Towards Precision Home Visiting: Results at Six Months Postpartum From a Randomized Pilot Implementation Trial to Assess the Feasibility of a Precision Approach to Family Spirit




Allison Ingalls, Paul Rebman, Lisa Martin, Elizabeth Kushman, Amanda Leonard, Aimee Cisler, Ingrid Gschwind, Amanda Brayak, Ann Marie Amsler, and Emily E. Haroz

Brief Type

Journal Publication


  • Family Spirit


Background: Shared implementation challenges at scale in early childhood home visiting have led researchers to explore precision home visiting as a promising service delivery mechanism to better address families’ unique needs and build greater program efficiencies. This randomized controlled pilot study aimed to assess the acceptability of a precision approach to one home visiting model, Family Spirit® and explore potential differences between Precision Family Spirit (PFS) and Standard Family Spirit (Standard FS) on participant-home visitor relationship and maternal outcomes. Methods: Participants (N=60) were at least 14 years old, pregnant or within two months postpartum, and enrolled in Family Spirit. Four sites in Michigan were randomized 1:1 to deliver PFS (up to 17 core lessons plus up to 13 additional lessons as needed) or Standard FS (home visiting services as usual). Primary (program acceptability, participant satisfaction, home visitor-participant relationship quality, retention, adherence) and secondary (knowledge, quality of life, difficulty with parenting problems, substance use, depression, stress) outcomes at 6 months postpartum are presented. PFS participants only were assessed during home visits on a subset of secondary measures that informed which lessons they should receive. Results: Mothers in both groups reported positive program acceptability, satisfaction, and home visitor-participant relationships at 6 months postpartum. However, open-ended feedback from Standard FS participants indicates that some lesson content may not be applicable to all participants. At six months, retention was 82.3% for PFS and 66.7% for Standard FS, and adherence was 30.1% for PFS and 20.6% for Standard FS. Conclusions: Preliminary findings indicate that precision home visiting may be acceptable and feasible, yet more research is needed to understand its impact as an implementation strategy. (author abstract)

Data Collection Methods

  • Program administrative record reviews
  • Standardized assessment tools
  • Surveys or questionnaires



For More Information

Ingalls, A., Rebman, P., Martin, L., Kushman, E., Leonard, A., Cisler, A., Gschwind, I., Brayak, A., Amsler, A. M., & Haroz, E. E. (2022). Towards precision home visiting: Results at six months postpartum from a randomized pilot implementation trial to assess the feasibility of a precision approach to Family Spirit [Preprint]. In Review. https://doi.org/10.21203/rs.3.rs-1620081/v1


  • Participant, Family, and Program Outcomes
  • Program Enhancements, Innovations, and Promising Approaches
  • Participant Recruitment, Retention, Engagement, and Dosage