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

Model effectiveness research report last updated: 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 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 source2
1

1When an individual manuscript reports findings from multiple studies, HomVEE reviews each study as a distinct manuscript. In these rare instances, HomVEE counts that manuscript multiple times in this table, once for each study identified, screened, and reviewed by HomVEE.

2Additional sources have findings or details that perfectly overlap with another manuscript and are not rated.

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

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Summary of findings

To see details on each finding HomVEE reviewed in well-designed research, click on the name of an outcome domain in the tables below. Findings rated low quality by HomVEE are not summarized here.

Outcomes
Findings

Outcome Child Development and School Readiness

Findings:
Favorable: 10
No effect: 30
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

Findings:
Favorable: 5
No effect: 47
Unfavorable or ambiguous: 0

Outcome Positive Parenting Practices

Findings:
Favorable: 7
No effect: 11
Unfavorable or ambiguous: 0

Outcome Reductions in Child Maltreatment

Not measured

Outcome Reductions in Juvenile Delinquency, Family Violence, and Crime

Not measured

The section above focuses on findings from the full sample in a study. Subgroups that have been replicated in distinct samples also have findings reported above. HomVEE does not report the findings of non-replicated subgroups. Beginning with research reviewed in 2021, however, HomVEE, lists those subgroups on the details page of each manuscript that had at least one finding that rated moderate or high.

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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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