Utilizing broad-based partnerships to design a precision approach to implementing evidence-based home visiting

Area of Science:

• Community Health
• Implementation Science
• Program Adaptation

Background:

• Evidence-based home visiting programs are crucial for supporting families.
• The Family Spirit program serves Native American and low-income communities.
• Adapting programs ensures relevance and effectiveness across diverse populations.

Purpose of the Study:

• To describe a participatory process for adapting the Family Spirit implementation strategy.
• To utilize a precision approach for tailoring the program.
• To enhance responsiveness to diverse family needs while maintaining program fidelity.

Main Methods:

• Conducted 5 workshops with key stakeholders.
• Administered an online survey to 81 program implementers.
• Identified hypothesized active ingredients and pivot points for program tailoring.

Main Results:

• Key active ingredients include the home visitor-client relationship, child safety and development lessons, parent-child communication, and goal setting.
• Identified pivot points for tailoring include substance abuse history, risk of childhood obesity, and sexual/reproductive health concerns.
• Results are informing the adaptation of the Family Spirit implementation strategy.

Conclusions:

• A participatory, precision-based approach can effectively adapt evidence-based programs.
• Tailoring strategies can enhance program responsiveness to diverse family needs.
• Balancing adaptation with fidelity is essential for maintaining program integrity and effectiveness.