Precision Home Visiting: New Ways of Thinking, Conceptualizing Research and Program Development

Precision medicine aims to identify treatments that target individual patients on the basis of genetic, biomarker, phenotypic or psychosocial characteristics (Augisti et al, 2015). Precision public health aims to improve society’s ability to prevent disease and reduce disparities through better surveillance and targeted policies and public health interventions to improve overall population health (Khoury, 2015). In order to achieve efficient and effective outcomes from prevention science, the field should consider how these concepts may apply to the design and testing of prevention science programs. One group attempting to apply these concepts to prevention science is the Home Visiting Applied Research Collaborative (HARC R&D), a national home visiting research and development platform. It aims to transform the field of home visiting by using innovative methods, such as breakthrough impact research, and building the evidence base for precision home visiting. Precision home visiting is the differentiation of what works, for whom, in what contexts to achieve specific outcomes. Precision home visiting, therefore, means individualizing the content and style of home visiting to each family’s unique circumstances in order to achieve meaningful outcomes efficiently. The purpose of this roundtable is to discuss the concepts behind precision medicine and public health, how they may apply to prevention science, and more specifically precision home visiting as an exemplar. While in the abstract the idea of precision prevention science may appear to align with current prevention science, the team has discovered that developing a common understanding of what are precision research questions, what methods should be used to test precision research questions, and how precision home visiting may be implemented at scale has been complex and thought-provoking. Each of the speakers will briefly discuss the topic and then open the conversation to the audience. The first discussant will present the concepts of precision medicine and precision public health as a platform for the discussion. The second discussant will present the definition of precision home visiting and provide some examples of the kinds of questions precision home visiting research aims to answer. The third discussant will discuss some of the research methods that align with the principles of precision home visiting. The fourth discussant will provide examples from their own research that align with the definition of precision home visiting. The final discussant will present the impetus for research and development center on precision home visiting from the perspective of HHS and how precision home visiting fits within the national research funding priorities.