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Family Spirit®

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

In Brief

Last Updated

May 2016


Evidence of Program Model Effectiveness

This program model meets the criteria established by the Department of Health and Human Services (DHHS) for an “evidence-based early childhood home visiting service delivery model” for both general and tribal populations.


Program Model Description

Family Spirit is designed for pregnant women and families with children younger than age 3 in Native American communities. It may also be used with non-Native populations with high maternal and child behavioral health disparities. It aims to promote mothers’ parenting skills, while assisting them in developing coping and problem-solving skills to overcome individual and environmental stressors. The curriculum, which incorporates traditional tribal teachings, consists of 63 lessons divided into six domains. Family Spirit recommends initiating the program with weekly visits by at least 28 weeks of gestation and tapering to bimonthly visits until the child’s third birthday. Paraprofessional Health Educators conduct the visits, which typically last 45 to 90 minutes. Family Spirit recommends that Health Educators come from the participating community and have familiarity with the local/tribal culture, traditions, and language(s). For more information, please read the Program Model Overview.


Extent of Evidence

Results of Search and ReviewNumber of Studies
Released from 1979 to 2015 6
Eligible for review 6
     Rated high 2
     Rated moderate 2
     Rated low 1
     Additional sourcesa 1

aAdditional sources overlap with another study and are not rated.

For more information, see the study database. For more information on the criteria used to determine the study ratings, please read Producing Study Ratings.


Summary of Findings

Outcomes Primary Outcome Measures Secondary Outcome Measures
Child Development and School Readiness

Favorable: 10
No effect: 30
Unfavorable or ambiguous: 0

Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Child Health Not measured Not measured
Family Economic Self-Sufficiency Not measured Not measured
Linkages and Referrals Not measured Not measured
Maternal Health

Favorable: 2
No effect: 17
Unfavorable or ambiguous: 0

Favorable: 3
No effect: 31
Unfavorable or ambiguous: 0

Positive Parenting Practices

Favorable: 0
No effect: 5
Unfavorable or ambiguous: 0

Favorable: 7
No effect: 6
Unfavorable or ambiguous: 0

Reductions in Child Maltreatment Not measured Not measured
Reductions in Juvenile Delinquency, Family Violence, and Crime Not measured Not measured

Please read Describing Effects for more information on these categories. Only results from studies that meet the standards for the high or moderate ratings are included above.


Criteria Established by the Department of Health and Human Services

Information Based on Comprehensive Review of All High- and Moderate-Impact Studies for this Model
High- or moderate-quality impact study? Yes
Across high- or moderate-quality studies, favorable impacts in…
   at least two outcome domains within one sample
   the same domain for at least two non-overlapping samples?
Favorable impacts on full sample? Yes
Any favorable impacts on outcome measures sustained at least 12 months after program enrollment?a Yes
One or more favorable, statistically significant impact reported in a peer-reviewed journal?a Yes

aThis information is reported for all program models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

Please read the DHHS Criteria for Evidence-Based Program Models for more information.