Maternal Early Childhood Sustained Home-Visiting Program (MECSH) Lessons Learned


Two of the three studies reported lessons learned about implementing the program.

One study’s authors found no differences between first-time mothers and multiparous mothers on a number of outcomes, suggesting that the benefits of home visiting programs are not limited to first-time mothers.

One study examined successful approaches to establishing a trusting partnership with families in which they feel comfortable sharing sensitive personal information. The study described the following lessons.

  • The relationship involves a constant give and take between the nurse and the family. The home visitor responds to a family’s display of trust by providing additional practical support. The nurse may also reciprocate by sharing some of her personal experiences.
  • The home visitors need to cultivate the skill of being “actively passive.” Through patient, unobtrusive observation, the nurse becomes attuned to the family’s signals.
  • The family is the initiator in the relationship. The mother decides when and how much information she wants to share with the home visitor. She cannot be pushed into divulging personal information and should not be punished for choosing not to share.
  • The disclosure of personal information is not necessarily a sign that the nurse has been able to establish a trusting partnership with the family. Families may share information if a relationship has not been established or choose not to disclose information if they have established a trusting relationship with the home visitor. The critical element is that the family is able to speak with someone, whether it is the nurse or someone else, about their personal issues.
  • The families, not the nurses, choose their goals and strategies. The continuity of a sustained relationship is also important to the development of a trusting partnership.