The First Steps program is a primary prevention strategy that aims to promote child health and development by improving the quality of parenting behaviour. It achieves this by building parenting capacity and supports, specifically the protective factors of parenting knowledge and social support.
The program model has two main components:
Mothers are provided with both an information packet and a brief discussion with a healthcare professional on various topics around infant development.
The First Steps program is designed for mothers who have just given birth (within 2 days).
The First Steps program has only been evaluated in the USA (O’Neill et al. 2018).
A randomised control trial was conducted with 558 people (278 people were in the intervention group and 280 people were in the control group). On average, parents were 27 years old. Almost 60% of families were African American and more than 50% were employed.
The program has not been evaluated in Australia, or with Aboriginal Australians.
The First Steps program has positive effects on client outcomes.
Promising research evidence:
No RCT/QED studies show statistically significant adverse effects.
The First Steps program consists of an in-person hospital room visit, and optional additional telephone contact. On average, visits are 18 minutes.
Hospital room visit: First Steps providers give families a packet of parenting information and a guide to community resources during the initial visit. They typically review these materials with the mother, provide information about needed community resources and answer any questions the mother has.
Content covered in the information packet includes:
Content of visits include:
Not reported
First Steps providers spent the greatest amount of time talking about infant crying, a topic area in which mothers were not particularly interested, but in which they showed the greatest gains in knowledge.
Mothers contributed more to the conversation when providers used statements of support, reassurance and partnership building. Mothers talked less when providers merely gave information.
In the RCT completed by O’Neill et al. (2018) only 25% of families received additional telephone support.
One RCT conducted in the USA, with 558 participants (O’Neill et al. 2018).
16 Feb 2023
We acknowledge Aboriginal people as the First Nations Peoples of NSW and pay our respects to Elders past, present, and future.
Informed by lessons of the past, Department of Communities and Justice is improving how we work with Aboriginal people and communities. We listen and learn from the knowledge, strength and resilience of Stolen Generations Survivors, Aboriginal Elders and Aboriginal communities.
You can access our apology to the Stolen Generations.