Association for Public Policy Analysis & Management

Investments in home visiting programs for young children and their parents are increasing nationwide, with a particular emphasis on evidence-based programs. This study evaluates the effectiveness of the First Born Program (FBP) in improving parenting practices in the first year of life. FBP is a home visitation program that combines specially trained parent educators and health care professionals to provide parents and families with information, training, and access to resources designed to promote early childhood development. All services are free and offered to all first-time families. Services may begin at any time during pregnancy or up to two months after the baby’s birth and may continue until the child is three years old. In addition, a nurse postpartum home visit is offered to the parents of all participating newborns.

This study addresses the following question: Do parents participating in the First Born Program engage in more recommended parenting practices compared to parents not receiving program services? We will examine a set of parenting practices recommended in the first year of life, such as those  recommended by the American Academy of Pediatrics. We examine such outcomes as immunizations, breastfeeding, reading to children, and limiting television.

To identify the effects of program participation, this study conducted a randomized-controlled trial of the program offered to all new parents in Santa Fe County, New Mexico. Families referred to the program were randomized on a rolling basis to treatment or comparison group status as home visiting slots became available. The study includes 138 families assigned to the treatment group and 106 families assigned to the control group. We estimate a contamination-adjusted intent-to-treat model to account for the fact that a number of families assigned to treatment did not receive services and typical intention-to-treat models may underestimate the value of receiving services. We use parent interview data on reported background characteristics and parenting behaviors at the 12-month interview, which asks the caregiver respondent about the child’s first year of life.