Family Spirit® Meets HHS Criteria Meets HHS criteria for an evidenced based model in tribal populations

Model effectiveness research report last updated: 2022

Effects shown in research

To see details on each finding HomVEE reviewed in well-designed research, click on the name of an outcome domain.

Effects shown in research

Maternal health

Findings rated high

Family Spirit®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
ASEBA - Externalizing
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 38.20 Adjusted mean = 40.70 Mean difference = -2.50 Study reported = -0.20 Statistically significant,
p = 0.04

footnote162

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Negative value is favorable to the intervention.

ASEBA - Externalizing
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 40.09 Adjusted mean = 41.46 Mean difference = -1.37 Study reported = -0.13 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

ASEBA - Internalizing
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 41.48 Adjusted mean = 43.99 Mean difference = -2.51 Study reported = -0.19 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

ASEBA - Internalizing
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 43.80 Adjusted mean = 45.12 Mean difference = -1.32 Study reported = -0.12 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

ASEBA - Total Problems
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 38.01 Adjusted mean = 40.37 Mean difference = -2.36 Study reported = -0.18 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

ASEBA - Total Problems
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 40.27 Adjusted mean = 41.65 Mean difference = -1.38 Study reported = -0.13 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

CES-D
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 11.54 Adjusted mean = 13.41 Mean difference = -1.89 Study reported = -0.20 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

CES-D
FavorableUnfavorable or ambiguousNo Effect
2 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 13.06 Adjusted mean = 13.40 Mean difference = -0.34 Study reported = -0.07 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

CES-D
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 12.46 Adjusted mean = 13.41 Mean difference = -0.95 Study reported = -0.16 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

POSIT Mental Health
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 2.77 Adjusted mean = 2.91 Mean difference = -0.14 Study reported = -0.04 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

POSIT Mental Health
FavorableUnfavorable or ambiguousNo Effect
2 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 3.23 Adjusted mean = 3.56 Mean difference = -0.33 Study reported = -0.13 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

POSIT Mental Health
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 3.05 Adjusted mean = 3.30 Mean difference = -0.25 Study reported = -0.09 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

POSIT Substance Abuse
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 0.13 Adjusted mean = 0.45 Mean difference = -0.32 Study reported = -0.13 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

POSIT Substance Abuse
FavorableUnfavorable or ambiguousNo Effect
2 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 0.56 Adjusted mean = 0.61 Mean difference = -0.05 Study reported = -0.03 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

POSIT Substance Abuse
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 0.39 Adjusted mean = 0.55 Mean difference = -0.16 Study reported = -0.08 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

Alcohol - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 25.77 Adjusted mean % = 21.55 OR = 1.14 HomVEE calculated = 0.14 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

Alcohol - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
2 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 17.92 Adjusted mean % = 17.81 OR = 0.80 HomVEE calculated = 0.00 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Alcohol - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 16.88 Adjusted mean % = 20.02 OR = 0.71 HomVEE calculated = -0.13 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Any alcohol or illegal drug - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 38.93 Adjusted mean % = 34.64 OR = 1.07 HomVEE calculated = 0.11 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Any alcohol or illegal drug - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
2 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 32.91 Adjusted mean % = 29.11 OR = 1.04 HomVEE calculated = 0.11 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Any alcohol or illegal drug - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 27.74 Adjusted mean % = 30.78 OR = 0.76 HomVEE calculated = -0.09 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Any illegal drug - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 21.34 Adjusted mean % = 21.90 OR = 0.83 HomVEE calculated = -0.02 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Any illegal drug - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
2 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 22.89 Adjusted mean % = 21.92 OR = 0.93 HomVEE calculated = 0.03 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

Marijuana - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 18.91 Adjusted mean % = 19.65 OR = 0.83 HomVEE calculated = -0.03 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Marijuana - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
2 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 20.63 Adjusted mean % = 21.02 OR = 0.87 HomVEE calculated = -0.01 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Marijuana - past 30 days, use of
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted % = 12.39 Adjusted mean % = 18.83 OR = 0.57 HomVEE calculated = -0.30 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Family Spirit®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
ASEBA Externalizing (T-score)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Adjusted mean = 41.35 Adjusted mean = 42.58 Mean difference = -1.23 Study reported = 0.14 Statistically significant, p = 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

ASEBA Internalizing (T-score)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Adjusted mean = 42.89 Adjusted mean = 43.72 Mean difference = -0.83 Study reported = 0.09 Not statistically significant, p = 0.22

footnote162

Submitted by user on

Negative value is favorable to the intervention.

