December 2021 Board of Health Meeting - Legacy for Children™- An Evidence-Based Parenting Program for Windsor-Essex County Information Report

Meeting Document Type
Information Report
Legacy for Children™- An Evidence-Based Parenting Program for Windsor-Essex County


Healthy Families Department


December, 2021


COVID-19 Surveillance and Epidemiology


The quality of parenting children receive during infancy and childhood has a significant impact on their development, well-being, and life opportunities. Positive parenting practices provide children with many developmental and life advantages such as secure attachment, higher academic achievement, and improved physical health to name a few. Positive parenting practices are associated with reduced risk of substance misuse problems and anti-social behaviors among children and youth, and can buffer children from the consequences of other hardships (e.g. the stresses of living in poverty).

Local data pertaining to child poverty, and school readiness identify that positive parenting interventions need to be a priority for the vulnerable in our community. As well, the Mental Health Promotion Framework (WECHU, 2019) identified the domain related to family, including parenting style as a key area for future intervention.

Poverty remains a significant issue children face in Windsor- Essex County. Approximately, one in four (26%) children under 5 years live in low-income households (Windsor-Essex County Health Unit, 2019). This proportion is higher than any other age group, and the proportion of children under age 5 living in low-income is higher than the provincial average (19.8%) (Windsor-Essex County Health Unit, 2019). Children living in low-income households are at greater risk for poor outcomes related to healthy and growth and development (Perou et al., 2019).

Research has identified that warm, sensitive parent-child relationships and positive parenting practices play an important role for children’s readiness for school (Welsh, 2014).  Local Early Development Instrument (EDI) data (2017/2018) indicated 28.1% of kindergarten students were vulnerable in at least one of the five early development domains (i.e., physical health and well-being, communication skills and general knowledge, emotional health and maturity, social competence, and language and cognitive development).

Additionally the COVID-19 pandemic has had a significant impact on supports and services for parents and young children. Many of the supports and services that families rely upon were cancelled, delayed or reduced during the COVID-19 pandemic. As well, public health measures such social distancing impact the development of many skills for children, including socialization and self-regulation.


Legacy for Children™ is an evidenced-based, parent-focused program geared towards low-income, low-resourced mothers of infants and young children. The Legacy model was developed by the Centers for Disease Control and Prevention (CDC). Legacy aims to positively influence child development by: promoting sensitive and responsive mother-child interactions; enhancing maternal self-efficacy; and promoting a sense of community. Research through a randomized control trial has shown that children whose mothers participated in Legacy had significantly higher cognitive scores, and experienced fewer behavioral and social emotional problems than non-legacy children.

Legacy is a three- year program, offered in a group setting starting ideally in the third trimester of pregnancy, and ends when the child reaches age three. Each Legacy group meets for 2 hours per week. In addition, the program includes one-on-one time (e.g., home visits, phone calls) between program staff, (referred to as the Intervention Specialist) and the participant during program breaks. This is an opportunity for the Intervention Specialist to reinforce curriculum content, and provide extra support to participants.

Legacy is facilitated by Intervention Specialists, who are trained by University of California, Los Angeles and CDC.  To date, some Healthy Families’ Public Health Nurses and Social Workers have been trained as Intervention Specialists.  The Intervention Specialists use a variety of techniques during group sessions: videos, slides, role-playing, structured discussion activities, etc.

Starting in February 2022, the Healthy Families Department will be partnering with Connections Early Years Family Centre (Connections) to pilot a hybrid model of Legacy due to the pandemic. The plan is to have 8 participants in-person with the two Intervention Specialists at Connections, and roughly 7 participants online for a total of 15 participants. The WECHU will work through existing partners to assist with identifying and recruiting potential participants including: Healthy Babies Healthy Children prenatal clients, Building Blocks for Better Babies, WECHU’s Nurse Practitioner, local Obstetricians, Windsor-Regional Hospital Social Worker(s), Connections, Ready Set Go, Windsor Youth Centre, VON Immigrant Health Centre, Children First, etc.

Connections is supporting the pilot by providing their facility in-kind, and offering child care to in-person participants needing child care. The child care will be provided by Connections’ Early Childhood Educators.

In addition, a Legacy Stakeholder Advisory Committee has been established to provide guidance and support to WECHU in the implementation of the Legacy program in Windsor- Essex County. The scope of the committee will be to: assist with recruitment and retention of participants, inform and guide evaluation, and provide recommendations for future sites based on community needs.

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