footnote162
Negative value is favorable to the intervention.
Model effectiveness research report last updated: 2022
The Family Spirit conceptual framework is based on G.R. Patterson’s model, which suggests that parenting is the critical link between parents’ personal characteristics and environment, and children’s individual risks and outcomes. The Family Spirit intervention seeks to improve mothers’ parenting skills while helping them develop 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 Native American communities.
Paraprofessional home visitors meet with families in their homes. The home visitors try to establish a close rapport with families to enable 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, such as planning, nutrition, physical exercise, budgeting, health, and communication; and (6) healthy living, including goal-setting, substance abuse prevention, family planning, and prevention of sexually transmitted infections. The home visitors also refer families to community resources to address specific needs.
The curriculum package includes an implementation guide, home visitor lesson plans, a reference manual on lesson topics, and a sample participant workbook with handouts and worksheets.
Family Spirit serves pregnant women and families with children from birth to age 36 months. The developer strongly recommends enrolling mothers while they are pregnant. Family Spirit was designed to be implemented with Native American families. However, it is now also used in non-Native populations with high maternal and child behavioral health disparities.
Family Spirit National Office
Johns Hopkins Center for Indigenous Health
Email:
familyspirit@jhu.edu
Website:
https://www.jhsph.edu/research/affiliated-programs/family-spirit/
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 |
footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative value is favorable to the intervention. |
Alcohol - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
12 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 25.77 | Adjusted mean % = 21.55 | OR = 1.14 | HomVEE calculated = 0.14 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Alcohol - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
2 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 17.92 | Adjusted mean % = 17.81 | OR = 0.80 | HomVEE calculated = 0.00 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Alcohol - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
6 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 16.88 | Adjusted mean % = 20.02 | OR = 0.71 | HomVEE calculated = -0.13 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Any alcohol or illegal drug - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
12 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 38.93 | Adjusted mean % = 34.64 | OR = 1.07 | HomVEE calculated = 0.11 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Any alcohol or illegal drug - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
2 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 32.91 | Adjusted mean % = 29.11 | OR = 1.04 | HomVEE calculated = 0.11 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Any alcohol or illegal drug - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
6 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 27.74 | Adjusted mean % = 30.78 | OR = 0.76 | HomVEE calculated = -0.09 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Any illegal drug - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
12 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 21.34 | Adjusted mean % = 21.90 | OR = 0.83 | HomVEE calculated = -0.02 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Any illegal drug - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
2 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 22.89 | Adjusted mean % = 21.92 | OR = 0.93 | HomVEE calculated = 0.03 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Marijuana - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
12 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 18.91 | Adjusted mean % = 19.65 | OR = 0.83 | HomVEE calculated = -0.03 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Marijuana - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
