A universal support program for expectant parents and families with children up to age 5.
The Evidence Summaries presented on this site were drawn from the best available evidence of the program’s effectiveness. It does not necessarily reflect all the evidence about the program. The research was selected and assessed for inclusion on the Menu and towards the evidence rating because it met selection criteria related to the specific topic area, study design, quality assessment and the outcomes of interest.
Overview
Evidence Rating
Pathway
- Early help
Australian Study
Risk of Bias
Cost
Target Age Group
About
First Steps is a primary early intervention parent support plan for all expectant parents and families with children up to age 5. First Steps provides families with a localised community resource guide and referrals to relevant resources and age-appropriate information. First Steps is delivered across the state of Georgia, United States.
Aims
- Prevent child maltreatment
- Improve parenting knowledge for new mothers
- Promote child health and development
- Improve quality of parenting behaviour
- Provide information about pregnancy, health, safety and nutrition
- Helps families get access to services
- Connect families to community resources.
Impact
Evidence suggests that First Steps was effective in improving parents' education specifically, their self-reported increased need for service access. There was no effect in improving housing outcomes and evidence for other outcomes was mixed and inconclusive.
| Outcome domain | Outcome measured | Positive effect | No effect | Negative effect |
|---|---|---|---|---|
| System | Health service use | Yes | Yes | Yes |
| Family | Housing | Not found | Yes | Not found |
| Family | Welfare/poverty | Yes | Yes | Not found |
| Parent/caregiver | Education | Yes | Not found | Not found |
| Parent/caregiver | Parenting skills | Yes | Yes | Not found |
How to read the table:
When ‘Yes’ is indicated for one of the three directions of effect, this means there is evidence of ‘positive’, ‘no effect’ or ‘negative effect’. Evidence is mixed and inconclusive when ‘Yes’ is indicated for two or more directions of effect. Further information about direction of effect can be found on the Using the Menu page.
First Steps has an evidence rating of Supported.
This means that First Steps has evidence from one randomised controlled trial (RCT) or quasi-experiment (QE) demonstrating positive, short-term impact on at least one child and family outcome.
This assessment is based on one research output of RCT design. First Steps has not received a Well-supported rating as it has not yet replicated its results in another RCT or QE with a different population or setting.
| Study design | Number of research outputs included |
|---|---|
| Systematic review with meta-analysis | Not identified or included |
| Randomised controlled trial | 1 |
| Quasi-experiment | Not identified or included |
The evidence has some concerns with risk of bias.
We can be reasonably confident about the results and quality of evidence from the included study.
The study was conducted in the United States and does not include Aboriginal children and families.
Aboriginal knowledge and evidence is critical to recognise, document and share practices that lead to improved outcomes for Aboriginal children and families. The department is consulting with the Aboriginal community and stakeholders on how Aboriginal knowledge and evidence is defined and included on the Menu.
Location
- The study was conducted in Georgia, United States.
- There were 19 First Steps sites across the state of Georgia at the time the study was conducted. 2 hospital-based sites in Georgia were chosen through a process evaluation for having high fidelity to the service model and being financially stable.
Sample characteristics
- All 749 eligible mothers (374 intervention, 375 control) enrolled in the study.
- The target population was mothers that had given birth on the day or recruitment or the day before. Both groups scored high on characteristics with a likelihood of negative outcome.
- The mean age of the mothers was 27.
- Participants identified as African American (59%), White (35%) and Hispanic (5%).
Implementation
Delivery model and mode
- First Steps is delivered in-person, with the option of follow-up through mail/phone, to the parent only.
Target cohort
- Parents of children up to age 5.
Program delivery
- The First Steps service model has 2 main components:
- Required brief in-person initial visit with the mother
- Optional telephone or mail follow-up contact.
- First Steps providers give families a packet of parenting information and a guide to community resources during the initial visit, at which they typically review the materials with the mother, provide information about community resources and answer any questions the mother has. Content areas covered in the packet of materials include maternal, newborn and child health, home and child safety, community and family safety, family economic self-sufficiency and school readiness.
- A paid coordinator oversees services at each site.
- With community partners, a First Steps plan is developed to provide services and support for families by:
- Identifying a universal target population and service delivery locations
- Ensuring access for parents of all ages and all ethnic and socio-economic backgrounds. This is enabled by connecting with community partners that will provide access to families, establishing referral partner agreements, establishing consistent referral process practices and establishing a tracking system for referrals
- Identifying key needs of families participating in the program and identifying community resources to meet those needs
- Completing all documentation including state required data entry and all essential records required by First Steps Georgia
- Coordinating within Great Start Georgia, if applicable.
Manuals and guides
- We were unable to locate any manuals or guides to implement First Steps.
Additional information
- The United Way of Central Georgia website has more information about First Steps.
Staffing
- First Steps providers vary by site, but include volunteers, student interns or both. Generally, First Steps relies on volunteer help.
Training
- Great Start Georgia provides training of coordinators, ongoing technical support and financial support.
- Coordinators are responsible for developing site-specific materials and training and supervision of other staff.
To our knowledge, First Steps is not available and has not been implemented in Australia.
Cost
First Steps is sponsored by the Georgia Department of Public Health and supported by the community. The program is provided to families at no cost.
References
Studies identified and included in the review
- O’Neill KMG, Cluxton-Keller F, Burrell L, Crowne SS & Duggan A (2020). Impact of a child abuse primary prevention strategy for new mothers. Prevention Science, 21(1):4-14.
Studies identified but not counted towards the evidence rating due to study quality
No studies that were identified were excluded due to study quality.