The development of the Promoting First Relationships home visiting program and caregivers' comments about their experiences across four RCT studies.

Promoting First Relationships (PFR) is an evidence-based home-visiting program for caregivers and their children from birth to age 5 years. It focuses on caregiver-child interaction, attachment, and relationship quality using video feedback of unedited recordings to elicit reflection and provide positive feedback linked to knowledge development. This paper provides a brief history of PFR and reports on a qualitative study of 222 caregivers' comments about their PFR experiences following participation in one of four randomized controlled trials conducted over the past decade in the United States (two studies within child welfare setting, one study with Native American families, and one study with Spanish and English-speaking mothers), using a thematic analysis approach to code excerpts from written satisfaction surveys and oral satisfaction interviews. Caregivers' comments about PFR were positive and were classified into four major thematic areas: a caring, trusting relationship with the provider; enthusiastic program endorsement; improved relationship with their child; and reports of their personal growth and development. The qualitative results align with the key components of the PFR program and confirm aspects of the PFR theory of change model.