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Helping families thrive while developing a strong working alliance: The benefits of Recipe 4 Success

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Infant Mental Health Journal

Published online on

Abstract

["Infant Mental Health Journal: Infancy and Early Childhood, Volume 47, Issue 4, July 2026. ", "\nAbstract\nThis study explored whether the strength of parent‐home visitor working alliances might alter the benefits of Recipe 4 Success, a highly structured food‐based curriculum designed to promote parents’ sensitive scaffolding, responsive food parenting practices, toddlers’ self‐regulation, and healthy eating habits. This study included 242 parents and their toddlers residing in the United States, most of whom were living in poverty (37% white, 25% Black, 19% Latiné, 17% Multiracial, and 2% Asian; median income = $1555 per month). Families were randomly assigned to Recipe 4 Success or usual practice home visits within home visitor caseload. Home visitors tended to rate their working alliance as very strong versus less strong. Within‐group regression equations revealed that, among families with a less strong working alliance, Recipe 4 Success was more effective than usual practice home visits in improving parents’ sensitive scaffolding, responsive food parenting practices, and toddlers’ self‐regulation. In contrast, among families who had a strong working alliance, Recipe 4 Success was more effective than usual practice home visits in changing toddlers’ healthy eating habits, including reducing body mass index for toddlers with overweight/obesity. These findings highlight how families with varying strengths of working alliances may benefit differently from highly structured evidence‐based curricula.\n"]