At the time of this review, no research studies that evaluate the curriculum's effect on child outcomes have been published in peer-reviewed journals. Although one program evaluation mentioned this curriculum, the study also mentioned the use of other home visiting curricula (Kirkland & Mitchell-Herzfeld, 2012). Outcomes from this evaluation are omitted in this review because the effects were not clearly linked to use of Partners for a Healthy Baby. Some evidence indicates that use of this curriculum was associated with a reduction in rates of low birth weight (e.g., Lee et al., 2009) and maternal depression (DuMont et al., 2008). However, more rigorous research is needed in order to establish evidence for positive effects of the Partners for a Healthy Baby curriculum on child outcomes.

For more information on Partners for a Healthy Baby as a parenting curriculum, see the Parenting Curricula for Home-Based Delivery Database.

References:

DuMont, K., Rodriguez, M., Mitchell-Herzfeld, S., Walden, N., Kirkland, K., Greene, R., & Lee, E. (2008). Effects of Healthy Families New York on maternal behaviors: Observational assessments of positive and negative parenting. Rensselaer, NY: New York State Office of Children and Family Services.

Kirkland, K., & Mitchell-Herzfeld, S. (2012). Final report: Evaluating the effectiveness of home visiting services in promoting children's adjustment in school. Washington, DC: Pew Center on the States.

Lee, E., Mitchell-Herzfeld, S., Lowenfels, A., Green, R., Dorabawila, V., & DuMont, K. (2009). Reducing low birth weight through home visitation: A randomized controlled trial. American Journal of Preventive Medicine, 36(2), 154–160.

Home Visiting Practices and Interactions: Partners for a Healthy Baby promotes a few home visiting practices and interactions that research has shown to be effective in engaging parents. For example, the curriculum includes specific information on how a home visitor can facilitate parent-child interactions and address child development. Additionally, the "Detailed Information Pages" provide guidance to parents on how to communicate with families about a pre-chosen topic, with specific open-ended questions to start the conversation. However, while the "User's Guide" calls out the importance of key research-based home visiting practices and interactions (e.g., "build a trusting relationship," "empower the family," "address the family's concerns first," "be observant"), it lacks specific guidance for home visitors on how to engage in these practices. In addition, the curriculum provides minimal guidance on how to address a family's needs and follow their lead to jointly plan home visits that build on the family's strengths and needs. The topics for the "Purposes" are predetermined, and the home visit planning process that is outlined in the "User's Guide" includes very little family input. 

Parenting Practices: The curriculum promotes research-based parenting practices to support children's development and learning. For example, many of the handouts throughout the curriculum encourage parents to engage in sensitive, responsive interactions with children (e.g., contingently responding to a child's cues). The curriculum also provides guidance for parents on how to model and support the development of children's social skills, emotional regulation, and cognitive skills. It supports families to promote a language and literacy-rich environment (e.g., "Talking with your baby;" "Making more time for books"), but less consistent guidance is offered on use of the home language throughout the curriculum. Many of the parent handouts and "Detailed Information Pages" for home visitors focus on using routines such as mealtime and naptime as opportunities for learning. Additionally, the curriculum mentions the importance of following a child's lead and provides guidance on how to support children's active exploration and play (e.g., the "Watch My Skills Grow" series). It emphasizes the importance of setting up the home to create a safe play environment and provides suggestions for how to use materials in the home to support children's active play and exploration.

Scope: The curriculum identifies four developmental domains in the "Scope and Sequence" section of "Baby's/Toddler's Development:" Language and Literacy; Social Emotional Development; Developmental Skills; and Play, Learning, and Cognition. The domain "Developmental Skills" does not clearly identify a particular area of development, but focuses generally on observing and reflecting on new skills that the baby/toddler develops. The "Watch Me Grow!" parent handouts provide a broad introduction to child development under the following four domain categories: Motor, Language, Thinking, and Feeling. The varying naming conventions for domains throughout the curriculum do not allow for a clear connection between the curriculum materials (e.g., parent handouts) and the domains listed in the "Scope and Sequence."

Sequence: Partners for a Healthy Baby provides a sequence of learning experiences that supports children as they build knowledge and skills in each of the ELOF domains, with materials organized by child's age, from 1 to 36 months. For example, in a series of handouts (e.g., "Watch My Motor Skills Grow," "Watch My Thinking Skills Grow," "Watch My Language Skills Grow," "Watch My Social Emotional Skills Grow," and "Watch My Play Skills Grow"), the curriculum includes tips to support children's learning and development at different age levels from birth to 36 months. The curriculum offers multiple, related opportunities for children to explore or learn concepts or skills in the ELOF domains of Approaches to Learning, Language and Communication, and Cognition. However, the curriculum lacks a variety of experiences that provide children with ample opportunities to build skills in the domain of Perceptual, Motor, and Physical Development and in some areas of Social and Emotional Development, such as Relationships with Other Children and Sense of Identity and Belonging. Additionally, the curriculum does not provide clear guidance on how home visitors can use the sequences of learning experiences in ways that allow for flexibility based on the interests, strengths, and needs of children.