ASEBA Total Problems (T-score)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Adjusted mean = 40.51 Adjusted mean = 41.36 Mean difference = -0.86 Study reported = 0.10 Not statistically significant, p = 0.18

footnote162

Submitted by user on

Negative value is favorable to the intervention.

CES-D score (0-60)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Adjusted mean = 12.48 Adjusted mean = 13.65 Mean difference = -1.17 Study reported = 0.16 Statistically significant, p = 0.01

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Alcohol use in past 30 days (proportion)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Unadjusted mean = 0.17 Unadjusted mean = 0.16 Mean difference = 0.01 HomVEE calculated = 0.04 Not statistically significant, p = 0.67

footnote183

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Lower values favor the intervention

Any illegal drug use in past 30 days (proportion)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Unadjusted mean = 0.12 Unadjusted mean = 0.17 Mean difference = -0.05 HomVEE calculated = -0.24 Statistically significant, p = 0.01

footnote183

Submitted by user on

Lower values favor the intervention

Marijuana use in past 30 days (proportion)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Unadjusted mean = 0.11 Unadjusted mean = 0.16 Mean difference = -0.05 HomVEE calculated = -0.26 Statistically significant, p = 0.01

footnote183

Submitted by user on

Lower values favor the intervention

Parenting stress index (range 0-180)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Adjusted mean = 75.53 Adjusted mean = 79.10 Mean difference = -3.57 Study reported = 0.18 Not statistically significant, p = 0.10

footnote162

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Negative value is favorable to the intervention.

Findings rated moderate

Family Spirit®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Alcohol in last month - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers Adjusted mean % = 19.00 Adjusted mean % = 13.00 OR = 1.54 HomVEE calculated = 0.25 Not statistically significant,
p = >=.10
Alcohol in last month - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers Adjusted mean % = 11.00 Adjusted mean % = 7.00 OR = 1.52 HomVEE calculated = 0.30 Not statistically significant,
p = >=.10
Alcohol in last month - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers Adjusted mean % = 12.00 Adjusted mean % = 6.00 OR = 2.19 HomVEE calculated = 0.39 Not statistically significant,
p = >=.10
Change in depressive symptoms (CES-D) - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers Adjusted mean = -2.00 Adjusted mean = -3.30 coeff = 0.05 HomVEE calculated = 0.12 Not statistically significant,
p = >=.10
Change in depressive symptoms (CES-D) - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers Adjusted mean = -4.00 Adjusted mean = -4.00 coeff = -0.58 HomVEE calculated = 0.00 Not statistically significant,
p = >=.10
Change in depressive symptoms (CES-D)- 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers Adjusted mean = -3.10 Adjusted mean = -2.00 coeff = -1.69 HomVEE calculated = -0.10 Not statistically significant,
p = >=.10
Change in social support - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers Adjusted mean = 0.50 Adjusted mean = -2.20 coeff = 1.98 HomVEE calculated = 0.13 Not statistically significant,
p = >=.10
Change in social support - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers Adjusted mean = -0.40 Adjusted mean = -1.70 coeff = -0.21 HomVEE calculated = 0.07 Not statistically significant,
p = >=.10
Change in social support - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers Adjusted mean = -3.70 Adjusted mean = -2.50 coeff = -0.98 HomVEE calculated = -0.06 Not statistically significant,
p = >=.10
Cigarette in last month - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers Adjusted mean % = 19.00 Adjusted mean % = 15.00 OR = 1.27 HomVEE calculated = 0.14 Not statistically significant,
p = >=.10
Cigarette in last month - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers Adjusted mean % = 13.00 Adjusted mean % = 17.00 OR = 0.74 HomVEE calculated = -0.19 Not statistically significant,
p = >=.10
Cigarette in last month - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers Adjusted mean % = 22.00 Adjusted mean % = 13.00 OR = 2.06 HomVEE calculated = 0.35 Not statistically significant,
p = >=.10
Illegal substance in last month - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers Adjusted mean % = 16.00 Adjusted mean % = 9.00 OR = 2.37 HomVEE calculated = 0.41 Not statistically significant,
p = >=.10
Illegal substance in last month - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers Adjusted mean % = 13.00 Adjusted mean % = 7.00 OR = 2.02 HomVEE calculated = 0.41 Not statistically significant,
p = >=.10
Illegal substance in last month - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers Adjusted mean % = 7.00 Adjusted mean % = 3.00 OR = 2.57 HomVEE calculated = 0.49 Not statistically significant,
p = >=.10
Parenting stress index - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers Adjusted mean = 62.60 Adjusted mean = 60.40 coeff = 3.91 HomVEE calculated = 0.14 Not statistically significant,
p = >=.10
Parenting stress index - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers Adjusted mean = 62.30 Adjusted mean = 66.80 coeff = -3.31 HomVEE calculated = -0.26 Not statistically significant,
p = >=.10
Parenting stress index - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers Adjusted mean = 63.30 Adjusted mean = 64.10 coeff = 1.01 HomVEE calculated = -0.05 Not statistically significant,
p = >=.10
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Child development and school readiness