2 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 20.63 | Adjusted mean % = 21.02 | OR = 0.87 | HomVEE calculated = -0.01 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Marijuana - past 30 days, use of | FavorableUnfavorable or ambiguousNo Effect |
6 months | Family Spirit RCT, 2006-2008 sample | 322 mothers | Adjusted % = 12.39 | Adjusted mean % = 18.83 | OR = 0.57 | HomVEE calculated = -0.30 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative value is favorable to the intervention. |
Alcohol use in past 30 days (proportion) | FavorableUnfavorable or ambiguousNo Effect |
2006-2008 sample, 3 years postpartum | Full | 322 mothers | Unadjusted mean = 0.17 | Unadjusted mean = 0.16 | Mean difference = 0.01 | HomVEE calculated = 0.04 | Not statistically significant, p = 0.67 | footnote183Lower values favor the intervention |
Any illegal drug use in past 30 days (proportion) | FavorableUnfavorable or ambiguousNo Effect |
2006-2008 sample, 3 years postpartum | Full | 322 mothers | Unadjusted mean = 0.12 | Unadjusted mean = 0.17 | Mean difference = -0.05 | HomVEE calculated = -0.24 | Statistically significant, p = 0.01 | footnote183Lower values favor the intervention |
Marijuana use in past 30 days (proportion) | FavorableUnfavorable or ambiguousNo Effect |
2006-2008 sample, 3 years postpartum | Full | 322 mothers | Unadjusted mean = 0.11 | Unadjusted mean = 0.16 | Mean difference = -0.05 | HomVEE calculated = -0.26 | Statistically significant, p = 0.01 | footnote183Lower 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 | footnote162Negative value is favorable to the intervention. |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
---|---|---|---|---|---|---|---|---|---|
Alcohol in last month - 12 months | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Mothers enrolled 2002-2004 | 82 mothers | Adjusted mean % = 19.00 | Adjusted mean % = 13.00 | OR = 1.54 | HomVEE calculated = 0.25 | Not statistically significant, p = >=.10 |
Alcohol in last month - 2 months | FavorableUnfavorable or ambiguousNo Effect |
2 months postpartum | Mothers enrolled 2002-2004 | 125 mothers | Adjusted mean % = 11.00 | Adjusted mean % = 7.00 | OR = 1.52 | HomVEE calculated = 0.30 | Not statistically significant, p = >=.10 |
Alcohol in last month - 6 months | FavorableUnfavorable or ambiguousNo Effect |
6 months postpartum | Mothers enrolled 2002-2004 | 115 mothers | Adjusted mean % = 12.00 | Adjusted mean % = 6.00 | OR = 2.19 | HomVEE calculated = 0.39 | Not statistically significant, p = >=.10 |
Change in depressive symptoms (CES-D) - 2 months | FavorableUnfavorable or ambiguousNo Effect |
2 months postpartum | Mothers enrolled 2002-2004 | 125 mothers | Adjusted mean = -2.00 | Adjusted mean = -3.30 | coeff = 0.05 | HomVEE calculated = 0.12 | Not statistically significant, p = >=.10 |
Change in depressive symptoms (CES-D) - 6 months | FavorableUnfavorable or ambiguousNo Effect |
6 months postpartum | Mothers enrolled 2002-2004 | 115 mothers | Adjusted mean = -4.00 | Adjusted mean = -4.00 | coeff = -0.58 | HomVEE calculated = 0.00 | Not statistically significant, p = >=.10 |
Change in depressive symptoms (CES-D)- 12 months | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Mothers enrolled 2002-2004 | 82 mothers | Adjusted mean = -3.10 | Adjusted mean = -2.00 | coeff = -1.69 | HomVEE calculated = -0.10 | Not statistically significant, p = >=.10 |
Change in social support - 12 months | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Mothers enrolled 2002-2004 | 82 mothers | Adjusted mean = 0.50 | Adjusted mean = -2.20 | coeff = 1.98 | HomVEE calculated = 0.13 | Not statistically significant, p = >=.10 |
Change in social support - 2 months | FavorableUnfavorable or ambiguousNo Effect |
2 months postpartum | Mothers enrolled 2002-2004 | 125 mothers | Adjusted mean = -0.40 | Adjusted mean = -1.70 | coeff = -0.21 | HomVEE calculated = 0.07 | Not statistically significant, p = >=.10 |
Change in social support - 6 months | FavorableUnfavorable or ambiguousNo Effect |
6 months postpartum | Mothers enrolled 2002-2004 | 115 mothers | Adjusted mean = -3.70 | Adjusted mean = -2.50 | coeff = -0.98 | HomVEE calculated = -0.06 | Not statistically significant, p = >=.10 |
