Triadic Interactions in MIECHV: Relations to Home Visit Quality




Carla A. Peterson, Kere Hughes-Belding, Neil Rowe, Liuran Fan, Melissa Walter, Leslie Dooley, Wen Wang, and Chloe Steffensmeier

Brief Type

Journal publication


  • Early Head Start Home-Based Option
  • Home Instruction for Parents of Preschool Youngsters (HIPPY)
  • Nurse-Family Partnership (NFP)
  • Parents as Teachers (PAT)


Objectives: This study was conducted to look inside home visits to examine active intervention ingredients used and their relations with ratings of home visit quality. In particular, triadic interactions that engage the home visitor, parent, and child together and provide a context for home visitors to facilitate parent-child interactions by observing, modeling and coaching behaviors that promote optimal child development were examined. Methods: Observations were conducted to describe intervention activities (with the HVOF-R) and rate quality of home visit practices and engagement (with the HOVRS A+). Results: Analyses revealed the majority of home visit time (71%) was spent in home visitor-parent interactions with only a small proportion of home visit time (17%) spent in triadic interactions and an even smaller proportion of time (2%) during which home visitors actively coached parent-child interactions. Amount of time spent in triadic interactions was related positively to quality ratings of home visit practices and engagement. Moreover, time spent coaching parent-child interactions uniquely predicted home visit quality after accounting for visit length and home visitor time spent observing and modeling. Conclusions for Practice: Increasing the percentage of home visitors engage the parent and child in triadic interaction should be a focus for home visiting programs. Home visitors will likely need professional development and supervisory support to enhance their skills in coaching parent-child interactions during triadic interactions. (author abstract)

Data Collection Methods

  • Home Visit Observations
  • Program administrative record reviews
  • Standardized assessment tools



For More Information

Peterson, C. A., Hughes-Belding, K., Rowe, N., Fan, L., Walter, M., Dooley, L., ... & Steffensmeier, C. (2018). Triadic interactions in MIECHV: Relations to home visit quality. Maternal and Child Health Journal, 22(1), 3-12. https://doi.org/10.1007/s10995-018-2534-x
Author Contact Information:
Carla A. Peterson


  • Participant, Family, and Program Outcomes
  • Program Quality, Continuous Quality Improvement, and Fidelity