Findings rated high

Family Spirit®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
ITSEA - Competence domain
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 319 mothers Adjusted mean = 1.07 Adjusted mean = 1.02 Mean difference = 0.05 Study reported = 0.12 Not statistically significant, p ≥ 0.05
ITSEA - Competence domain, % clinically at risk
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 319 mothers Adjusted % = 20.27 Adjusted mean % = 17.66 OR = 0.86 HomVEE calculated = 0.10 Not statistically significant, p ≥ 0.05
ITSEA - Dysregulation domain
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 319 mothers Adjusted mean = 0.54 Adjusted mean = 0.59 Mean difference = -0.06 Study reported = -0.15 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

ITSEA - Dysregulation domain, % clinically at risk
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 319 mothers Adjusted % = 15.80 Adjusted mean % = 18.67 OR = 1.37 HomVEE calculated = -0.12 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

ITSEA - Externalizing domain
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 319 mothers Adjusted mean = 0.62 Adjusted mean = 0.71 Mean difference = -0.09 Study reported = -0.19 Statistically significant,
p = 0.03

footnote162

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Negative value is favorable to the intervention.

ITSEA - Externalizing domain, % clinically at risk
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 319 mothers Adjusted % = 13.69 Adjusted mean % = 20.62 OR = 1.88 HomVEE calculated = -0.30 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

ITSEA - Internalizing domain
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 319 mothers Adjusted mean = 0.57 Adjusted mean = 0.62 Mean difference = -0.05 Study reported = -0.10 Not statistically significant, p ≥ 0.05

footnote162

Submitted by user on

Negative value is favorable to the intervention.

ITSEA - Internalizing domain, % clinically at risk
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 319 mothers Adjusted % = 20.27 Adjusted mean % = 27.16 OR = 1.61 HomVEE calculated = -0.23 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

