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Implementing Family Spirit®

Meets DHHS criteria for an evidenced based model Meets DHHS criteria for an evidenced based model in tribal populations

Prerequisites for Implementation

Last Updated

May 2016


Type of Implementing Agency

Family Spirit is implemented within the context of local, state, tribal, and federal organizations. Some affiliates offer standalone Family Spirit programs, and others nest the model within existing programs and services that their organization offers. There are no requirements for the type of organization that can implement the model.


Staffing Requirements

Paraprofessionals from the community, called health educators, conduct home visits. A supervisor guides and monitors implementation of the curriculum. Nurses may also work with health educators to conduct home visits and teach the lessons deemed most relevant to their clinical expertise. The Family Spirit national office noted that an evaluator may be useful given the model’s data collection requirements.


Staff Education and Experience

Family Spirit recommends that health educators come from the participating community and are familiar with the local/tribal culture, traditions, and language(s). Health educators must have at least a high school education. Specific Family Spirit training, described elsewhere in this report, is also required. The developers recommend that supervisors have a college degree or equivalent work experience, and have experience in home visiting, case management, community networking, and staff supervision.


Supervision Requirements

Family Spirit recommends weekly supervision of home visitors’ activities and challenges. The program provides three tools that agencies can use to facilitate supervision and monitor implementation quality:

  • Health educator weekly report: Home visitors submit this form to their supervisors describing the activities they completed that week, challenges encountered, and supplies needed.
  • Supervisor response to health educator weekly report: Supervisors complete this form to address any challenges or needs raised by the home visitors. 
  • Quality assurance form: Supervisors observe home visitors and rate the structure and quality of the visit according to a systematic rating scale.

Family Spirit recommends a maximum ratio of 6 to 10 home visitors per supervisor, depending on the design and scope of the program site.


Staff Ratio Requirements

Family Spirit recommends a caseload of 20 to 25 families for each full-time health educator, depending on the participants’ stages of enrollment and the commuting distance associated with home visits.


Data Systems/Technology Requirements

Affiliates must report process data quarterly to the Family Spirit national office. There are no data system requirements for how affiliates must transmit these data.



The information contained on this page was last updated in May 2016. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the Family Spirit team at Johns Hopkins University Center for American Indian Health on March 23, 2016. HomVEE reserves the right to edit the profile for clarity and consistency.