Study Details | Pathways to Work

101031-Study of Child First

Study quality: High

High

Reason for the rating: This study received a high study quality rating because it is a randomized controlled trial with low attrition, suggesting the findings can be attributed to the program.

Program: Child First

Characteristics of study participants:

At least a high school diploma or equivalent, Parents

Services provided:

Case management, Mental health services

Setting: Tested in multiple settings

Methods and Standards Protocol version used for review: Version 2.0

Learn about our protocol

Study design

Design:

Randomized controlled trial

Study group formation:

Site supervisors responsible for screening new applicants randomized eligible families into either the Child First program group or the comparison group, with applicants having a 60 percent chance assignment to the program group and a 40 percent chance of assignment to the comparison group. A total of 224 families were randomized, with 134 families assigned to Child First and 90 families assigned to the comparison group.

Time period of study:

The study ran from June 2019 to March 2021. Participants were enrolled between June 2019 and March 2020. Study data were collected between August 2020 and March 2021 in a 12-month follow-up survey.

Primary outcome domains examined:

Increase short-term employment, Decrease short-term benefit receipt

Other outcome domains examined:

Food insecurity, housing stability, caregiver psychological well-being, child behavior, other financial assistance or support received not related to public benefits

Study funded by:

The study was funded by Arnold Ventures and The Duke Endowment.

Results

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Outcome domain	Measure	Timing	Study quality by finding	Comparison group mean	Program group mean	Impact	Units	Sample size
Increase short-term employment	Currently employed	Month 12	High	49.84	51.64	1.80	percentage points	182
Decrease short-term benefit receipt	Received any public assistance benefits, follow-up period	Month 12	High	55.45	59.06	3.61	percentage points	182
Decrease short-term benefit receipt	Received food stamps/SNAP, follow-up period	Month 12	High	59.13	53.50	-5.63	percentage points	182
Decrease short-term benefit receipt	Received UI payments, follow-up period	Month 12	High	21.60	22.76	1.16	percentage points	182

Short-term outcomes are those measured 18 months or fewer after participants are first offered services. Long-term outcomes are those measured between 18 months and 5 years after participants are first offered services. Very long-term outcomes are those measured 5 years or more after participants are first offered services.

Means are not displayed when not reported or not aligned with the impact estimates. For example, if the impact estimate is regression-adjusted but only unadjusted means are reported in the study, the unadjusted means are not displayed as they are not aligned with the adjusted impact estimate.

Impact estimates are not shown when the estimate units cannot be converted to natural units.

Findings quality key:

High
Moderate

Study quality terms?

The findings quality describe our confidence that a given study’s finding is because of the program. We do not display findings that rate low.

Findings key:

A moderate-to-large favorable finding that is unlikely to be due to chance
A moderate-to-large favorable finding that might to be due to chance
A small favorable finding that is unlikely to be due to chance
A small favorable finding that might be due to chance
A favorable finding that is unlikely to be due to chance, but we cannot determine the standardized effect size
A favorable finding that might be due to chance, but we cannot determine the standardized effect size
A moderate-to-large unfavorable finding that is unlikely to be due to chance
A moderate-to-large unfavorable finding that might to be due to chance
A small unfavorable finding that is unlikely to be due to chance
A small unfavorable finding that might be due to chance
An unfavorable finding that is unlikely to be due to chance, but we cannot determine the standardized effect size
An unfavorable finding that might be due to chance, but we cannot determine the standardized effect size
A finding that is unlikely to be due to chance, but we cannot determine the standardized effect size or direction
A finding of no effect that might be due to chance

Favorable findings are impacts in a direction that is socially desirable. Statistical significance indicates the likelihood that a study finding is due to the program, rather than due to chance. Findings are described as moderate-to-large if the program produced a sufficiently large change in the outcome. An impact receives this designation if the standardized effect size is equal to or greater than 0.25 or equal to or less than -0.25.

Sample characteristics

The study sample consisted of families with children between the ages of 0 and 5 years old who were experiencing challenges with caregiver mental health or child behavior problems. The majority of families reported having low incomes (75 percent), receiving public assistance (74 percent), and having current or previous involvement in the child welfare system (58 percent). The average age of the primary caregiver was 35 years old.

Age

Mean age

35 years

Sex

Female

35%

Race and ethnicity

Black or African American	20%
White, not Hispanic	44%
Hispanic or Latino of any race	31%
Another race	4%

The race and ethnicity categories may sum to more than 100 percent if the authors reported race and ethnicity separately; in these cases, we report the category White, rather than White, not Hispanic.

Family status

Parents	100%
Single parents	39%

Employment and public benefit status

Were employed	64%
Were unemployed	36%

Education

Had a high school diploma or GED	88%
Did not have a high school diploma or GED	12%

Specific employment barriers

Were experiencing homelessness

18%

Program implementation

Implementing organization:

Child First

Program history:

The Child First program started in 2011.

Program services:

Families in the program group received a hybrid version of the typical Child First program. The program consisted of care coordination, connecting families to available and relevant resources, and a trauma-informed program aimed at promoting executive functioning and healthy family relationships delivered by a trained clinician. Families had contact twice a week, either in-person or virtually, with a clinician and a care coordinator during the first month of enrollment, followed by weekly visits for the remainder of the program.

Mandatory services:

None

Comparison services:

Families in the comparison group were placed on an 18-month embargo that made them ineligible to receive Child First services and received a list of other available resources in their community.

Service receipt duration:

Families received Child First for an average duration of approximately eight months.

Program funding:

The study did not specify the program funding source.

Study publications

Xia, Samantha, Mervett Hefyan, Meghan McCormick, Maya Goldberg, Emily Swinth, and Sharon Huang (2026). Child First Home Visiting Impacts During the COVID-19 Pandemic: Evidence from a Randomized Controlled Trial, Journal of Family Psychology 40(1): 37-48. Available at: https://doi.org/10.1037/fam0001393

Xia, Samantha, Mervett Hefyan, Meghan McCormick, Maya Goldberg, Emily Swinth, and Sharon Huang (2026). Child First home visiting impacts during the COVID-19 pandemic: Evidence from a randomized controlled trial, Journal of Family Psychology 40(1): 37-48. [Online Supplement] Available at: https://doi.org/10.1037/fam0001393

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