Date of Award


Degree Name

Curriculum and Instruction


College of Education

Type of Degree


Document Type


First Advisor

Luke E. Lassiter

Second Advisor

Linda Spatig

Third Advisor

Ronald B. Childress

Fourth Advisor

Karen McComas


MIHOW, the Maternal Infant Health Outreach Worker Program, is a parent-to-parent home visitation program that aims to enhance early childhood development and parent education in economically disadvantaged and geographically isolated families with children birth to three. This qualitative case study conducted in two rural Appalachian counties examined the perceptions and experiences of paraprofessionals who are trained and work as home visitors in the MIHOW Program. Findings were interpreted in relation to extant literature on the use of paraprofessionals in home visitation. Three themes emerged from the data. The first theme related to the use of a strength-based approach and how it was implemented with mothers and with home visitors. The second theme related to the personal and professional support home visitors provided one another. The third theme was related to the training of the home visitors and how it was prescribed but yet customized. The findings provide new evidence that home visitors within the MIHOW program felt their training was effective and adequate to carry out MIHOW’s mission, its principles, and its strategies.


Early childhood education -- Appalachian Region.

Home care services -- Employees.