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Taos First Steps Program

  • Need: Support for families that promotes early childhood development and the parent-child relationship.
  • Intervention: Home visits which provide information, support, and access to early childhood resources and tools for building relationships.
  • Results: Easily replicable program, even for rural areas, that result in growth in knowledge and self-sufficiency for families as they provide for and understand their child's earliest years.

A program of Holy Cross Hospital since 2007, Taos First Steps supports new families and promotes early childhood development and the parent-child relationship. New families are referred by various agencies, healthcare systems, or people can self-refer after hearing about the program themselves. A soon-to-be new family can enter First Steps as early as the mother’s pregnancy and can continue up until the child reaches his/her third birthday.

Taos First Steps logo

At the heart of the program is supporting the parent-child relationship. Home Visitors are trained to provide education, information, and access to early childhood development and for building that parent-child relationship. Home Visitors can come as often as once a week and are committed to being responsive to a family’s needs, priorities, and concerns. Working with the family to establish goals and then assisting with accomplishing them if appropriate are parts of Home Visitors’ duties. After collaborating with family members and ascertaining needs, Home Visitors make referrals to various organizations, agencies, and classes.

Taos First Steps staff
Taos First Steps staff celebrates 10 years of service in 2017

On an annual satisfaction survey, one Taos First Steps participant wrote, “My home visitor is so very helpful and provides alternatives to me when I am feeling most overwhelmed. She has been especially helpful as our family transitions and adapts to a new baby.”

Funding for Taos First Steps comes solely through the New Mexico Children, Youth, and Families Department (CYFD). In 2017, the program celebrated its 10th year of service to the community. With the current funding, they are budgeted to serve 150 families each year.

Services offered

Taos First Steps provides the following services for participants:

Taos First Steps participants group
Taos First Steps serves families of New Mexico.
  • Home visits provide information and support for developing the parent-child relationship.
  • Access to early childhood resources in the community
  • Preparation for parents coping with everyday stressors in order to build a strong family foundation
  • Classes to increase familial support and understanding of their children’s needs: Love and Logic parenting classes, infant massage, Birth Art, nutrition, ESL for Parenting, Parenting with Emotional Intelligence, and Circle of Security for Parents.
  • Referrals to various agencies or organizations addressing healthcare needs, behavioral health, and breastfeeding education and support
  • Group events at community locations: swimming pool, play dates, story time
  • For families with low incomes, providing assistance with accessing programs such as Medicaid, TANF (Temporary Assistance for Needy Families), food stamps, WIC (Supplemental Nutrition Program for Women, Infants and Children), housing

In fiscal year 2016-2017, 262 families were served and 2,366 home visits were completed. Of the 262 families, 56 were new to the Taos First Steps program. Most referrals come from healthcare providers and the WIC office.

Taos First Steps Home Visitors make service referrals to members of participating families. Of the 899 service referrals, one-fourth were for healthcare. The others comprised of referrals for early intervention, behavioral health, parenting classes, family and social support, and breastfeeding.

In the 2016-2017 annual satisfaction survey, 101 families (85% of families surveyed) responded. For the statement “My home visitor is responsive to my family’s needs and culture,” 94% of respondents indicated ‘Strongly Agree’ while the remaining 6% indicated ‘Agree.’

Home Visitor Beth Enson and First Steps Program Manager Jaci Imberger were authors of the following publications:

Enson, B. (2017). Weaving Emotional Intelligence into a Home Visiting Model. ZERO TO THREE, 38(1).

Imberger, J. (2016). Using the FAN Approach to Deepen Trauma–Informed Care for Infants, Toddlers, and Families. ZERO TO THREE, 36(6).

Imberger, J. (2016). Strengthening Reflective Capacity in Skilled Home Visitors. ZERO TO THREE, 37(2).

  • Consistently meeting the deliverables of the contract due to staff turnover
  • Providing consistent service to families
  • Providing ongoing education to community partners so they embrace the foundational aspects of the program

Partnering with local agencies, community partners, and supporters is key to a successful replication to this program. Referrals from participating agencies provide the majority of new families coming into the program and then also provide some of the services needed for these families.

Taos First Steps participating adult and child

Taos First Steps administrators are willing to contract out their services to other organizations that are considering the implementation of an early-childhood home visiting model in their community.

Staff presented a poster at the annual Zero to Three conference in November 2017 in San Diego. The poster outlined Beth Enson’s article on the history of Taos First Steps and discussed program replication.

View the Taos Health Toolbox for more resources and information.

Contact Information
Jaci Imberger, RN, BSN, IMH-E® II, Program Manager
Holy Cross Medical Center
Taos First Steps
Benefit enrollment and application
Children and youth
Community health workers
Hispanics and Latinos
Prenatal care and obstetrics
Wellness, health promotion, and disease prevention
States served
New Mexico
Date added
January 22, 2007
Date updated or reviewed
March 6, 2018

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.