bond with others, and this drive is reinforced by attentive parenting. Further, it is the child–caregiver relationship that shapes a child's development, making the quality of parental care in early childhood vital. Attachment theory is used in NFP in two ways. First, it is used to encourage mothers to bond with their children (e.g., explaining that infants learn to recognize mother's voice in the womb, pointing out when the child expresses trust in and dependence on the mother). Second, it is used to inform the nurse's relationship with the mother to build trust, and to model the skill. Goals NFP nurses work with mothers and families to achieve three major goals, which include improving: "1) the outcomes of pregnancy by helping women improve their prenatal health; 2) children's subsequent health and development by helping parents provide competent care; and 3) women's own health and self-sufficiency by helping them set goals for themselves and take steps to accomplish those goals, including planning the timing of subsequent pregnancies." Based upon such positive results from early clinical trials NFP was implemented across the United States in 1996 and contributed to the inclusion of funding for maternal and infant home visiting in the Affordable Care Act, of 2010. The NFP National Service Office (NSO) does provide support and training to NFP accredited sites to ensure adherence to the NFP model in addition to monitoring program implementation and outcome for quality improvement purposes. Target demographics NFP targets low-income, first-time mothers, following the idea that the best time to teach health and development behaviors is during the mother's first pregnancy. This also gives time for mothers to work on potentially problematic behaviors before interacting face-to-face with the child. The mothers are often young and single; based on data collected from 1995 to 2017, the mothers in the program had a median age of 20, and 84% were unmarried. Additionally, 57% had completed high school, and the average yearly income was $9,000. While NFP was developed to target mothers, the program welcomes fathers, partners, family members and close friends, to participate. The goal is to ensure that everyone who will be supporting the baby and ideally forming close attachments with him or her will be well-equipped to do so. Intervention delivery Length and timing Clients enroll in the program early in their pregnancy (usually during the first trimester) and continue until the child's second birthday. Ideally, the