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Study Detail

Barlow, A., Mullany, B., Neault, N., Goklish, N., Billy, T., Hastings, R., ... Walkup, J. T. (2015). Paraprofessional-delivered home-visiting intervention for American Indian teen mothers and children: 3-Year outcomes from a randomized controlled trial. American Journal of Psychiatry, 172(2), 154-162.

Program(s) Reviewed: Family Spirit®

Study Screening Details

Screening DecisionScreening Conclusion
Study Passes ScreensEligible for Review

Study Design Details

RatingDesignAttritionBaseline EquivalenceReassignmentConfounding Factors
HighRandomized controlled trialLowEstablished on race, SES, and outcome measures assessable at baselineNoneNone

Child outcomes (Infant-Toddler Social Emotional Assessment) rated moderate for this study, because of high attrition. Through communication with the first author, we established that the mothers of children in the child outcomes sample were equivalent at baseline on race/ethnicity and SES; the child outcomes themselves were not assessable at baseline because the sample enrolled prenatally.

Study Characteristics

Study Participants Between 2006 and 2008, expectant women who were at less than or equal to 32 weeks gestation, aged 12-19 at conception, self-identified as American-Indian, and residing in one of the four participating reservation communities, were recruited into the study. Eligible participants were randomized by site, age, and history of previous live births. The sample sizes for the maternal parenting and health outcomes were as follows: analytic sample: 322 (159 T and 163 C) baseline sample: 322 (159 T and 163 C). Note: the study does not use a consistent analytic sample across different outcomes. The sample sizes shown here are relevant for maternal outcomes only. Sample sizes for child outcomes differ.
Setting Four southwestern reservation communities
Home Visiting Services The Family Spirit intervention consisted of 43 lessons delivered by Native American para-professionals from within participating communities. The lessons focused on parenting skills and maternal behavioral and psychosocial risks. The lessons were conducted in each participant's home and the visits lasted approximately one hour each. The visits occurred weekly through pregnancy, biweekly until 4 months postpartum, monthly between 4-12 months postpartum, and bimonthly between 12-36 months postpartum.
Comparison Condition "Optimized Standard Care consisted of transportation to recommended prenatal and well-baby clinic visits, pamphlets about childcare and community resources, and referrals to local services."
Staff Characteristics and Training Training and staff characteristics are not described.
Funding Source Supported by National Institute on Drug Abuse grant R01 DA-019042 (principal investigator, J. Walkup).
Author Affiliation The corresponding author is one of the program developers.

Study Registration Identifier: NCT00373750. Study registration was assessed by HomVEE beginning with the 2014 review.


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