Alignment with the ELOF: A thorough review of all of the curriculum materials indicates that Partners for a Healthy Baby is fully aligned with the ELOF domains and sub-domains. The "Detailed Information Pages" for home visitors and parent handouts support children across all ELOF sub-domains.

Learning Goals: The curriculum does not specify learning goals for children's development and learning. Broad concepts of child development for children from birth to 36 months are introduced as part of the "Watch Me Grow!" handouts. Each handout includes three indicators of development in each of the following areas: Motor, Language, Thinking, and Feeling. However, these are not specific goals for children's learning and development. Finally, the curriculum does not offer guidance to engage families in identifying individual goals for children's development and learning.

Ongoing Observation: The curriculum provides general guidance in parent handouts to help families and home visitors reflect, every month or two, on a child's development (1 to 36 months). For example, a series of "Detailed Information Pages" for home visitors, called "Continue to promote parents' observation and reflection skills with baby," provide home visitors with general suggestions for supporting parents in their observations (e.g., "Your role is to help the family continue to be careful observers of what is happening with their baby and how their interactions are changing over time"). These pages mention a "Review, Observe, Reflect" process, but the curriculum does not provide details on how to engage in this process or what it entails. The parent handouts include sentence starters for families to use as they think about the child's development, such as "I can tell my baby is interested in something when ...," but the handouts do not include specific guidance on how to observe children. Additionally, the curriculum does not provide information on how to connect this information to home visit planning. 

Standardized and Structured Assessment Instruments: The curriculum provides information on using developmental screening tools (e.g., Ages & Stages Questionnaires® (ASQ®)) based on parental observation and reflection as the basis for screening. However, it does not include guidance for home visitors and families on how to select and use standardized and structured child assessment instruments.

Relationships with Parents and Families: The curriculum provides general guidance on building relationships with families. The "User's Guide" includes a brief section called "How Do I Build a Trusting Relationship?" with some general tips for building a trusting relationship with families (e.g., "keep their confidences," "respect their culture and values"). The "User's Guide" states, "To fulfill your role, you must first be able to establish warm, supportive, and empowering relationships with families whose culture, beliefs, values, and priorities may not be the same as your own. Establishing a good relationship with each family is key to your effectiveness." However, the curriculum does not offer specific guidance for supporting a relationship-building process between home visitors and families that is integrated throughout the curriculum materials. 

Responsive Interactions with Parents and Families: The "User's Guide" briefly describes the importance of responding to a family's concerns during a home visit. It provides some general tips and reflection questions to promote responsive interactions with families (e.g., "Inquire about any immediate needs or concerns," "Address the family's concern first," "Did I attend to what the family was telling me with their words and non-verbal cues?"). In addition, the "Detailed Information Pages" provide open-ended questions home visitors can use with the family to start conversations. However, there is little room in the "Detailed Information Pages" for home visitors to actively respond to families' unique needs, and the home visit planning process does not involve families. Additionally, little consideration is given to how home visitors engage in responsive interactions with diverse families. 

Peer Support: Partners for a Healthy Baby includes several parent handouts and "Detailed Information Pages" that discuss the importance of social support for families (e.g., "Circle of Support for My Baby and Me"). However, no explicit guidance is provided on how home visitors can gather families together for group socializations.

Professional Development: Partners for a Healthy Baby offers a two- or three-day initial in-person training, "Partners for a Healthy Baby Workshop for Home Visitors," either in Florida or at a program site. The workshop covers a variety of topics, including children's learning and development in different domains, planning home visits, and using the curriculum with fidelity. In addition, Partners for a Healthy Baby offers an initial training for supervisors, as well as initial training on parts of the curriculum (e.g., the prenatal curriculum only). Coaching support and mentoring for programs are offered on request. 

Curriculum Materials to Support Implementation: The curriculum includes some overview materials and guidance to facilitate understanding of the curriculum. Each volume has a "User's Guide" that provides lists of tips for a home visitor, such as "What Is My Role as a Home Visitor?" One section called "How Do I Conduct a Home Visit?" offers specific step-by-step information on how to use the curriculum to plan a home visit. The "Detailed Information Pages" provide some specific guidance on how to use the parent handouts with families. The curriculum provides information about how it is organized, but it is unclear how the handouts and the "Detailed Information Pages" should be combined and implemented as part of a cohesive program. The curriculum only provides the following general recommendation: "Tailor your choice of purposes to the needs of each family while using the curriculum as a guide to ensure critical information is covered."