Findings rated moderate

Family Spirit®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
ITSEA Competence domain
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.94 Adjusted mean = 0.95 coeff = -0.01 HomVEE calculated = -0.03 Not statistically significant,
p = >=.10
ITSEA Competence: Attention
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 1.11 Adjusted mean = 1.07 coeff = 0.05 HomVEE calculated = 0.08 Not statistically significant,
p = >=.10
ITSEA Competence: Compliance
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.91 Adjusted mean = 0.84 coeff = 0.10 HomVEE calculated = 0.18 Not statistically significant,
p = >=.10
ITSEA Competence: Empathy
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.66 Adjusted mean = 0.59 coeff = 0.09 HomVEE calculated = 0.15 Not statistically significant,
p = >=.10
ITSEA Competence: Imitation/play
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 1.08 Adjusted mean = 1.10 coeff = -0.03 HomVEE calculated = -0.05 Not statistically significant,
p = >=.10
ITSEA Competence: Mastery motivation
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 1.30 Adjusted mean = 1.34 coeff = -0.05 HomVEE calculated = -0.08 Not statistically significant,
p = >=.10
ITSEA Competence: Prosocial peer relations
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.51 Adjusted mean = 0.79 coeff = -0.24 HomVEE calculated = -0.68 Not statistically significant,
p = >=.10
ITSEA Dysregulation domain
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.43 Adjusted mean = 0.49 coeff = -0.05 HomVEE calculated = -0.22 Not statistically significant,
p = >=.10
ITSEA Dysregulation: Eating
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.43 Adjusted mean = 0.44 coeff = -0.02 HomVEE calculated = -0.04 Not statistically significant,
p = >=.10
ITSEA Dysregulation: Negative emotionality
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.47 Adjusted mean = 0.48 coeff = 0.02 HomVEE calculated = -0.03 Not statistically significant,
p = >=.10
ITSEA Dysregulation: Sensory sensitivity
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.37 Adjusted mean = 0.52 coeff = -0.14 HomVEE calculated = -0.41 Not statistically significant,
p = >=.10
ITSEA Dysregulation: Sleep
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.44 Adjusted mean = 0.53 coeff = -0.06 HomVEE calculated = -0.25 Not statistically significant,
p = >=.10
ITSEA Externalizing domain
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.39 Adjusted mean = 0.57 coeff = -0.17 HomVEE calculated = -0.63 Statistically significant, p<.05

footnote182

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Negative differences favor the program group

ITSEA Externalizing: Activity/impulsivity
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.69 Adjusted mean = 0.98 coeff = -0.27 HomVEE calculated = -0.65 Statistically significant, p<.05

footnote182

Submitted by user on

Negative differences favor the program group

ITSEA Externalizing: Aggression/defiance
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.27 Adjusted mean = 0.35 coeff = -0.06 HomVEE calculated = -0.29 Not statistically significant,
p = >=.10
ITSEA Externalizing: Peer aggression
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.13 Adjusted mean = 0.30 coeff = -0.23 HomVEE calculated = -0.68 Statistically significant, p<.05

footnote182

Submitted by user on

Negative differences favor the program group

ITSEA Internalizing domain
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.48 Adjusted mean = 0.55 coeff = -0.06 HomVEE calculated = -0.35 Not statistically significant,
p = >=.10
ITSEA Internalizing: Depression/withdraw
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.12 Adjusted mean = 0.15 coeff = 0.01 HomVEE calculated = -0.13 Not statistically significant,
p = >=.10
ITSEA Internalizing: General anxiety
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.20 Adjusted mean = 0.21 coeff = 0.01 HomVEE calculated = -0.04 Not statistically significant,
p = >=.10
ITSEA Internalizing: Inhibition to novelty
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.73 Adjusted mean = 0.82 coeff = -0.09 HomVEE calculated = -0.24 Not statistically significant,
p = >=.10
ITSEA Internalizing: Separation distress
FavorableUnfavorable or ambiguousNo Effect
12 months old Mothers enrolled 2002-2004 65 children Adjusted mean = 0.84 Adjusted mean = 1.02 coeff = -0.17 HomVEE calculated = -0.52 Statistically significant, p<.05

footnote182

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Negative differences favor the program group

Family Spirit®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
CBCL mean, Externalizing domain (0-48) (T-score)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with CBCL data 280 children Adjusted mean = 42.45 Adjusted mean = 42.59 Mean difference = -0.14 Study reported = 0.01 Not statistically significant,
p = 0.89

footnote162

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Negative value is favorable to the intervention.

CBCL mean, Internalizing domain (0-72) (T-score)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with CBCL data 280 children Adjusted mean = 44.23 Adjusted mean = 44.91 Mean difference = -0.68 Study reported = 0.06 Not statistically significant,
p = 0.57

footnote162

Submitted by user on

Negative value is favorable to the intervention.

