Partners for a Healthy Baby: A Curriculum Home Visitors Can Trust

How do home visitors build trusting relationships with families? They can start by taking some tips from the FSU Partners for a Healthy Baby Parenting and Home Visiting curriculum, a 4-volume series with an online digital subscription option, developed by researchers at Florida State University’s Center for Prevention and Early Intervention Policy in Tallahassee. The FSU Partners curriculum advises you to explain your role as a home visitor during your first few visits with each family. Then, you begin the process of developing a trusting relationship with them. “This happens when you arrive at the time you say you will, do what you say you will do, keep their confidences, respect their culture and values and listen earnestly without judgement,” the curriculum explains. And every single part of the interaction matters because “the trusting relationship you build with each family is the key to your effectiveness as a home visitor.”

Over 3,700 home visiting programs trust the FSU Partners curriculum to guide them in effectively serving pregnant and parenting families around the world. Evidence-based home visiting models such as Early Head Start, Nurse Family Partnership, Healthy Families America and Parents as Teachers use the FSU Partners curriculum. The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program uses the curriculum. So do other home visiting programs such as Healthy Start, the U.S. Military’s New Parent Support Program, state health departments and teen parent programs. Millions of home visitors have used the curriculum because it’s comprehensive in scope and flexible enough to meet the goals of all home visiting programs.

There was no comparable home visiting curriculum in 1996 when a multidisciplinary team came together at FSU to fill the gap. “At the time, we had a federal Healthy Start home visiting program,” says Christine Chiricos, a researcher at FSU and one of the curriculum’s authors and trainers. “We were serving six rural communities around Tallahassee and working with home visitors who had a wide range of educational backgrounds. We had home visitors who were nurses and social workers, along with non-degreed paraprofessional home visitors. And at the time, there was no comprehensive curriculum that really met the needs of all the families we were serving. So, our multidisciplinary faculty decided to write a curriculum that has now developed into a four-volume series — Before Baby Arrives, Baby’s 1st Year (Months 1-12), Baby’s 2nd Year (Months 13-24) and Toddler’s 3rd Year — each with a set of Parent Handouts, available in English and Spanish, that are intended to be shared with families.”

Unlike other home visiting curriculums, the Partners curriculum is not tied to a specific home visiting model, says Mirine Richey, also a researcher at FSU and a curriculum trainer. “This means that home visitors can choose to use the curriculum where it applies to their program and its goals. Let’s say your program emphasizes infant-toddler development and you’re working with a family around their child’s development. Meanwhile the mom may not have a job and may be dealing with depression. Or the family may not have a home. So, you need to have a comprehensive curriculum that covers a wide range of concerns.”

The Partners curriculum does that by addressing the whole gamut of issues facing new and expecting families: improving prenatal health and healthy birth outcomes, bonding and attachment, enhanced child health and development, infant mental health, family stability, and economic self-sufficiency. These areas play different roles in home visiting programs, so the beauty of the Partners curriculum is that programs can use it to meet a wide range of family and program goals.

“We provide the content,” Richey explains, “and programs can use it as they see best, even in conjunction with another curriculum, if needed.” And the research team at FSU has done its best to meet the changing needs of families and programs by keeping the content up to date. “We revised the curriculum in 2017,” Chiricos says, “and one of the things we took great pains to do was to revisit the goals of the programs that we knew were using the Partners curriculum. We wanted to make sure the content met the programs’ various goals and responded to the wide range of families that home visitors serve.”

You can see the diversity of this population when you look at the handouts that Partners provides for parents in both English and Spanish, Chiricos says. “We tried to represent, on the 672 Parent Handouts, the different families that are enrolled in home visiting programs that use the Partners curriculum. To that end we have Caucasian, Latino, African American and Asian families, as well as same-sex couples represented on the Parent Handouts.”

