Date of Award


Degree Name

Curriculum and Instruction


College of Education

Type of Degree


Document Type


First Advisor

Linda Spatig

Second Advisor

Ronald Childress

Third Advisor

LeAnne Olson

Fourth Advisor

Robert Angel


MIHOW, the Maternal Infant Health Outreach Worker Program, is a parent-to-parent home visitation program that aims to enhance early childhood development in economically disadvantaged and geographically isolated families with children from birth to three. This qualitative case study conducted in two rural Appalachian counties examined the perceptions and experiences of moms and home visitors regarding the influence MIHOW has on child development. Findings were interpreted in relation to extant literature on the prevention of developmental delays. Five themes emerged from the data. The first theme related to the developmental checklists and screening materials and moms’ understanding of how the checklists related to monthly growth and development. The second theme related to how moms characterize home visitors as “like a friend,” and the nature of peer relationships between home visitors and moms. The third theme was related to the frequency, consistency, and scheduling of home visits. The fourth theme related to concerns associated with lack of transportation and how this created a barrier for moms connecting with community resources. A lack of attention to social-emotional development was the fifth theme. The findings provide evidence that the program is helpful to parents in preventing, identifying, and treating developmental delays related to cognitive, physical, and communication. The program was not as effective with moms in preventing delays related to social-emotional.


Child development.

Early childhood education.