CBCL mean, Total Problems (0-200) (T-score)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with CBCL data 280 children Adjusted mean = 44.00 Adjusted mean = 44.79 Mean difference = -0.79 Study reported = 0.07 Not statistically significant,
p = 0.52

footnote162

Submitted by user on

Negative value is favorable to the intervention.

Family Spirit®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
ITSEA Competence domain (proportion clinically at risk (>10%))
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with ITSEA data 288 children Unadjusted mean = 0.24 Unadjusted mean = 0.23 Mean difference = 0.01 HomVEE calculated = 0.03 Not statistically significant, p = 0.78
ITSEA Dysregulation domain (proportion clinically at risk (>10%))
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with ITSEA data 288 children Unadjusted mean = 0.10 Unadjusted mean = 0.15 Mean difference = -0.04 HomVEE calculated = -0.23 Not statistically significant, p = 0.08

footnote162

Submitted by user on

Negative value is favorable to the intervention.

ITSEA Externalizing domain (proportion clinically at risk (>10%))
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with ITSEA data 288 children Unadjusted mean = 0.17 Unadjusted mean = 0.24 Mean difference = -0.07 HomVEE calculated = -0.24 Statistically significant, p = 0.03

footnote162

Submitted by user on

Negative value is favorable to the intervention.

ITSEA Internalizing domain (proportion clinically at risk (>10%))
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with ITSEA data 288 children Unadjusted mean = 0.10 Unadjusted mean = 0.15 Mean difference = -0.05 HomVEE calculated = -0.27 Statistically significant, p = 0.04

footnote162

Submitted by user on

Negative value is favorable to the intervention.

ITSEA mean, Competence domain (range 0-2)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with ITSEA data 288 children Adjusted mean = 1.28 Adjusted mean = 1.24 Mean difference = 0.04 Study reported = 0.14 Not statistically significant, p = 0.09
ITSEA mean, Dysregulation domain (range 0-2)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with ITSEA data 288 children Adjusted mean = 0.48 Adjusted mean = 0.55 Mean difference = -0.07 Study reported = 0.27 Statistically significant, p < .001

footnote162

Submitted by user on

Negative value is favorable to the intervention.

ITSEA mean, Externalizing domain (range 0-2)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with ITSEA data 288 children Adjusted mean = 0.64 Adjusted mean = 0.71 Mean difference = -0.07 Study reported = 0.23 Statistically significant, p < .01

footnote162

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Negative value is favorable to the intervention.

ITSEA mean, Internalizing domain (range 0-2)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Children with ITSEA data 288 children Adjusted mean = 0.54 Adjusted mean = 0.60 Mean difference = -0.05 Study reported = 0.23 Statistically significant, p < .01

footnote162

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Negative value is favorable to the intervention.

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Positive parenting practices

Findings rated high

Family Spirit®
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Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
HOME inventory - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 25.92 Adjusted mean = 25.41 Mean difference = 0.51 Study reported = 0.08 Not statistically significant, p ≥ 0.05
HOME inventory - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 22.79 Adjusted mean = 22.75 Mean difference = 0.04 Study reported = 0.01 Not statistically significant, p ≥ 0.05
PLOC Parental self-efficacy - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 23.21 Adjusted mean = 24.71 Mean difference = -1.51 Study reported = -0.23 Statistically significant,
p = 0.01

footnote162

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Negative value is favorable to the intervention.

PLOC Parental self-efficacy - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 22.98 Adjusted mean = 23.83 Mean difference = -0.85 Study reported = -0.13 Not statistically significant, p ≥ 0.05

footnote162

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Negative value is favorable to the intervention.

