Studies have identified home visiting programs consisting of structured visits by a professional over an extended period of time during the perinatal period, as a potentially effective means of prevention of child abuse. In 2001, a new intensive home visiting service was established at 48 GP practices across 2 counties. The home visiting begins up to 6 months before birth and continues for 12 months after the birth. It comprises weekly visits from a home visitor that has received training in the parent advisor model and strategies for enhancing parent-infant interaction. Studies show that the effectiveness of such programs depends on the population selected, the success with which the skills of the staff have been matched to the needs of the family, and the duration of the program. The new service aims to incorporate as many of the core design characteristics as possible to increase the likelihood of success in child abuse prevention. The program is concerned with taking a positive stance towards the parents without being judgmental. Training of the home visitors involved theoretical framework and skills of effective parent counseling based upon the partnership model; risk factors of child abuse; the needs of parents and infants; and methods of promoting maternal empathy. Clinical supervision sessions are to provide home visitors with the opportunity to discuss individual families and concerns; help home visitors work in more effective ways; and to explore the impact of the work on themselves. One of the biggest challenges in the development of the service was finding an effective means of engaging hard-to-reach families. The home visiting service is currently being evaluated as part of a randomized controlled trial in which families are randomly allocated to receive the intensive home visiting service or the standard service. The effectiveness of the service is being assessed in terms of its ability to improve a range of parent and infant outcomes, including maternal attitudes, self-esteem, and social support. 2 tables, 45 references