Implementing Maternal Early Childhood Sustained Home-Visiting Program (MECSH) Meets HHS Criteria

Implementation last updated: 2020

The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the research reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Similarly, models described here may not all have impact studies, and those with impact studies may vary in their effectiveness. Please see the Effectiveness button on the left for more information about research on the effectiveness of the models discussed here.

Prerequisites for implementation

Type of implementing program

MECSH is implemented by organizations providing maternal, child, and family health and social services. Implementing agencies must have existing mechanisms, such as a population assessment and referral pathways, to identify and enroll eligible families.
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Staffing requirements

The MECSH model is implemented by a team of nurses, a nurse coordinator, supervisors, managers, and administrative staff. A program site must be supported by health and human services professionals, including social workers, perinatal psychiatrists, dieticians, and drug and alcohol counselors.
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Staff education and experience

Home visits are provided by registered nurses with a bachelor’s degree (or equivalent) and experience with and postgraduate training in child and family health nursing (or equivalent). Supervisors must be formally trained and/or have extensive experience with reflective clinical practice, a process of contemplating experiences while they are happening and retrospectively. Health and human services professionals who support the program site must be trained to meet their profession’s local registration requirements. The developer does not have minimum requirements regarding the education or experience of management staff; agencies implement MECSH using their existing management systems.
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Supervision requirements

The developer requires that nurse home visitors receive monthly team supervision, and recommends monthly individual supervision (with more frequent sessions for staff new to the MECSH model) to support reflection on clinical practices that the nurses deliver in the home. Clinical supervisors should oversee the home visitors and managers should provide supervision related to program management.

The ratio of supervisors to home visitors is based on the home visitor team structure and supervisor arrangements for each program site.

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Staff ratio requirements

Full-time nurse home visitors manage a caseload of up to 30 families. Part-time home visitors and those with a higher proportion of families with very complex needs, or with families in rural areas that require additional travel time, have smaller caseloads. Caseloads should include a mix of families at varying program stages. The developer suggests 6 prenatal families, 6 families with children 0 to 6 months old, 6 families with children 6 to 12 months old, and 12 families with children older than 12 months.
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Data systems/technology requirements

MECSH requires a data system to record key fidelity measures, including client eligibility, recruitment, retention, model delivery, and client impact. The data system should be established within the administrative data systems of the agency implementing the model.
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Implementation notes

The information contained on this page was last updated in July 2020. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Dr. Lynn Kemp at the Western Sydney University on February 21, 2020. HomVEE reserves the right to edit the profile for clarity and consistency.

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