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The Precision Paradigm

The Precision Paradigm

Precision Paradigm – Key Resources

Using the Precision Paradigm in State-Led Evaluations

MIECHV Coordinated State Evaluation awardees are encouraged to develop evaluation plans that reflect the principles of precision home visiting.  HARC’s Coordinating Center prepared a guide to support awardees and other research teams in designing studies to promote precision in home visiting services and implementation systems.

Theories of Behavior Change

In November 2021, we surveyed 100 intervention researchers regarding Theories of Behavior Change.  Our survey asked researchers about their familiarity with a set of 48 theories and how they would rate the quality and relevance of theories familiar to them.  The first report of results can be found here.

Mechanisms of Action

In March 2022, we surveyed 116 intervention researchers regarding Mechanisms of Action.  Our survey asked researchers to rate the clarity, uniqueness and relevance for home visiting precision research for each of 26 mechanisms of action.  The first report of results can be found here.

Theories of Behavior

In April 2022, we surveyed 112 intervention researchers regarding Theories of Behavior.  Our survey asked researchers about their familiarity with a set of 34 theories and how they would rate the quality and relevance of theories familiar to them.  The first report of results can be found here.

Precision Paradigm Video Overview

This short video provides a general introduction to the Precision Paradigm and our work to develop each component.

 

Precision Paradigm – Overview

For the past few decades, home visiting impact research has typically estimated average effects of full home visiting models, as shown in Figure 1.

Figure 1. Traditional Home Visiting Research Paradigm

We know that the families who enroll in home visiting are very different from one another, that local programs operate in communities that are very different from one another, that many families do not engage in services, and that average impacts have remained small over the past few decades.  To strengthen family engagement and home visiting’s benefits for families, we need a different approach to research. We need to focus on interventions within and across home visiting models. We need to answer the question: What works best, for which families, in which contexts, why and how?

This requires a framework that includes mediators — mechanisms of actions and target behaviors — as well as family engagement and other moderators of impacts, as shown in Figure 2.

Figure 2. Precision Paradigm

 

This framework reflects the shift in intervention science toward precision. Within home visiting, we need to specify the framework in alignment with science and with the perspectives of home visiting stakeholders.

Over the next year, we are working to build out each component of the paradigm.  We are working with intervention researchers with expertise developing and/or evaluating interventions that address one or more of the following areas: birth outcomes, parenting to promote child development and social-emotional well-being, maternal psychosocial well-being, cardiovascular health of mothers and children, and family economic well-being.