Supporting early social and emotional relationships through a public health parenting program: The legacy for children™ intervention

This chapter describes a group-based public health approach to prevent developmental delays associated with poverty by supporting positive parenting. Legacy for Children™ (Legacy) is designed to support sensitive, responsive mother-child relationships, build maternal self-efficacy, and foster peer networks of support among mothers living in poverty. Legacy groups start during pregnancy or infancy, and mothers in the group all have children within several months of the same age. Mothers can attend the group until their children are age 3 or 5 years, depending on the curriculum version. As the children age, the curriculum covers developmentally appropriate topics such as attachment, discipline, maternal self-care and stress reduction, reading and literacy, safety and nutrition, and promotion of child social skills. Randomized controlled trial (RCT) data from Legacy indicate intervention effects 3-6 years post-intervention for child socioemotional and cognitive outcomes. Legacy is currently being implemented in sites across the United States in a variety of infrastructures: child care, health care, and community-based organizations. Implementation has been supported by the Centers for Disease Control and Prevention (CDC) through training and technical assistance. Legacy has been adapted and translated for Spanish speakers; implementation and evaluation of Legacy for Spanish-speaking mothers is underway. Implementation, scalability, and next steps for the program are discussed as well as the importance of a developmental focus in programming.