Child First is a comprehensive, home-based, therapeutic intervention that targets young children and families with multiple risks and connects them with the services they need to support healthy child development. An earlier randomized controlled trial of Child First in one location showed that the program improved children’s social-emotional skills and language development, reduced mothers’ depression and improved their psychological functioning, reduced families’ involvement with child protective services, and increased families’ connections to services and support.

With funding from the Laura and John Arnold Foundation and The Duke Endowment, the current study aims to replicate the findings from the earlier study in multiple locations across two states. Because this study has a larger sample it can examine program impacts over a longer time and among subgroups of participants who share certain characteristics of interest. This subgroup analysis can help policymakers and practitioners target the families most likely to benefit from Child First.

Agenda, Scope, and Goals

The current study seeks to answer whether the impacts of Child First demonstrated in the earlier study will be seen again in a randomized controlled trial that tests the program on a larger scale and in multiple locations.

This study will examine three primary research questions:

  1. What is the impact of Child First on families’ involvement with child protective services 12 months after random assignment?

  2. What is the impact of Child First on families’ involvement with child protective services 36 months after random assignment?

  3. What is the impact of Child First on parents’ psychological functioning 12 months after random assignment?

These outcomes are the domains in which the original study identified impacts of Child First at 12 months and 36 months. The current study will also ask a series of secondary research questions that are equally relevant to policymakers. For example, the study will estimate impacts on children’s language development and social-emotional skills. Further, the study will assess whether Child First is more beneficial for certain subgroups of families, including families with caregivers who have experienced trauma or substance abuse or who have a history of depression, and those with children exhibiting issues with behavior or language development.

Design, Sites, and Data Sources

MDRC will randomly assign approximately 600 eligible families to receive the Child First program or to a control group who receive the usual care. Families will be enrolled in participating Child First locations in Connecticut and North Carolina.