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

Last updated: May 2016

Model Overview

Theoretical Model

The Family Spirit conceptual framework is based on G. R. Patterson’s model that posits parenting as the critical link between parents’ personal characteristics and environmental context and children’s individual risks and outcomes. The Family Spirit intervention is designed to promote mothers’ parenting skills, while assisting them in developing coping and problem-solving skills to overcome individual and environmental stressors.

The model also incorporates traditional tribal teachings throughout the curriculum. The model developers believe that cultural teachings are protective factors that can improve maternal and child health in American Indian communities.

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Model Components

Paraprofessional health educators visit families in their homes. They try to establish a close rapport with families to facilitate delivery of the curriculum, which consists of 63 lessons within the following six domains: prenatal care, infant care, child development, toddler care, life skills, and healthy living. The health educators also refer families to community resources to address specific needs.

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Target Population

Family Spirit serves pregnant women and families with children younger than age 3. The developer strongly recommends enrolling mothers early in pregnancy. Family Spirit was designed to be implemented in Native American communities. However, it is now also being used with non-Native populations with high maternal and child behavioral health disparities.

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Where to Find Out More

Allison Ingalls
Program Manager
Phone: (443) 287-5154
Email: aingalls@jhu.edu or familyspirit@jhu.edu
Website: www.jhsph.edu/caih/familyspirit

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Effects Shown in Research & Outcome Measure Details

Summary of Findings

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.

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Positive Parenting Practices

Outcomes 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 Outcome Type 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
Primary
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
Primary
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
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Secondary
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
Secondary
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
Secondary
Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

HOME Inventory - 12 months

45-item assessment of parental behavior, parent-child interaction, and home environment Researcher observation

α = 0.75

Primary

HOME Inventory - 6 months

45-item assessment of parental behavior, parent-child interaction, and home environment Researcher observation

α = 0.75

Primary

PLOC Parental self-efficacy - 12 months

Self-efficacy subscale from Parental Locus of Control assessment

Maternal self-report

α = 0.67

Secondary

PLOC Parental self-efficacy - 6 months

Self-efficacy subscale from Parental Locus of Control assessment

Maternal self-report

α = 0.67

Secondary

Home safety attitudes

8-item assessment of attitudes towards home safety for children Maternal self-report

α = 0.57 for attitudinal component

Secondary

Home safety practices

8-item assessment of attitudes towards home safety for children Maternal self-report

α = 0.57 for attitudinal component

Secondary

Parenting knowledge

30-item assessment created by the investigator team to measure knowledge gains Maternal self-report

α = 0.65

Secondary
Family Spirit®
Show Findings Details
Outcome Measure Effect Follow-up Timing Sample Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type 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 Primary
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 Secondary
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 Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

HOME inventory (range 0-37)

37-item assessment of parental behavior, parent-child interaction, and home environment (maternal acceptance subscale was omitted) Researcher observation

a = 0.73

Primary

Parenting knowledge (range 0-30)

30-item assessment created by the investigator team to measure knowledge gains Maternal self-report

a = 0.58

Secondary

Parenting locus of control (range 27-135)

27-item assessment of parent self-efficacy, parent control, and child control Maternal self-report

a = 0.84

Secondary

Outcomes 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 Outcome Type
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 HomeVEE calculated = -0.04 Not statistically significant,
p = >=.10
Secondary
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 HomeVEE calculated = 0.15 Not statistically significant,
p = >=.10
Secondary
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 HomeVEE calculated = 0.03 Not statistically significant,
p = >=.10
Secondary
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 HomeVEE calculated = 0.86 Statistically significant, p<.01 Secondary
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 HomeVEE calculated = 0.06 Not statistically significant,
p = >=.05
Secondary
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 HomeVEE calculated = 0.81 Statistically significant, p<.01 Secondary
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 HomeVEE calculated = -0.04 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.14 Not statistically significant,
p = >=.10
Primary
Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

Change in maternal involvement - 2 months

5-item assessment scored on a 4-point scale adapted from Substance Abuse and Mental Health Administration measures Maternal self-report

α = 0.65

Secondary

Change in maternal involvement - 12 months

5-item assessment scored on a 4-point scale adapted from Substance Abuse and Mental Health Administration measures Maternal self-report

α = 0.65

Secondary

Change in maternal involvement - 6 months

5-item assessment scored on a 4-point scale adapted from Substance Abuse and Mental Health Administration measures Maternal self-report

α = 0.65

Secondary

Change in parenting knowledge - 12 months

76-item assessment created by the investigator team to measure knowledge gains Maternal self-report

α = 0.95

Secondary

Change in parenting knowledge - 2 months

76-item assessment created by the investigator team to measure knowledge gains Maternal self-report

