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

Last updated: 2016

Model overview

Theoretical approach

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 seeks 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 services

Paraprofessional home visitors meet with families in their homes. The home visitors try to establish a close rapport with families to facilitate delivery of the curriculum, which consists of 63 lessons within the following six domains: (1) prenatal care, (2) infant care, (3) child development, (4) toddler care, (5) life skills, and (6) healthy living. The home visitors also refer families to community resources to address specific needs.

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Intended population

Family Spirit serves pregnant women and families with children younger than age 3. The developer strongly recommends enrolling mothers prenatally. Family Spirit was designed to be implemented with American Indian families. However, it is now also 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: (716) 406-3376
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

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 &#37 = 20.27 Adjusted mean % = 17.66 OR = 0.86 HomeVEE 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

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

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

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

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

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

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 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

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

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

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

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

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

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

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

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
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

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

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

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 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

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

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

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 HomeVEE 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 HomeVEE calculated = -0.23 Not statistically significant, p = 0.08

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

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

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
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 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

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

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 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

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

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

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

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

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

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

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

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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE calculated = -0.63 Statistically significant, p<.05

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

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
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

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
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
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
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
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

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 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Positive parenting practices

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
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

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

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
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
Show outcome measure summary
Outcome measure Outcome measure description Collection method Properties Operations links

HOME Inventory - 12 months

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

α = 0.75

HOME Inventory - 6 months

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

α = 0.75

PLOC Parental self-efficacy - 12 months

Self-efficacy subscale from Parental Locus of Control assessment

Maternal self-report

α = 0.67

PLOC Parental self-efficacy - 6 months

Self-efficacy subscale from Parental Locus of Control assessment

Maternal self-report

α = 0.67

Home safety attitudes

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

α = 0.57 for attitudinal component

Home safety practices

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

α = 0.57 for attitudinal component

Parenting knowledge

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

α = 0.65

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

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 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

Parenting knowledge (range 0-30)

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

a = 0.58

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

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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE calculated = -0.14 Not statistically significant,
p = >=.10
Show outcome measure summary
Outcome measure Outcome measure description Collection method Properties 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

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

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

Change in parenting knowledge - 12 months

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

α = 0.95

Change in parenting knowledge - 2 months

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

α = 0.95

Change in parenting knowledge - 6 months

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

α = 0.95

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

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

View Revisions

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 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

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

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

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

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

Alcohol - past 30 days, use of

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

Not applicable

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

Any illegal drug - past 30 days, use of

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

Not applicable

CES-D

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

α = 0.88

Marijuana - past 30 days, use of

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

Not applicable

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 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

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

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

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

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

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

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

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 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

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

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

CES-D score (0-60)

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

a = 0.84

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

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

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

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

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 &#37 (Adjusted) = 19.00 Adjusted mean % = 13.00 OR = 1.54 HomeVEE 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 &#37 (Adjusted) = 11.00 Adjusted mean % = 7.00 OR = 1.52 HomeVEE 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 &#37 (Adjusted) = 12.00 Adjusted mean % = 6.00 OR = 2.19 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE 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 &#37 (Adjusted) = 19.00 Adjusted mean % = 15.00 OR = 1.27 HomeVEE 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 &#37 (Adjusted) = 13.00 Adjusted mean % = 17.00 OR = 0.74 HomeVEE 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 &#37 (Adjusted) = 22.00 Adjusted mean % = 13.00 OR = 2.06 HomeVEE 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 &#37 (Adjusted) = 16.00 Adjusted mean % = 9.00 OR = 2.37 HomeVEE 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 &#37 (Adjusted) = 13.00 Adjusted mean % = 7.00 OR = 2.02 HomeVEE 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 &#3 (Adjusted) = 7.00 Adjusted mean % = 3.00 OR = 2.57 HomeVEE 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 HomeVEE 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 HomeVEE 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 HomeVEE calculated = -0.05 Not statistically significant,
p = >=.10
Show outcome measure summary
Outcome measure Outcome measure description Collection method Properties 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 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). For more information, please read the Model Overview.

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Extent of evidence

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
1
  …but manuscript is additional source1
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.

View Revisions

Summary of findings

View Revisions

Criteria established by the U.S. Department of Health and Human Services

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

Notes: If the model does not meet criterion 3 but meets criteria 1 and 2 based on findings from subgroups, the impacts must be replicated in the same domain in two or more studies using non-overlapping analytic study samples. HomVEE assesses and reports criteria 4 and 5 for all models that have well-designed research, but meeting those two criteria is only required of models for which all findings are from randomized controlled trials. Please read the HHS criteria for evidence-based models for more information.

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