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

Last updated: May 2016

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.

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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.

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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

1Additional sources overlap with another study and are not rated.

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

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Summary of Findings

Outcome domain links to effects details by study.
Outcomes
Primary Outcome Measures
Secondary Outcome Measures

Outcome Child Development and School Readiness

Primary outcome measures:
Favorable: 10
No effect: 30
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 0
No effect: 0
Unfavorable or ambiguous: 0

Outcome Child Health

Not measured

Outcome Family Economic Self-Sufficiency

Not measured

Outcome Linkages and Referrals

Not measured

Outcome Maternal Health

Primary outcome measures:
Favorable: 2
No effect: 17
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 3
No effect: 30
Unfavorable or ambiguous: 0

Outcome Positive Parenting Practices

Primary outcome measures:
Favorable: 0
No effect: 5
Unfavorable or ambiguous: 0
Secondary outcome measures:
Favorable: 7
No effect: 6
Unfavorable or ambiguous: 0

Outcome Reductions in Child Maltreatment

Not measured

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Not measured

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

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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

1This information is reported for all models, but the requirements for sustained findings and inclusion in a peer-reviewed journal only apply to models for which all findings are from randomized controlled trials.

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

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