Home safety attitudes
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 29.54 Adjusted mean = 28.61 Mean difference = 0.94 Study reported = 0.19 Statistically significant,
p = 0.03
Home safety practices
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 1.56 Adjusted mean = 1.30 Mean difference = 0.26 Study reported = 0.16 Not statistically significant, p ≥ 0.05
Parenting knowledge
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 322 mothers Adjusted mean = 15.43 Adjusted mean = 14.08 Mean difference = 1.35 Study reported = 0.33 Statistically significant,
p = 0.001
Family Spirit®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance Notes
HOME inventory (range 0-37)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Adjusted mean = 31.73 Adjusted mean = 31.63 Mean difference = 0.10 Study reported = 0.02 Not statistically significant, p = 0.77
Parenting knowledge (range 0-30)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Adjusted mean = 15.94 Adjusted mean = 14.66 Mean difference = 1.28 Study reported = 0.42 Statistically significant, p < .001
Parenting locus of control (range 27-135)
FavorableUnfavorable or ambiguousNo Effect
2006-2008 sample, 3 years postpartum Full 322 mothers Adjusted mean = 64.34 Adjusted mean = 66.03 Mean difference = -1.69 Study reported = 0.17 Statistically significant, p = 0.02

footnote162

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Negative value is favorable to the intervention.

Findings rated moderate

Family Spirit®
Show findings details
Outcome measure Effect Follow-up timing Sample Sample size Intervention group Comparison group Group difference Effect size Statistical significance
Change in maternal involvement - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers Adjusted mean = 1.10 Adjusted mean = 1.20 coeff = -0.60 HomVEE calculated = -0.04 Not statistically significant,
p = >=.10
Change in maternal involvement - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers Adjusted mean = 1.00 Adjusted mean = 0.60 coeff = 0.22 HomVEE calculated = 0.15 Not statistically significant,
p = >=.10
Change in maternal involvement - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers Adjusted mean = 1.30 Adjusted mean = 1.20 coeff = -0.15 HomVEE calculated = 0.03 Not statistically significant,
p = >=.10
Change in parenting knowledge - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers Adjusted mean = 26.60 Adjusted mean = 15.20 coeff = 13.92 HomVEE calculated = 0.86 Statistically significant, p<.01
Change in parenting knowledge - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers Adjusted mean = 3.20 Adjusted mean = 2.60 coeff = 3.10 HomVEE calculated = 0.06 Not statistically significant, p ≥ 0.05
Change in parenting knowledge - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers Adjusted mean = 23.80 Adjusted mean = 12.80 coeff = 13.46 HomVEE calculated = 0.81 Statistically significant, p<.01
Home Observation for Measurement of the Environment - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers Adjusted mean = 37.10 Adjusted mean = 37.40 coeff = -0.04 HomVEE calculated = -0.04 Not statistically significant,
p = >=.10
Home Observation for Measurement of the Environment - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers Adjusted mean = 32.50 Adjusted mean = 33.40 coeff = -1.27 HomVEE calculated = -0.14 Not statistically significant,
p = >=.10
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In brief

Evidence of model effectiveness

Title General population Tribal population Domains with favorable effects
Family Spirit® Yes, Meets HHS Criteria Meets HHS criteria Meets HHS criteria for an evidenced based model in tribal populations Meets HHS criteria for an evidenced based model in tribal populations
  • Child development and school readiness,
  • Maternal health,
  • Positive parenting practices,

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Family Spirit is designed for American Indian pregnant women and families with children younger than age 3. It can 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 organized into six domains: (1) prenatal care, (2) infant care, (3) child development, (4) toddler care, (5) life skills, and (6) healthy living. 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 home visitors conduct the visits, which typically last 45 to 90 minutes. Family Spirit recommends that home visitors be members of the participating community and have familiarity with the local or tribal culture, traditions, and language(s).

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39

Results of search and review
Number of manuscripts
At least one finding was eligible for review…
6
  …and at least one finding rated high
2
  …and at least one finding rated moderate (but none rated high)
2
  …and all findings that were eligible for review rated low or indeterminate2
1
  …but manuscript is additional source3
1

For more information, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.

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103

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29

Information based on comprehensive review of all high- and moderate-rated manuscripts
CriterionCriterion descriptionCriterion met?
1High- or moderate-quality impact study?Yes
2Across high- or moderate-quality studies, favorable impacts in at least two outcome domains within one sample OR the same domain for at least two non-overlapping samples?Yes
3Favorable impacts on full sample?Yes
4Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?
Reported for all research but only required for RCTs.
Yes
5One or more favorable, statistically significant impact reported in a peer-reviewed journal?
Reported for all research but only required for RCTs.
Yes
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