Home visitors have a lot of leeway in how they use content in the curriculum, including the Parent Handouts, since “the instructions are very gender neutral and fluid in terms of life style,” Richey adds. “So, the home visitor should consider the strengths and cultural background of the parents and use the handouts that are appropriate.” And they have a lot to choose from since there are handouts to guide parents in facing all the major issues that come with having a child. For example, they’ll get information on how to have a healthy pregnancy, make changes for a healthier life lifestyle, reach their goals, recognize early signs of health and pregnancy-related problems, be prepared to have a baby, learn ways to support a baby’s development and growth, manage the stress that comes with a having a new baby and boost their self-esteem. They’re all issues that also concern home visitors who are earning their Child Development Associate® (CDA) credential.

“We’ve been providing training on the Partners curriculum for years to home visitors, many of whom were working toward their CDAs,” Richey says. “Now that we have a formal agreement with the Council for Professional Recognition, which shows how the Partners curriculum training is aligned with the eight subject areas of the CDA credential, those seeking a Home Visitor CDA can use the Partners training hours as part of the 120 hours of coursework they’re required to complete.”

FSU has been offering training as long as they’ve had the curriculum, Chiricos explains. “It’s a three- day training in Orlando, and we typically have 14 to 16 states represented at each session. We also provide on-site training on request. So, let’s say an Early Head Start program has adopted the Partners curriculum for their home visiting program, and they have 10 to 12 home visitors, we will come to them and provide a two-day version of the training.”

The training attracts many different types of home visitors, Chiricos says. “We have people attending the training who have already earned their CDAs and those who are still getting it, along with people with different levels of experience and education. The curriculum is designed for use by a wide range of home visitors. And this year we began offering CDA credit for the training — good news for those getting their CDAs.”

Training on how to use the Partners curriculum is not required, but it is recommended, Richey says, because the training helps home visitors use the curriculum to fidelity, which home visitors find very useful. “The number-one comment I hear is about them getting a little more in-depth look at the content and using it correctly. It turns out that it makes their job much easier.”

This is noted in comments from training participants who acknowledge that “some of us had never been trained and it wasn’t until we took the training that we realized we weren’t using the materials correctly.” The training is full of “aha moments” like this, Richey says, as home visitors learn to navigate the curriculum and boost their knowledge of the field. “We spend the first day and a half walking the participants through Before Baby Arrives to address issues related to the prenatal period, then we spend the next day and a half going through Baby’s 1st Year, Baby’s 2nd Year and Toddler’s 3rd Year. Along the way, we give the participants a lot of practice using the curriculum and a lot of practice on visit planning. We do a lot of scenarios. It’s a very interactive training.”

And it’s “a lot of fun,” as Chiricos points out. “We do role play. We have them actively engage each other in trouble shooting and problem solving to plan a home visit for a family who might be having multiple types of issues in the home. We use video and interactive teaching. The training is so active and engaging that a lot of people come away saying they could have stayed longer.”

The comments about the Partners curriculum training that come from attendees speak for themselves: “Enjoyable and fun. I learned a lot about the curriculum for home visitors,” one attendee said. “Very informative and presented in an engaging way,” another said.” And yet another enthused, “Had a blast and learned a lot.”

In addition, Richey points out, “Outcomes are better with in-person training. And one of the things we talk about is the importance of relationships. We want to train the home visitors who are using this curriculum to work with families to develop a healthy relationship with their babies and make the bonds that are so important. Very often that home visitor may be the only person with whom that family has developed a sense of trust. And when we provide the training, we work hard to develop a relationship with the people who come. We spend a lot of time making sure that they’re okay, that they’re comfortable, and that they understand the content.”

An important aspect of that is how to build trust, Chiricos adds, “So we talk about that at the very beginning of the training. You can provide information to a family all day long, but without a trusting relationship, the outcomes won’t be the same. So, a big part of a home visitor’s role when they start working with a family is to start building that relationship because you’re talking about some very sensitive topics, like sex and STDs, family planning, birthing a baby and fighting the baby blues. Unless you have a trusting relationship, you’re not going to get very far. Forming a trusting relationship is absolutely at the heart of home visiting.”