α = 0.95

Secondary

Change in parenting knowledge - 6 months

76-item assessment created by the investigator team to measure knowledge gains Maternal self-report

α = 0.95

Secondary

Home Observation for Measurement of the Environment - 12 months

45-item assessment of parental behavior, parent-child interaction, and home environment Researcher observation

α = 0.89

Primary

Home Observation for Measurement of the Environment - 6 months

45-item assessment of parental behavior, parent-child interaction, and home environment Researcher observation

α = 0.89

Primary
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Maternal Health

Outcomes 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 Outcome Type 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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 25.77 Adjusted mean % = 21.55 OR = 1.14 HomeVEE calculated = 0.14 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 17.92 Adjusted mean % = 17.81 OR = 0.80 HomeVEE calculated = 0.00 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 16.88 Adjusted mean % = 20.02 OR = 0.71 HomeVEE calculated = -0.13 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 38.93 Adjusted mean % = 34.64 OR = 1.07 HomeVEE calculated = 0.11 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 32.91 Adjusted mean % = 29.11 OR = 1.04 HomeVEE calculated = 0.11 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 27.74 Adjusted mean % = 30.78 OR = 0.76 HomeVEE calculated = -0.09 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 21.34 Adjusted mean % = 21.90 OR = 0.83 HomeVEE calculated = -0.02 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 22.89 Adjusted mean % = 21.92 OR = 0.93 HomeVEE calculated = 0.03 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 18.91 Adjusted mean % = 19.65 OR = 0.83 HomeVEE calculated = -0.03 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 20.63 Adjusted mean % = 21.02 OR = 0.87 HomeVEE calculated = -0.01 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 12.39 Adjusted mean % = 18.83 OR = 0.57 HomeVEE calculated = -0.30 Not statistically significant,
p > 0.05
Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

ASEBA - Externalizing

Achenbach System of Empirically Based Assessment is a 112 item assessment of externalizing, internalizing, and total problems that produces results in relation to multicultural norms Maternal self-report

α range = 0.69-0.79 across scales

Primary

ASEBA - Internalizing

Achenbach System of Empirically Based Assessment is a 112 item assessment of externalizing, internalizing, and total problems that produces results in relation to multicultural norms Maternal self-report

α range = 0.69-0.79 across scales

Primary

ASEBA - Total Problems

Achenbach System of Empirically Based Assessment is a 112 item assessment of externalizing, internalizing, and total problems that produces results in relation to multicultural norms Maternal self-report

α range = 0.69-0.79 across scales

Primary

POSIT Mental Health

Problem Oriented Screening Instrument for Teens is a 139 item assessment containing 6 subscales, which include mental health and substance abuse. Maternal self-report

α range = 0.60-0.83 across scales

Secondary

POSIT Substance Abuse

Problem Oriented Screening Instrument for Teens is a 139 item assessment containing 6 subscales, which include mental health and substance abuse. Maternal self-report

α range = 0.60-0.83 across scales

Secondary

Alcohol - past 30 days, use of

Substance use, according to the Voices of Indian Teens survey Maternal self report

Not applicable

Secondary

Any alcohol or illegal drug - past 30 days, use of

Substance use, according to the Voices of Indian Teens survey Maternal self report

Not applicable

Secondary

Any illegal drug - past 30 days, use of

Substance use, according to the Voices of Indian Teens survey Maternal self report

Not applicable

Secondary

CES-D

Center for Epidemiological Studies Depression is a 20-item assessment of depressive symptoms Maternal self-report

α = 0.88

Secondary

Marijuana - past 30 days, use of

Substance use, according to the Voices of Indian Teens survey Maternal self report

Not applicable

Secondary
Family Spirit®
Show Findings Details
Outcome Measure Effect Follow-up Timing Sample Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type 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 Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 Secondary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 HomeVEE calculated = 0.04 Not statistically significant, p = 0.67 Secondary

footnote183

Submitted by user on Fri, 03/15/2019 - 14:29

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 HomeVEE calculated = -0.24 Statistically significant, p = 0.01 Secondary

footnote183

Submitted by user on Fri, 03/15/2019 - 14:29

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 HomeVEE calculated = -0.26 Statistically significant, p = 0.01 Secondary

footnote183

Submitted by user on Fri, 03/15/2019 - 14:29

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 Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

ASEBA Externalizing (T-score)

Achenbach System of Empirically Based Assessment is a 112 item assessment of externalizing, internalizing, and total problems that produces results in relation to multicultural norms Maternal self-report

a = 0.90 for overall scale

Primary

ASEBA Internalizing (T-score)

