Precision home visiting is home visiting that differentiates what works, for whom, and in what contexts to achieve specific outcomes. It focuses on the components of home visiting services rather than on complex models of home visiting that are administered uniformly.
Precision home visiting is akin to precision medicine and precision public health. Within medicine, there has been a push toward customizing treatments so that they are more effective and efficient. In precision medicine, patients receive the treatment that is most likely to be effective in light of their genetic make-up and other characteristics, and researchers work toward developing the most efficient of those treatments.
Precision public health customizes interventions in the same way—by determining what interventions are most effective for different groups, and working toward the most efficient of those. Home visiting, as a public health intervention, must consider not only the individual, but also his or her social and cultural context.
A focus on high-risk communities
The MIECHV Program wants states and territories to focus on high-risk communities and high-priority families who, by definition, face certain kinds of hardships. But families enrolling in home visiting differ in important ways—beyond economic, social, or health status—that are likely to affect which services they need and how service options should be offered to them. For example, parents’ cognitive functioning may vary, as may their comfort in working with service providers and their preferences for shared decision-making regarding services and goals. One family may be more aware of their needs than another, and some may be ready for or want the things home visiting may offer, while others will not.