• Fidelity Tool: The curriculum offers the "Partners for a Healthy Baby Fidelity Checklist," which can be used to assess fidelity of implementation. Supervisors use the checklist quarterly during reflective supervision; home visitors can also use it as a self-reporting tool. The tool can be used to assess how home visitors are following the curriculum's steps of planning and implementing a home visit.

Family-Child Relationship: Partners for a Healthy Baby emphasizes the family-child relationship as the foundation for a child's learning and development. The curriculum provides abundant guidance to home visitors about ways to engage parents in building relationships with their children through a variety of reflections and handouts (e.g., "Encourage different ways parents can be available as toddler's secure base."). Guidance for facilitating parent-child relationships is delineated in the "Baby's Development" and "Caring for Baby" sections and is also embedded throughout the curriculum. 

Active Exploration and Play: The curriculum consistently emphasizes the importance of play and provides guidance to home visitors and parents on how to engage children in ongoing active play and exploration. Parent handouts such as "Watch My Thinking Skills Grow" and "Watch My Play Skills Grow," and the "Detailed Information Pages" for home visitors, discuss the importance of play in children's development and include some guidance for supporting children's play skills at different age levels. For example, at 7 months, "Talk about baby's first play skills and why play is important;" and at 8 months, "Explain how play helps the baby learn." The parent handouts offer ideas to promote play and exploration (e.g., "Make the fun tub a fun place to learn by adding plastic cups, measuring cups ... She'll love to think of the different ways to make the water splash and ripple."). The parent handout "Children Learn Through Play" provides ideas for supporting children's learning. Similar guidance is offered throughout the curriculum to support children's problem-solving, observation, and exploration skills. Although advice for supporting active exploration and play is embedded throughout curriculum materials, suggestions for parents in the handouts (e.g., "You can ...") are often brief and not specific. 

Interactions that Extend Children's Learning: Throughout the curriculum materials, some guidance is provided on extending children's communication, thinking, and exploration. For example, parent handouts such as the "Watch My Thinking Skills Grow" and "Watch My Play Skills Grow" series describe prompts for parents to extend conversations (e.g., "Talk about the way [toys] feel, the sounds they make, and what color they are," "Ask your baby questions with the words 'more' or 'again' ") and to engage in responsive interactions (e.g., "Copy the different sounds the child makes and give him time to respond with something new."). Additionally, handouts to support language and literacy provide guidance on how to extend children's communication and language skills (e.g., "Encourage turn-taking conversations between parents and baby," "Talk about labeling everyday objects"). However, suggestions for interactions that extend children's learning are often provided as brief, general statements of what parents can do to support new play skills. 

Individualization: The curriculum includes some guidance for home visitors to support parents as they learn about their children's development and interests (e.g., "It is time to look again at the things you have been observing with your baby. I am excited to hear what you've noticed your baby doing since my last visit."). However, it includes little information on how to collaborate with families to create learning experiences that build on children's individual strengths or needs. Additionally, the curriculum provides only a few activities that build on families' cultures and home languages.

Environment: The curriculum includes some general guidance on supporting the home as a learning environment. The focus of much of the guidance relates to safety in the home; for example, "Equipment Safety Tips" provides tips for organizing a home and making sure items are safe for infants. It also includes some general guidance on organizing the home learning environment to support exploration and play (e.g., "Arrange your Home for Success"). It does not include guidance on making a home learning environment accessible for a child with a disability, suspected delay, or other special need. 

Learning Materials: The curriculum provides some specific guidance, particularly in parent handouts, on using developmentally appropriate learning materials found in the home. A few handouts (e.g., "Smart Toys from Your Kitchen," "Homemade Toys to Help Me Learn") include suggested materials families can gather from the kitchen or from other areas of the home (e.g., cooking spoons, pots, boxes) for children to use in play. The curriculum includes some guidance on how to use the materials to foster open-ended exploration and inquiry (e.g., building, creating, problem-solving). However, it does not provide guidance on how to incorporate materials that are accessible for a child with a disability, suspected delay, or other special need.

Routines: Partners for a Healthy Baby consistently guides families in establishing and supporting developmentally appropriate routines that are responsive to a child's needs. The curriculum includes specific guidance on routines that is embedded throughout the "Detailed Information Pages" for home visitors and the parent handouts, particularly in the "Caring for Baby" section. It also includes materials to support routines that are responsive to a child's needs at mealtimes, bedtime, during transitions, and at other points in the day.