Achenbach System of Empirically Based Assessment is a 112 item assessment of externalizing, internalizing, and total problems that produces results in relation to multicultural norms Maternal self-report

a = 0.90 for overall scale

Primary

ASEBA Total Problems (T-score)

Achenbach System of Empirically Based Assessment is a 112 item assessment of externalizing, internalizing, and total problems that produces results in relation to multicultural norms Maternal self-report

a = 0.90 for overall scale

Primary

CES-D score (0-60)

Center for Epidemiological Studies Depression is a 20-item assessment of depressive symptoms Maternal self-report

a = 0.84

Secondary

Alcohol use in past 30 days (proportion)

Proportion with use as measured by Voices for Indian Teens, a culturally specific assessment that measures quantity and frequency of substance use Maternal self-report

a = 0.73 for overall scale

Secondary

Any Illegal Drug use in past 30 days (proportion)

Proportion with use as measured by Voices for Indian Teens, a culturally specific assessment that measures quantity and frequency of substance use Maternal self-report

a = 0.73 for overall scale

Secondary

Marijuana use in past 30 days (proportion)

Proportion with use as measured by Voices for Indian Teens, a culturally specific assessment that measures quantity and frequency of substance use Maternal self-report

a = 0.73 for overall scale

Secondary

Parenting stress index (range 0-180)

36-item assessment of parenting-related stress, for which scoring norms are available by child age Maternal self-report

a = 0.94

Primary

Outcomes 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 Outcome Type
Alcohol in last month - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers &#37 (Adjusted) = 19.00 Adjusted mean % = 13.00 OR = 1.54 HomeVEE calculated = 0.25 Not statistically significant,
p = >=.10
Secondary
Alcohol in last month - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers &#37 (Adjusted) = 11.00 Adjusted mean % = 7.00 OR = 1.52 HomeVEE calculated = 0.30 Not statistically significant,
p = >=.10
Secondary
Alcohol in last month - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers &#37 (Adjusted) = 12.00 Adjusted mean % = 6.00 OR = 2.19 HomeVEE calculated = 0.39 Not statistically significant,
p = >=.10
Secondary
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 HomeVEE calculated = 0.12 Not statistically significant,
p = >=.10
Secondary
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 HomeVEE calculated = 0.00 Not statistically significant,
p = >=.10
Secondary
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 HomeVEE calculated = -0.10 Not statistically significant,
p = >=.10
Secondary
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 HomeVEE calculated = 0.13 Not statistically significant,
p = >=.10
Secondary
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 HomeVEE calculated = 0.07 Not statistically significant,
p = >=.10
Secondary
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 HomeVEE calculated = -0.06 Not statistically significant,
p = >=.10
Secondary
Cigarette in last month - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers &#37 (Adjusted) = 19.00 Adjusted mean % = 15.00 OR = 1.27 HomeVEE calculated = 0.14 Not statistically significant,
p = >=.10
Secondary
Cigarette in last month - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers &#37 (Adjusted) = 13.00 Adjusted mean % = 17.00 OR = 0.74 HomeVEE calculated = -0.19 Not statistically significant,
p = >=.10
Secondary
Cigarette in last month - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers &#37 (Adjusted) = 22.00 Adjusted mean % = 13.00 OR = 2.06 HomeVEE calculated = 0.35 Not statistically significant,
p = >=.10
Secondary
Illegal substance in last month - 12 months
FavorableUnfavorable or ambiguousNo Effect
12 months postpartum Mothers enrolled 2002-2004 82 mothers &#37 (Adjusted) = 16.00 Adjusted mean % = 9.00 OR = 2.37 HomeVEE calculated = 0.41 Not statistically significant,
p = >=.10
Secondary
Illegal substance in last month - 2 months
FavorableUnfavorable or ambiguousNo Effect
2 months postpartum Mothers enrolled 2002-2004 125 mothers &#37 (Adjusted) = 13.00 Adjusted mean % = 7.00 OR = 2.02 HomeVEE calculated = 0.41 Not statistically significant,
p = >=.10
Secondary
Illegal substance in last month - 6 months
FavorableUnfavorable or ambiguousNo Effect
6 months postpartum Mothers enrolled 2002-2004 115 mothers &#3 (Adjusted) = 7.00 Adjusted mean % = 3.00 OR = 2.57 HomeVEE calculated = 0.49 Not statistically significant,
p = >=.10
Secondary
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 HomeVEE calculated = 0.14 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.26 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.05 Not statistically significant,
p = >=.10
Primary
Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

Alcohol in last month - 12 months

Self-report item developed by Substance Abuse and Mental Health Services Administration regarding participants’ substance use in the previous month Maternal self-report

