Friend, foe or facilitator? The role of the parent-service provider relationship in the early implementation of a family-based community intervention

Early home visiting intervention programmes have been associated with greater familial well-being, yet their success depends on attaining engagement from the outset. Implementation practices, central to positive programme outcomes, rely on a strong relationship between programme providers and families. The present study explored the role of this relationship in the implementation of an Irish early childhood intervention. A randomised controlled trial of the Preparing for Life (PFL) programme was conducted in disadvantaged Dublin communities involving 233 participants recruited during pregnancy and assigned to a high or low intervention group. High intervention involved regular home visits from a trained home visitor providing parenting support and information. This study presents qualitative findings from focus groups with high intervention parents (n=11) and interviews with home visitors (n=5) conducted when participating children were on average 5 months old. Though early engagement challenges were identified, in time parents noted the strengthening parent-home visitor relationship. Findings highlight the importance of programme flexibility and parent-home visitor rapport to programme engagement. Wellbeing did not arise as a salient theme, though it may emerge as a longer-term programme outcome. These findings reveal key aspects of early implementation which may contribute to the ultimate success of the programme.