Opening doors: factors influencing the establishment of a working relationship between paraprofessional home visitors and at-risk families.

The purpose of this phenomenological study was to identify and describe factors that influence the establishment of a working relationship between paraprofessionals and at-risk families. In-depth, semi-structured interviews were conducted with a purposive sample of 6 family visitors and 6 public health nurses hired to visit at-risk families in their homes. Analysis revealed that nurses have an important role to play in marketing home visiting programs and facilitating family visitor access to the home. Factors related to the family visitor, the client, and the client's household influenced relationship development. Family visitor-client engagement occurred through "finding common ground" and "building trust." Increased understanding of these factors will help both nurses and family visitors to access those families who are hard to reach and resist support and the provision of services. The findings have implications for nurses who are responsible for hiring, training, and supervising family visitors.