practices (bonding and positive interactions)
- Decrease in incidencts of child abuse and/or maltreatment
- Increase in parental/caregiver social support
- Increase in parent/caregiver confidence and satisfaction
Core Components for Model Fidelity
There are 6 elements that capture the activities necessary to implement First Born and More with fidelity.
- Element 1: Completion of model certification training.
- Element 2: Share curricula during home visit. For more information on the options available, visit the First Born and More Program Curriculum webpage.
- Prenatal
- First Year of Life
- Toddler Years
- 3-5 Years Old
- Early Literacy Development
- Racial Identity Development
- COVID-19
- Element 3: Maintain home visitor to family ratio.
- Element 4: Deliver services following model's dosage guidelines.
- Element 5: Home visitors and managers receive reflective supervision each month.
- Element 6: Child development, parental mental health and family functioning assessments are conducted at appropriate intervals.
Note: Based on the populations sampled in the research, Smart Start funding is allowable for implementing First Born and More with prenatal populations through age 3 years.
Languages Materials are Available in
English, Spanish
Delivery Mode
In-person home visits, with some flexibility for meeting outside of the home or in a virtual session.
Dosage
During the first year, home visits occur once a week, with each session lasting at least 45 minutes each. In the next four years, home visits occur at least twice a month.
Note: Based on the populations sampled in the research, Smart Start funding is allowable for implementing First Born and More with prenatal populations through age 3 years.
Infrastructure for Implementation
Materials: Laptops/iPads/Smart Cellphones, Wi-Fi accessibility, Curriculum, Assessment Forms/Materials, Pens/Pencils, Notebooks and data management/tracking system.
Space: Office space that supports confidentiality and HIPAA guidelines, and record management requirements.
Other: Partnership with organizations in the community to provide support to program and families.
Staffing Requirements
Program Manager (1.0 FTE):
- Bachelor’s degree in social work, psychology, or related field is required.
- Master's degree in social work, counseling, or related field, (licensed as LMSW or LCSW) is preferred.
- Minimum three (3) years professional experience in social work, counseling, or related field is required.
- Minimum two (2) years of supervisory experience is required.
Home Visitor (1.0 FTE serves up to 20 families):
- High school diploma or GED is required.
- College degree (or pursuing a degree) in Social Work, Counseling, Early Childhood Education, or related field is preferred.
- Knowledge of infant and toddler development and experience working with families during pregnancy, with children ages 0-5 and representing a wide range of socio-economic and cultural backgrounds is preferred.
Training for Model Fidelity
The core certification training requirements are:
- Completion of eight (8) competencies areas on basic home visiting skills in an online platform including successfully completing the knowledge assessment at the end of each module with a passing score of at least 80%.
- Completion of ten (10) hours instructor-led training offered virtually or in-person by model staff. Instructor-led training is offered each month for new home visitors, with a two (2) hour session each week and supports the integration of the online platform learning.
- Completion of an online evaluation of the training. Trainees are able to complete home visits under the direct supervisor of their manager after successfully completing the third session of the instructor-led training.
If necessary and requested, a one-on-one (1:1) remedial session is offered.
For more information, visit the Home Visitor Training webpage or the Become a Program webpage.
Contact Information
First Born and More Model Office, Santa Fe Community College: firstbornandmore@sfcc.edu
Cost Estimates
- Annual Licensing Fee: $4,500 (one-time fee)
- Annual Renewal Licensing Fee: $2,000
- Curriculum Access Fee: $300/per person
- Core Home Visiting Training: $1,100/per person
- Core Program Manager Training: $500/per person
Programs should consider adding initial training costs for future new hires after startup/initial implementation phase budget based on their retention rate.
Purpose Service Code (PSC)
5413 – Prenatal/Newborn Services
Program Identifier (PID)
First Born
Minimal Outputs for NCPC Reporting
FY 24-25:
- Number of parents/guardians participating†
†Select Family Support Programs data collection will include basic demographic data for parent/guardian participants including Race, Ethnicity. Data on interpretation and transportation will be collected when appropriate.
Minimal Outcomes for NCPC Reporting
FY 24-25:
- Increase in parent use of services
- Increase in parent social support
Minimal Measures for NCPC Reporting
FY 24-25:
- Parent Use of Services Calculation
- Social Support Index (SSI)
NCPC Evidence Categorization
Evidence Informed- 2 publications. 1 randomized control trial and 1 program evaluation using a nonexperimental design.
Research Summary
The referenced studies include a randomized controlled trial and a program evaluation using a nonexperimental design. In 2017, Kilburn and Cannon1 studied the First Born program and its relationship with the use of infant health care. Families that were part of the First Born Program intervention were 1/3 less likely to visit the emergency room during the first year of the child’s life and were 41% less likely to visit their primary care doctor more than 9 times. FBP children were less likely to have serious injuries or to be admitted to the hospital, but these differences were not statistically significant. The significant results remained significant for the lower-risk families and so FBP was shown to be effective for both low-risk and high-risk families. In a program evaluation of First Born in 2005,2 the researchers found that mothers significantly improved their social support network, including emotional, marital, personal, and community support. Though there was a small sample size for those with mental health issues, substance abuse issues, psychical history, and history of abuse, there were significant improvements noted. Mothers also showed significant improvements in their perception of their child, martial relationships, mutual support, male involvement, and a significant reduction in violence. Specific to the postpartum testing, families significantly improved in parenting skills, parental supervision, developmental expectations, perception of child, and bonding/interacting with the child, as well as a reduction in abuse/neglect. While this study does not provide cause-and-effect analysis, the results are promising for FBP to help improve factors related to family resiliency in the face of risk factors such as poverty and teenage parenthood.
- ^ See Kilburn & Cannon (2017). The study was conducted as an independent randomized controlled trial. Participants included the primary caregivers and their first-born children and caregivers that were pregnant with their first child. Data was collected through interviews with the families that assessed demographics, family background, child health, maternal health, parenting practices, and other outcomes.
- ^ See de la Rosa et al., (2005). The program evaluation was conducted using a nonexperimental design in which they had one non-experimental group that completed pre- and post-measures. The study population included mothers in a rural community who were pregnant with their first child or were raising their first child. The authors focused on evaluating possible improvements in certain domains tied to family resiliency. The Revised North Carolina Family Assessment Scale was used for data collection.
Researched Population
- First time pregnant women
- Families raising their first child
- Medicaid eligible (low-income)
- Racially/ethnically diverse (including Hispanic/ESL)
- Diverse family formations (cohabiting, separated, divorced, etc.)
- Child ages ranged from prenatal to 36 months (3 years)
Clearinghouse and Compendium References
National Home Visiting Resource Center- rated Emerging
Kilburn, M. R., & Cannon, J. S. (2017). Home visiting and use of infant health care: A randomized clinical trial. Pediatrics, 139(1). https://doi.org/10.1542/peds.2016-1274
De la Rosa, I. A., Perry, J., Dalton, L. E., & Johnson, V. (2005). Strengthening families with first-born children: Exploratory story of the outcomes of a home visiting intervention. Research on Social Work Practices, 15(5), 323-338. https://www.doi.org/10.1177/1049731505277004
Local Partnerships Currently Implementing
Local Partnerships in purple have adopted First Born and More. Local Partnership contact information can be found here.