# Intervention to improve outcomes for foster children reunited with their birth families.

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $563,971

## Abstract

ABSTRACT
Home visiting intervention and prevention efforts to prevent child maltreatment have gained popularity and
national funding support. However, little is known about the ability of existing prevention programs to intervene
with birth parents reunified with their infants or toddlers who were once placed in the child welfare foster care
system. One important reason for this lack of information is that evidence from existing programs do not
represent the higher risk population of reunified birth parents (Lee, Aos, & Miller, 2008). Birth parents of young
children who have been placed into foster care are a highly vulnerable population of caregivers. They are more
likely to have been foster children themselves and survivors of childhood maltreatment (Marcenko, Newby,
Mienko, & Courtney, 2011). They are at a much higher risk for co-morbidities, including mental health
disorders, substance abuse, poverty, low education, and homelessness (Marcenko, Lyons, & Courtney,
2011). Their infants and toddlers, similarly, are not only at risk for serious emotional, behavioral, neurological
and physiological health problems, they are also at risk for continued relationship disruptions throughout their
life course with multiple placements (Fuller, 2005). In this application we will evaluate the effectiveness of a
community based, home visiting intervention program with a population of birth parents recently reunified with
their child under the age of five after a foster care placement. In order to do this, we will first adapt the program
by adding material relevant to reunified birth families and adapt the material for older children. We will evaluate
the effectiveness of Promoting First Relationships (PFR; Kelly et al., 2008) to meet the parenting needs of this
vulnerable population. Promoting First Relationships was originally designed for children birth to three, and we
will expand the curriculum to meet the needs of children aged birth to five. Through a strong, established
community partnership between the state, a community mental health agency, and the University of
Washington, we will 1) adapt Promoting First Relationships (PFR) for reunified birth families and older children;
2) test the effectiveness of PFR to improve parental quality and parent-child interaction as compared to a
Resource and Referral service; 3) test the effectiveness of PFR on reducing social, emotional, and behavioral
problems in a population of children at risk for elevated emotional and behavioral disorders; 4) test the
effectiveness of PFR in reducing referrals to CPS and re-entry into foster care; and 5) test a proposed PFR
theoretical model, linking the PFR intervention to improved parental insightfulness and emotional competence,
which then contributes to parental sensitivity and improved child outcomes.

## Key facts

- **NIH application ID:** 9851423
- **Project number:** 5R01HD090176-04
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** MONICA L OXFORD
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $563,971
- **Award type:** 5
- **Project period:** 2017-05-12 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9851423

## Citation

> US National Institutes of Health, RePORTER application 9851423, Intervention to improve outcomes for foster children reunited with their birth families. (5R01HD090176-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9851423. Licensed CC0.

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