Through close collaboration with the Rhode Island Department of Health (RIDOH) and the Rhode Island Department of Children, Youth, and Families (RI DCYF), we will capitalize on established infrastructure to innovate and enhance a statewide short-term home visiting program. Our primary prevention program, Enhanced First Connections, will draw upon an infant mental health perspective to provide prenatal infant and early childhood mental health consultation in the context of the home visiting program. We will focus on a selected high-risk population, mothers with a history of adversity or trauma, with the goal of preventing adverse childhood experiences (ACES) exposure among infants. Primary outcomes of the randomized control trial (RCT) will include the prevention of child maltreatment (child abuse and neglect) and exposure to adult intimate partner violence. Secondary outcomes of the RCT will include increases in family engagement in longer-term evidence based home visiting programs, increases in family engagement in specialized support services to address maternal adversity and trauma, reductions in maternal risk factors, and the promotion of positive parenting and the parent-child relationship.