Save self-assessment
Generate self-assessment report
The Hexagon: An Exploration Tool
The Hexagon can be used as a planning tool to guide selection and evaluate potential programs and practice for use.
Click on each segment for more details
Core Components
Family Foundations is aimed at parents who are expecting their first baby and in the second or third trimester and are committed to raising the baby together. This can include same sex couples, non-cohabiting couples and couples where one person in the couple is already a parent. There is a slightly adapted programme for parents who enrol right after the infant’s birth.
The programme is delivered over eight sessions (four sessions before the birth and four post birth) lasting about 1 ½- 2 hours. Parents learn through a variety of group exercises, role play, couple discussion and homework activities. The programme content includes:
• Conflict resolution
Fidelity
Fidelity is obtained by self-report feedback forms completed by the group facilitators at the end of each session and observation forms completed by a supervisor or trained observer.
Modifiable Components
The programme has been adapted for delivery to a UK population with guidance from the programme developer. Adaptations include anglicising the film vignettes and adding content to the division of labour section to make them more father inclusive.
Family Foundations was developed in the USA by Prof. Mark Feinberg. Training is available in the UK by the Fatherhood Institute and is delivered over 3 days.
Support for Organisation / Practice
Implementation Support
The Family Foundations training programme is available in the UK from the Fatherhood Institute, who hold a licence to deliver training. Training is usually delivered in-house, with the commissioner identifying the practitioners to be trained. In addition to initial training and the provision of materials; implementation advice, such as recruitment to the programme and ongoing delivery, can be obtained from the programme developer and the Fatherhood Institute.
Data
The programme does not have a mandatory data management system, but advice can be given to sites should they wish to develop this. Data collection and storage is the responsibility of the implementing site.
Start- up costs
Start-up costs are currently under review and updated pricing will be available in the new year. Initial costs include training for a cohort of 10-20 practitioners, training materials, parent workbooks, supervision and a licence for the first 2 years of delivery.
Building Staff Competency
Qualifications Required
It is recommended that practitioners have level 3 qualifications (A level and above) and have experience in delivering groups. Facilitators come from a range of early years services including health and maternity services, early education, family support services and voluntary sector agencies.
Training Requirements
Training is usually commissioned and delivered to agencies on site. Cost will vary depending on the size of the cohort.
Supervision Requirements
It is recommended that an experienced supervisor from the commissioning site attend the training and can provide supervision to practitioners.
There are multiple evaluations of the Family Foundations programme demonstrating sustained intervention effects on parenting and child outcomes. There has also been an evaluation of a 2-year trial of the programme in the UK.
Theory of Change
The programme focuses on the co-parenting relationship to assist parents to work together supportively to promote healthy family relationships. The Family Foundations logic model, supported by empirical research, posits that improved parental self- regulation and co-parenting skills will help parents better manage environmental stressors and reduce parental stress, thereby improving parenting quality.
Parents work on improving their communication skills and conflict resolution strategies and learn to respond sensitively to their child. Parenting strategies also include an understanding of temperament, fostering children’s self-regulation and promoting attachment security. Enhancement of the co-parenting relationship positively impacts upon the child’s capacity to self-regulate and improve social and academic competence.
Antenatal / Perinatal: from conception to birth - Rating: 4
Research Design & Number of Studies
There are two RCT’s carried out in collaboration with the programme developer that have been shown to demonstrate the highest level of evidence for the Family Foundation programme. Further analyses of these RCT’s have shown sustained child and parent outcomes.
Outcomes Achieved
Child outcomes
Infants in the intervention group had a longer duration of attention and reports by father of greater soothability at age 6 months.
Intervention children displayed significantly higher levels of self- soothing at age 1yr.
Intervention boys displayed lower levels of behaviour problems, emotional and externalising problems.
Intervention children demonstrated better social competence and greater attentional control.
Significant improvement in sleep with less night-time wakening at 2 yrs follow up.
Parent outcomes
Significant decline in maternal depression and anxiety at 6 months post intervention.
Significant positive effect for both mother and father report of co-parental support and for father report of parenting-based closeness at 6 months post intervention.
Parents demonstrated less co-parental competitive behaviours and triangulation at 1yr post intervention.
Fathers showed higher levels of co-parental warmth and less parenting negativity at 1yr post intervention.
Intervention parents demonstrated significantly higher levels of positive parenting at 1yr post intervention.
Significantly greater triadic relationship quality at 2 years post intervention.
Reduced family violence (couple and parent-child aggression) at infant age one year.
A service evaluation of a 2-year UK trial of the programme (Garrat, 2014) reported the following outcomes:
Couples valued the course, with fathers reporting high levels of satisfaction with all aspects of the course.
