We are fascinated by the promise of precision health. Proponents of precision health have promised that, in the future, using data from well-designed prospective research and from rapidly growing electronic data repositories, we will have well-established clinical biomarkers that will allow for more accurate diagnosis and treatment of a host of health conditions. Precision health proponents promise that, by using these data, we will redefine and cure disease. We are not, however, promised a delivery date, and as time marches on, we are growing impatient. However, before we can have precision in healthcare delivery, including understanding the mechanisms underlying disease, the promotors for wellness, or the reasons interventions work or do not work or work for some people and not others, we need much more research.
Scientific institutions, including the National Institutes of Health and the Food and Drug Administration, have geared up for precision health by reducing time for review of clinical trials and pharmaceutical treatments. Funds have been allocated for precision health initiatives, including those geared toward greater understanding of how our genetic, psychological, social, and environmental composition affects the diseases we contract and our response to their treatments. Moreover, there is increasing and much needed encouragement to publish and otherwise disseminate quickly the results of research, especially results from clinical trials. These are positive developments for precision health-focused research. They are also generally positive developments for all research, including some of the world's most pressing health problems-prematurity, malnutrition, infectious diseases, malignancies, and cardiovascular diseases. Although we understand the general mechanisms that underlie many health conditions, we do not understand how to treat them effectively or perhaps, more importantly, prevent them.
The persistence of these pressing and widespread health conditions has contributed to concerns about the heavy focus on precision health and the touting of its promises. In fact, there are legitimate concerns that a focus on precision health may prove a barrier to the necessary work of defining the social and environmental determinants of health, which are known to be significant contributors to adverse health conditions (Bayer & Galea, 2015). The notion of precision health has even been labeled a "first-world" concern that will have little effect in areas of the world with a less well-developed scientific or healthcare delivery enterprise (Patel, 2015). To prevent this from happening, health determinants, including the social and physical environments we are born in and live in, access to health and healthcare resources, and the ever important health behaviors we engage in, need to be as fully studied in the precision health initiative as do our biology and genetic make-up.
Nurses have a long-standing commitment to understanding health and illness from a holistic perspective. Thus, nurse scientists should be well positioned to engage in precision health research that addresses not only the omics of a person's being but also the psychological, social, and environmental aspects of a person that affect health, illness, and illness treatments (Eckardt et al., 2017). Perhaps most exciting is the prospect of determining which nursing interventions are most effective for various populations of interest; work in this direction would add much to symptom management, palliative care, wellness promotion, and other areas of science so important to our discipline and practice.
The fascination with precision health has not escaped us at Nursing Research. In the last issue and in this one, as well as on our website, you will find the announcement of calls for articles for a special issue of the Journal in March/April 2019 on precision health, edited by Susan G. Dorsey at the University of Maryland. We have taken our cue for scope of work from the National Institutes of Health, defining precision health research as including approaches to individualizing prevention and healthcare management using multiomics and other physiological, psychological, imaging, environmental, and ethical factors for persons, families, and communities. We welcome full-length original articles, briefs reporting pilot study results, or innovative methods in precision health research. We are hopeful that many of the articles we receive will address nursing care practices or at least suggest where, when, and how nursing care might change in the future as the result of more "precise" knowledge.
The current emphasis on precision health research has raised awareness of the need for research about basic public healthcare needs and preventive care research. It has grabbed our interest, giving us new goals to pursue in order that we might provide the best care possible for people who need it. Nursing Research is excited to participate in the on-going dissemination of research focused on precision health; we promise you will have much to think about when you read the special issue. We hope your reading and thinking will inspire if not inform your own research and practice.
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