Not applicable

Secondary

Alcohol in last month - 2 months

Self-report item developed by Substance Abuse and Mental Health Services Administration regarding participants’ substance use in the previous month Maternal self-report

Not applicable

Secondary

Alcohol in last month - 6 months

Self-report item developed by Substance Abuse and Mental Health Services Administration regarding participants’ substance use in the previous month Maternal self-report

Not applicable

Secondary

Change in depressive symptoms (CES-D) - 2 months

Center for Epidemiological Studies Depression is a 20-item assessment of depressive symptoms scored on a 4-point scale Maternal self-report

α = 0.88

Secondary

Change in depressive symptoms (CES-D) - 6 months

Center for Epidemiological Studies Depression is a 20-item assessment of depressive symptoms scored on a 4-point scale Maternal self-report

α = 0.88

Secondary

Change in depressive symptoms (CES-D)- 12 months

Center for Epidemiological Studies Depression is a 20-item assessment of depressive symptoms scored on a 4-point scale Maternal self-report

α = 0.88

Secondary

Change in social support - 12 months

A 20-item assessment scored on a 5-point scale designed to measure participants’ perceived support form family, friends, and community Maternal self report

α = 0.93

Secondary

Change in social support - 2 months

A 20-item assessment scored on a 5-point scale designed to measure participants’ perceived support form family, friends, and community Maternal self report

α = 0.93

Secondary

Change in social support - 6 months

A 20-item assessment scored on a 5-point scale designed to measure participants’ perceived support form family, friends, and community Maternal self report

α = 0.93

Secondary

Cigarette in last month - 12 months

Self-report item developed by Substance Abuse and Mental Health Services Administration regarding participants’ substance use in the previous month Maternal self-report

Not applicable

Secondary

Cigarette in last month - 2 months

Self-report item developed by Substance Abuse and Mental Health Services Administration regarding participants’ substance use in the previous month Maternal self-report

Not applicable

Secondary

Cigarette in last month - 6 months

Self-report item developed by Substance Abuse and Mental Health Services Administration regarding participants’ substance use in the previous month Maternal self-report

Not applicable

Secondary

Illegal substance in last month - 12 months

Self-report item developed by Substance Abuse and Mental Health Services Administration regarding participants’ substance use in the previous month Maternal self-report

Not applicable

Secondary

Illegal substance in last month - 2 months

Self-report item developed by Substance Abuse and Mental Health Services Administration regarding participants’ substance use in the previous month Maternal self-report

Not applicable

Secondary

Illegal substance in last month - 6 months

Self-report item developed by Substance Abuse and Mental Health Services Administration regarding participants’ substance use in the previous month Maternal self-report

Not applicable

Secondary

Parenting stress index - 12 months

30-item assessment of parenting-related stress, for which scoring norms are available by child age Maternal self-report

α = 0.80

Secondary

Parenting stress index - 2 months

30-item assessment of parenting-related stress, for which scoring norms are available by child age Maternal self-report

α = 0.80

Secondary

Parenting stress index - 6 months

30-item assessment of parenting-related stress, for which scoring norms are available by child age Maternal self-report

α = 0.80

Secondary
View Revisions

Child Development and School Readiness

Outcomes 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 Outcome Type 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
Primary
ITSEA - Competence domain, % clinically at risk
FavorableUnfavorable or ambiguousNo Effect
12 months Family Spirit RCT, 2006-2008 sample 319 mothers Adjusted &#37 = 20.27 Adjusted mean % = 17.66 OR = 0.86 HomeVEE calculated = 0.10 Not statistically significant,
p > 0.05
Primary
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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 15.80 Adjusted mean % = 18.67 OR = 1.37 HomeVEE calculated = -0.12 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 13.69 Adjusted mean % = 20.62 OR = 1.88 HomeVEE calculated = -0.30 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 &#37 = 20.27 Adjusted mean % = 27.16 OR = 1.61 HomeVEE calculated = -0.23 Not statistically significant,
p > 0.05
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

ITSEA - Competence domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary

ITSEA - Competence domain, % clinically at risk

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary

ITSEA - Dysregulation domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary

ITSEA - Dysregulation domain, % clinically at risk

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary

ITSEA - Externalizing domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary

ITSEA - Externalizing domain, % clinically at risk

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary

ITSEA - Internalizing domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary

ITSEA - Internalizing domain, % clinically at risk

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.63-.81

Primary

Outcomes 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 Outcome Type 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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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
Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

CBCL mean, Externalizing domain (0-48) (T-score)

Child Behavior Check List is a 99-item normed parent report of child behavior Maternal report

