Reference Catalog

Innovation Toward Precision Home Visiting

Jill Filene, Kyle Peplinski, Lauren Supplee, Matthew Poes, April Wilson, and Susan Zaid

The Home Visiting Applied Research Collaborative (HARC) aims to advance the use of innovative methods in home visiting and translate research findings into policy and practice. HARC was originally established in 2012 to: 1) build a network of home visiting researchers, practices and other stakeholders; 2) articulate a stakeholder-driven research agenda; and 3) promote studies to advance that agenda.

In 2017, HARC launched a new initiative, Innovation toward Precision Home Visiting, to accelerate the field’s use of innovative research methods to advance the field’s understanding of what strategies within home visiting work best, for which families, under what conditions, in building families’ capacity for positive parenting.

Precision home visiting is intentional practice to align the ingredients of home visiting with relevant family characteristics such as parents’ psychosocial well-being, readiness for behavior change, comfort with forming trusting relationships, and reflective capacity. It is theory- and evidence-based planned variation in education and support strategies, to broaden and strengthen impacts on outcomes across diverse families.

Research to accelerate precision home visiting requires innovative methods – alternatives to traditional randomized trials that test average effects of complex home visiting models designed by researchers. This presentation will begin by defining the hallmarks of HARC’s approach to research to accelerate precision home visiting and then detailing how HARC has developed guidelines to further support this work:

• Focus on the Ingredients, rather than Complex Models: Most home visiting models combine many ingredients to achieve diverse outcomes. These ingredients might or might not have a strong evidence base. HARC focuses on ingredients that, if found effective, can be adopted across relevant models to hasten the scale up of what works.
• Efficiency in Testing Ingredients: HARC research guidelines promote use of new research designs such as adaptive trials and rapid cycle techniques to quickly generate innovations, and they focus on explicit testing of active ingredients to specify clear pathways and improve efficiency and effectiveness.
• Broad-based Partnerships: HARC brings together scientists, practitioners, community, and policymakers to partner in defining and testing specific ingredients to strengthen and broaden impacts. Such partnerships help generate new ideas, clarify and define research questions, identify design gaps, and translate results into practice.
• Explicit Definitions and Measurement: Understanding what specific ingredients work best, for whom, under what conditions, requires explicit definition and measurement of ingredients, outcomes, and moderators of impacts. Precision and coherence are critical when defining and measuring interventions; thus, the guidelines promote important research practices, such as the development of detailed theories of change, to clearly link home visiting components to outcomes and provide greater specificity in measurement.

As a key piece of HARC’s dissemination activities, the guidelines are a roadmap to support all stages of innovative research to accelerate precision home visiting, from the development of ideas through scale up of those found to be effective. The presentation will conclude by noting HARC’s major strategies to build stakeholder capacity to apply the research guidelines. These include: HARC’s website, publications, consultation, modest financial support for some pilot projects, and coordination of communities of learning. [author abstract]

Finished

• Program Enhancements, Innovations, and Promising Approaches