A Randomized Controlled Trial of Promoting First Relationships® Program With Parent-Child Dyads Reunified After Child Welfare System Separation

Promoting First Relationships® (PFR) is a 10-session, evidence-based home-visiting program adapted for reunified birth families. We conducted a randomized controlled trial involving 240 parent-child dyads (child age 1–5 years) who had been reunited after a prior child welfare system removal. Birth parents and their children were randomized to PFR or a resource and referral (control) condition following baseline assessment. Compared to prior trials, completion of the PFR intervention was low (57%). Intent-to-treat analyses revealed no statistically significant differences in parenting outcomes or child behavior. Children in the PFR condition were less likely to be removed from their parents’ home within 1.5 years of baseline (9.9% vs. 16.0%), but this difference was not statistically significant ( p = .159). Results are discussed in terms of the adversity experienced by this population, high attrition, and historical context of the trial that was impacted by the COVID-19 pandemic and changes to child welfare laws in Washington State. Clinical Trial Registry Number: NCT04382677 https://clinicaltrials.gov .