Cuomo served as First Lady of
New York State, where she was highly active in advocating for women, children, and families. She created initiatives that mentored children at-risk, facilitated finding long-term homes for foster children, and strengthened families through providing education, as well as nutrition and immunization programs. The state-run program served over 10,000 students and was active with Cuomo as chair until 1995. After the New York State program was discontinued, she transitioned the initiative into Mentoring USA, an international nonprofit child advocacy organization creating mentor relationships for youth ages 7–21. The New York State Mentoring Program was reinstated in 2015. Her mentorship book, first published in 1999, was reprinted in 2002 and 2012 featuring a foreword by
Hillary Clinton, and in 2016 was recorded as an audio book. Cuomo has appeared on the
Oprah Winfrey Show to discuss her work in support of mentoring programs. Cuomo co-chaired the Governor's Commission on Child Care and chaired the NY Citizens' Task Force on the Prevention of Child Abuse and Neglect. She led New York's role in the UN's World Summit for Children in 1990 and the USA's ratification of the UN Convention on the Rights of the Child. ==Awards and recognition==