Overview

A key objective of HARC is to promote active engagement in conceptualizing, designing, and implementing studies among all groups with an interest in building home visiting evidence. This includes groups such as researchers and evaluators, home visiting models, tribal and state leaders, policy makers, local program staff, and families. HARC is building the Precision Paradigm to support active engagement in collaborative research. This includes developing a shared language to support relevant research that produces meaningful results to guide program improvement and policy.

What is the Precision Paradigm?

The Precision Paradigm is a framework for organizing and defining concepts and how they are related to one another, also known as an ontology. Specifically, the Precision Paradigm defines seven concepts (shown in the diagram above) and the relationships between them. The overall purpose of the Precision Paradigm is to guide home visiting research and evaluation that helps us understand what works for whom, in which contexts, why, and how.

Concepts within ontologies can be further broken down into taxonomies. Taxonomies are menus of options, or ways to classify key aspects of home visiting. Options are described using clear and commonly understood terms and organized in meaningful groupings. Concepts, taxonomies and options are the language of the precision paradigm. Having a shared language makes it easier for research collaborators to communicate with one another when developing, describing, comparing and  or testing interventions within home visiting interventions. As an example, HARC is developing detailed taxonomies of home visiting intervention techniques and methods of delivery. HARC is developing these taxonomies using existing literature and input from individuals and groups with experience in home visiting and closely related fields.

The Precision Paradigm can help research collaborators see clearly how aspects of interventions within home visiting are expected to improve a specific outcome in a specific context. As the diagram above shows, the Paradigm highlights how theory, evidence, and home visiting experience can guide our understanding of home visiting interventions and our development of priority topics to address through research and evaluation. It also shows how change is expected to occur. Using the taxonomies, or menus of options, users might consider…

• An intended home visiting outcome
• The behaviors needed to achieve the outcome
• The mechanisms through which those behaviors are thought to occur
• Aspects of the intervention, including content, delivery, and tailoring
• How aspects of usage, such as reach and engagement in the intervention, might influence effectiveness
• How context can influence both usage and intervention effectiveness

How and by whom is the Precision Paradigm meant to be used?

The Precision Paradigm is most useful for developing and testing interventions or adaptations of interventions within home visiting that aim to promote individual or family-level outcomes by promoting specific behaviors such as responsive parenting, breastfeeding, or seeking postpartum care. As such, it draws heavily from existing evidence and ontologies related to behavior change interventions.