health promotion, home visitation, nurse-client relationship, program implementation



  1. Hanks, Carole DrPH, BSRN
  2. Kitzman, Harriet PhD, MSN
  3. Milligan, Rene PhD, MSN


Program designers and nurses developed and implemented the COACH Relationship Model to help low-income mothers change health-related behaviors as part of a clinical trial conducted from 1990 to 1994 of the impact of nurse home visitation. By first orienting the program nurses to the theoretical underpinnings (caring, ecological, role supplementation, and self-efficacy theories) and then involving them in developing program materials to translate the theoretical and philosophical concepts into nursing interventions, the essential features of the relationship model were retained through the implementation process.