Facilitators valued inter- agency working and the opportunity to work with other professionals.
The report emphasises the need for health and early years services to work in collaboration to obtain the best outcomes.
Key References
Feinberg, M.E., Jones, D.E., Roettger, M.E., Solmeyer, A. & Hostetler, M.L. (2014). Long-Term Follow-Up of a Randomized Trial of Family Foundations: Effects on Children’s Emotional, Behavioral, and School Adjustment. Journal of Family Psychology 28, (6), 821– 831.
Jones, D.E., Feinberg, M.E., Hostetler, M.L., Roettger, M.E., Paul, I.M. & Ehrenthal, D.B. (2018). Family and Child Outcomes 2 Years After a Transition to Parenthood Intervention. Family Relations 67, 270–286.
Garrat, J. (2014). Laying the right foundations: Supporting team parenting through pre and post- natal support. Experiences and observations from a two-year trial of the Family Foundations parenting programme in the UK. International Journal of Birth and Parent Education, 1,(3), p.43.
Infants and Toddlers: 0-36 months - Rating: 4
Research Design & Number of Studies
The best evidence for children in the 0-36 months age range is the same as for the antenatal age range above.
Need
Comparable Population
Family Foundations is a universal, preventative programme aimed at couples expecting their first child. It can also be delivered to targeted groups such as couples living in poverty, where there are difficulties within the interparental relationship and teenage parents.
Are expectant parents a specific priority for your organisation? Desired Outcome
Family Foundations aim to improve the co-parenting relationship to reduce parental stress and depression/anxiety, improve parenting quality, enhance parent-child attachment security and ultimately improve children’s self-regulation, social and emotional functioning, mental and behavioural health and educational functioning.
Is an improvement in parental mental health, parent-infant relationship and attachment security, and long-term child development adjustment, a priority for your organisation? Are there other initiatives that are targeting the co-parenting relationship in your area that are inherently father inclusive?
Need Score
Select a rating
1
2
3
4
5
Fit
Values
Family foundations believes in empowering families and sees the family as the expert on what works best for them. The materials provided have therefore, been developed to provide flexibility to suit each family’s needs. This includes couple skill building exercises as well as group activities. The programme aims to support couples become a strong cohesive, nurturing team to support the development of the child.
Is the delivery of the Family Foundations programme aligned with the key values and priorities of your organisation? Priorities
The programme is a universal, prevention programme aimed at improving child and parent outcomes by focussing on and improving the quality of the co-parenting relationship.
Is working with parents of babies and young children in an early intervention approach a priority for your organisation? Are improvements of children’s development, learning and mental and behavioural health, a priority for your organisation? Is improvement of maternal mental health a priority for your organisation? Existing Initiatives
Family Foundations suggest that the programme can easily be embedded in existing ante natal classes.
Does your organisation already deliver early intervention programmes that focus upon the improvement of the child’s development and parent and child mental health outcomes? Are there other early education programmes available that would complement the delivery of Family Foundations?
Fit Score
Select a rating
1
2
3
4
5
Capacity
Workforce
Family Foundations should be delivered by two trained facilitators with experience in delivering groups. Ideally, this should be a male/female combination, but it is not a requirement.
Do you have staff with the relevant experience to deliver this programme? Does your agency have capacity for practitioners to have dedicated time to deliver the programme? The programme is split into two delivery phases; ante-natal and post-natal.
To ensure the full programme is delivered, can you ensure staff are able to support parents to complete the programme? It is recommended that agencies work in partnerships with ante-natal health services to ensure a robust referral process is in place. Evaluations from the Fatherhood Institute have found the best UK model of delivery comprises of one health and one early years practitioner.
Does your organisation work in close partnership with ante natal services? Technology Support
Practitioners need access to drop box/ you tube to download the materials required to deliver groups. Practitioners will also need to film and upload videos of their practice for review in supervision.
Do you have the technology to support practitioners to access these tools necessary for group delivery and effective supervision? Administrative Support
Family Foundations recruitment requires one to identify suitable couples in the ante natal stage to engage with the programme.
Do you have sufficient administrative support to identify parents, manage referrals and arrange follow up in the post-natal period? Financial Support
Training in the programme is over 3 days and is usually delivered on site. The cost of training is dependent on the size of the cohort being trained. Trainer's travel and accommodation will need to be included in the cost of training.
Ongoing costs to the organisation include practitioner time and resources such as group room and hospitality for parents.
Do you have funds available for training and any required materials? Do you have finances to cover these recurring group delivery costs?
Capacity Score
Select a rating
1
2
3
4
5