Interactions: The curriculum's "User's Guide" includes a few mentions of the importance of home visitors interacting with families from diverse backgrounds and cultures. A section called "What Is My Role as a Home Visitor?" includes a brief description of establishing relationships with families who may be different than the home visitor. The curriculum lacks guidance on how to engage in culturally responsive interactions with families. In addition, gender-based stereotypes are perpetuated throughout the curriculum, particularly in the "Fatherhood" sections. Although the "Detailed Information Pages" and parent handouts address some topics that are specifically targeted at fathers, the materials often reflect stereotypes and do not promote a strengths-based approach (e.g., handouts reflect assumptions that fathers are often absent, do not help with household chores, and do not provide economic support for their children). 

Learning Experiences: The "User's Guide" describes the importance of planning learning experiences based on a family's culture. A bulleted list of skills that a home visitor needs, in a section called "Home Visitor Skills & Knowledge," includes "cultural sensitivity" and respecting the "cultural values" of a family. However, the curriculum does not include guidance on what these skills entail or how to collaborate or adapt learning experiences based on a family's traditions or culture.

Linguistic Responsiveness: The curriculum offers minimal guidance for how to intentionally support the development and learning of children who are DLLs. Two handouts specifically focus on asking families their preference of language learning and on the need to have a plan for exposing children to all languages that the child is learning, including the child's home language. One handout, "Benefits of Growing Up Multilingual," describes the strengths of learning two or more languages and encourages parents to talk with the child in English and in the child's home language. However, throughout the curriculum, very little guidance on how home visitors and families can support the development of children who are DLLs is provided.

Resources and Referrals: The "Watch Me Grow!" handouts throughout the curriculum provide brief information on the importance of referring families with a child with a disability, suspected delay, or other special need to resources in the community (e.g., "Be prepared to share information about Part C services with the family."). The curriculum offers minimal guidance on how to identify resources in the community or how to go through a referral process. 

Learning Environment: The curriculum does not address the accessibility of the home environment or learning materials for a child with a disability, suspected delay, or other special need. 

Parenting Practices and Interventions: The curriculum does not address adaptations to routines or learning experiences for a child with a disability, suspected delay, or other special need.

Individualization Based on Interests: Partners for a Healthy Baby provides prompts for families to observe and learn about their child's interests (e.g., "I can tell my baby is interested in something when ..."). A few resources also mention the importance of following a child's lead during play. For example, "A New Way to Read" describes how to follow a child's interests in books. However, the curriculum does not include explicit discussion of how to individualize or modify the home visit based on an individual child's interests. In addition, the home visit planning process is led by the home visitor, with little input from families about the child's interests.

Individualization Based on Strengths and Needs: Partners for a Healthy Baby provides minimal guidance on how to tailor home visits to be responsive to individual children's strengths and needs (e.g., the "User's Guide" says, "Inquire about any immediate needs or concerns"). The home visit planning process does not include collaborative planning with a family to determine how to individualize the home visit based on the strengths and needs of the child. Additionally, parent handouts that are designed to support children's development (e.g., the "Watch Me Grow!" series) do not provide guidance on how to tailor activities to individual children's strengths and needs.

Family Goals: The curriculum includes some general guidance for home visitors to engage families in setting goals, primarily through resources in the "Family Development" category. A few "Purposes" are specifically designed to support the family in setting goals for themselves (e.g., "Help families identify their dreams and achieve their goals."). The "Detailed Information Pages" provide language home visitors can use to help families set their goals (e.g., reinforcing the value of breaking big goals into smaller, more manageable steps). The curriculum also provides a few corresponding handouts for families (e.g., "Making My Dreams Come True," "Making Changes for Positive Outcomes," "Making Your Dream Happen: Next Steps"). Additionally, it engages families in setting goals that address specific challenges they might have, such as career development, budget planning, or setting priorities. However, it lacks a clear, collaborative process and strategies for how home visitors engage families to establish goals based on the family's needs.

Ongoing Assessment of Progress Toward Family Goals: Partners for a Healthy Baby provides follow-up activities for home visitors and families to revisit family goals at specific points in time established by the curriculum. For example, when the baby is 7 months old, the curriculum invites home visitors to "discuss family's progress toward their goals and offer suggestions for overcoming challenges." Other handouts for families, such as "Facing Challenges" and "Action Plan for Success," offer general affirmations on tackling issues that may arise (e.g., "Everyone has some rocks on their path to success ... How can you overcome them?"). However, there is no clear, systematic process for engaging families in ongoing assessment of their progress toward reaching their goals.

Resources and Referrals: The curriculum briefly describes the importance of connecting families to resources they might need in order to make progress toward future goals (e.g., "provide support [for them] to gain access to services that allow them to put their plans into action"). It encourages home visitors to contact the appropriate agency or support person in their program or community in relation to the need (e.g., Part C Early Intervention; infant mental health specialist; Women, Infants and Children (WIC); lactation consultant; program supervisor). However, it includes limited guidance on how to brainstorm resources with or refer families to specific resources in the community, such as a list of common public resources (e.g., libraries, local adult learning institutions), depending on the family-level goals.