Introduction to Precision Research

Home visiting provides critical, voluntary services to families so they can support their children in the earliest stages of life. Home visiting can improve child outcomes by building supports and reducing stressors that affect parenting. Decades of scientific research and evaluation have shown that home visits by a trained professional can improve the lives of children and families.

Much home visiting research and evaluation has compared the outcomes of families who receive home visiting services against the outcomes of families who do not. Such studies often show that families engaged in home visiting do better than their peers on average. What they do not show is that some families receive fewer benefits than other participants, some do not benefit at all, and some may even be worse off than they were before receiving services. To strengthen home visiting’s benefits for ALL families, we need a different approach to research. We need to answer the question: What works best, for whom, in which contexts, why, and how? Precision home visiting research and evaluation can help identify what aspects of home visiting are most effective in meeting families’ needs depending on their circumstances and preferences.

Home visiting cannot address all needs that families have and, as such, will always offer only a partial solution to what a family may need to care for their children. However, precision research can help us better understand the variation among program participants and the communities in which they live to maximize the odds that home visiting will realize optimal outcomes for families. Precision research can also help us better understand what home visiting can accomplish and how it fits within broader systems of care.

The Precision Paradigm provides a useful framework for the next generation of home visiting research and evaluation that will help the field:

• Address unanswered questions about what works best for which families and in what contexts
• Identify the elements of a home visiting program that are essential to achieving desired outcomes
• Develop and test adaptations of interventions for specific populations and contexts
• Match families to the best possible interventions to meet their individual strengths, needs, preferences, and desired outcomes.
• Better understand home visiting’s unique contributions in buffering the effects of family adversity within the broader social, economic, and environmental context
• Speed up the pace of learning and using knowledge to inform program improvement and policy

Precision research can help the field advance toward equity in home visiting access, implementation quality, and outcomes, but doing so will require meaningful collaboration among families, practitioners, researchers and evaluators, policymakers, and other interested groups.