α = 0.91 for subscale

Primary

CBCL mean, Internalizing domain (0-72) (T-score)

Child Behavior Check List is a 99-item normed parent report of child behavior Maternal report

α = 0.89 for subscale

Primary

CBCL mean, Total Problems (0-200) (T-score)

Child Behavior Check List is a 99-item normed parent report of child behavior Maternal report

α = 0.94 for subscale

Primary
Family Spirit®
Show Findings Details
Outcome Measure Effect Follow-up Timing Sample Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type 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 HomeVEE calculated = 0.03 Not statistically significant, p = 0.78 Primary
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 HomeVEE calculated = -0.23 Not statistically significant, p = 0.08 Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 HomeVEE calculated = -0.24 Statistically significant, p = 0.03 Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 HomeVEE calculated = -0.27 Statistically significant, p = 0.04 Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 Primary
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 Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

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 Primary

footnote162

Submitted by user on Fri, 03/15/2019 - 14:29

Negative value is favorable to the intervention.

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

ITSEA Competence domain (proportion clinically at risk (>10%))

Proportion clinically at risk on subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

a = 0.89 for subscale

Primary

ITSEA Dysregulation domain (proportion clinically at risk (>10%))

Proportion clinically at risk on subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

a = 0.89 for subscale

Primary

ITSEA Externalizing domain (proportion clinically at risk (>10%))

Proportion clinically at risk on subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

a = 0.84 for subscale

Primary

ITSEA Internalizing domain (proportion clinically at risk (>10%))

Proportion clinically at risk on subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

a = 0.80 for subscale

Primary

ITSEA mean, Competence domain (range 0-2)

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

a = 0.89 for subscale

Primary

ITSEA mean, Dysregulation domain (range 0-2)

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

a = 0.89 for subscale

Primary

ITSEA mean, Externalizing domain (range 0-2)

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

a = 0.84 for subscale

Primary

ITSEA mean, Internalizing domain (range 0-2)

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

a = 0.80 for subscale

Primary
Family Spirit®
Show Findings Details
Outcome Measure Effect Follow-up Timing Sample Sample Size Intervention Group Comparison Group Group Difference Effect Size Statistical Significance Outcome Type 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 HomeVEE calculated = -0.03 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = 0.08 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = 0.18 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = 0.15 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.05 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.08 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.68 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.22 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.04 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.03 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.41 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.25 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.63 Statistically significant, p<.05 Primary

footnote182

Submitted by user on Fri, 03/15/2019 - 14:29

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 HomeVEE calculated = -0.65 Statistically significant, p<.05 Primary

footnote182

Submitted by user on Fri, 03/15/2019 - 14:29

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 HomeVEE calculated = -0.29 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.68 Statistically significant, p<.05 Primary

footnote182

Submitted by user on Fri, 03/15/2019 - 14:29

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 HomeVEE calculated = -0.35 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.13 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.04 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.24 Not statistically significant,
p = >=.10
Primary
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 HomeVEE calculated = -0.52 Statistically significant, p<.05 Primary

footnote182

Submitted by user on Fri, 03/15/2019 - 14:29

Negative differences favor the program group

Show Outcome Measure Summary
Outcome Measure Outcome Measure Description Collection Method Properties Outcome Type Operations links

ITSEA Competence domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Competence: Attention

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Competence: Compliance

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Dysregulation domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Dysregulation: Eating

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Dysregulation: Negative emotionality

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Dysregulation: Sensory sensitivity

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Dysregulation: Sleep

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Externalizing domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Externalizing: Activity/impulsivity

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Externalizing: Aggression/defiance

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Externalizing: Peer aggression

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Internalizing domain

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Internalizing: Depression/withdraw

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Internalizing: General anxiety

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Internalizing: Inhibition to novelty

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary

ITSEA Internalizing: Separation distress

Subscale from 126 item normed assessment of child behaviors, the Infant Toddler Social Emotional Assessment Maternal report

α range = 0.71-.83

Primary
View Revisions

In Brief

Evidence of Model Effectiveness

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

View Revisions

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 Model Overview.

View Revisions

Extent of Evidence

Results of Research and Review
Number of studies
Eligible for review
6
Rated high
2
Rated moderate
2
Rated low
1
Additional source1
1

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

View Revisions

Summary of Findings

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.

View Revisions

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 OR the same domain for at least two non-overlapping samples?
Yes
Favorable impacts on full sample?
Yes
Any favorable impacts on outcome measures sustained at least 12 months after model enrollment?1
Yes
One or more favorable, statistically significant impact reported in a peer-reviewed journal?1
Yes

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

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