Achieving Early Childhood Home Visiting's Potential Through Precision Research-Reflections on the Value of...

Nearly 50 years of research confirms both the effectiveness of early childhood home visiting (HV) for expectant families and families with young children and the need to broaden and strengthen HV's benefits across diverse families and communities. But features of the prevailing research paradigm thwart achieving HV's potential as a prevention strategy. These include treating an HV model as a single intervention rather than a set of interventions; conducting single-model rather than cross-model studies; estimating average effects rather than testing for mediation and moderation; and describing HV interventions, mediators, and moderators using general and inconsistent terminology rather than a clear common language across models and studies. The field must shift to a precision research paradigm to learn how to tailor services to optimize benefits across diverse families and communities. A precision research framework focuses on HV interventions at a granular level and considers mediators and moderators of impacts on outcomes. A precision research paradigm also uses a precise common language, as in information science, to facilitate learning across HV models and across studies. Research partnerships with governmental agencies are critical for shifting to a precision paradigm. This commentary argues that, as partners, government agencies and researchers can carry out studies more consequential than those they could carry out alone. It grounds this argument in highlights of over 30 years of experience, accomplishments, and challenges of partnering with state and national government agencies in the USA. It concludes by considering what the shift to precision research will require of each stakeholder group going forward.