Cigarette in last month - 12 months | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Mothers enrolled 2002-2004 | 82 mothers | Adjusted mean % = 19.00 | Adjusted mean % = 15.00 | OR = 1.27 | HomVEE calculated = 0.14 | Not statistically significant, p = >=.10 |
Cigarette in last month - 2 months | FavorableUnfavorable or ambiguousNo Effect |
2 months postpartum | Mothers enrolled 2002-2004 | 125 mothers | Adjusted mean % = 13.00 | Adjusted mean % = 17.00 | OR = 0.74 | HomVEE calculated = -0.19 | Not statistically significant, p = >=.10 |
Cigarette in last month - 6 months | FavorableUnfavorable or ambiguousNo Effect |
6 months postpartum | Mothers enrolled 2002-2004 | 115 mothers | Adjusted mean % = 22.00 | Adjusted mean % = 13.00 | OR = 2.06 | HomVEE calculated = 0.35 | Not statistically significant, p = >=.10 |
Illegal substance in last month - 12 months | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Mothers enrolled 2002-2004 | 82 mothers | Adjusted mean % = 16.00 | Adjusted mean % = 9.00 | OR = 2.37 | HomVEE calculated = 0.41 | Not statistically significant, p = >=.10 |
Illegal substance in last month - 2 months | FavorableUnfavorable or ambiguousNo Effect |
2 months postpartum | Mothers enrolled 2002-2004 | 125 mothers | Adjusted mean % = 13.00 | Adjusted mean % = 7.00 | OR = 2.02 | HomVEE calculated = 0.41 | Not statistically significant, p = >=.10 |
Illegal substance in last month - 6 months | FavorableUnfavorable or ambiguousNo Effect |
6 months postpartum | Mothers enrolled 2002-2004 | 115 mothers | Adjusted mean % = 7.00 | Adjusted mean % = 3.00 | OR = 2.57 | HomVEE calculated = 0.49 | Not statistically significant, p = >=.10 |
Parenting stress index - 12 months | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Mothers enrolled 2002-2004 | 82 mothers | Adjusted mean = 62.60 | Adjusted mean = 60.40 | coeff = 3.91 | HomVEE calculated = 0.14 | Not statistically significant, p = >=.10 |
Parenting stress index - 2 months | FavorableUnfavorable or ambiguousNo Effect |
2 months postpartum | Mothers enrolled 2002-2004 | 125 mothers | Adjusted mean = 62.30 | Adjusted mean = 66.80 | coeff = -3.31 | HomVEE calculated = -0.26 | Not statistically significant, p = >=.10 |
Parenting stress index - 6 months | FavorableUnfavorable or ambiguousNo Effect |
6 months postpartum | Mothers enrolled 2002-2004 | 115 mothers | Adjusted mean = 63.30 | Adjusted mean = 64.10 | coeff = 1.01 | HomVEE calculated = -0.05 | Not statistically significant, p = >=.10 |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
ITSEA - Competence domain | FavorableUnfavorable or ambiguousNo Effect |
12 months | Family Spirit RCT, 2006-2008 sample | 319 mothers | Adjusted mean = 1.07 | Adjusted mean = 1.02 | Mean difference = 0.05 | Study reported = 0.12 | Not statistically significant, p ≥ 0.05 | |
ITSEA - Competence domain, % clinically at risk | FavorableUnfavorable or ambiguousNo Effect |
12 months | Family Spirit RCT, 2006-2008 sample | 319 mothers | Adjusted % = 20.27 | Adjusted mean % = 17.66 | OR = 0.86 | HomVEE calculated = 0.10 | Not statistically significant, p ≥ 0.05 | |
ITSEA - Dysregulation domain | FavorableUnfavorable or ambiguousNo Effect |
12 months | Family Spirit RCT, 2006-2008 sample | 319 mothers | Adjusted mean = 0.54 | Adjusted mean = 0.59 | Mean difference = -0.06 | Study reported = -0.15 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
ITSEA - Dysregulation domain, % clinically at risk | FavorableUnfavorable or ambiguousNo Effect |
12 months | Family Spirit RCT, 2006-2008 sample | 319 mothers | Adjusted % = 15.80 | Adjusted mean % = 18.67 | OR = 1.37 | HomVEE calculated = -0.12 | Not statistically significant, p ≥ 0.05 | footnote162Negative 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 |
footnote162Negative value is favorable to the intervention. |
ITSEA - Externalizing domain, % clinically at risk | FavorableUnfavorable or ambiguousNo Effect |
12 months | Family Spirit RCT, 2006-2008 sample | 319 mothers | Adjusted % = 13.69 | Adjusted mean % = 20.62 | OR = 1.88 | HomVEE calculated = -0.30 | Not statistically significant, p ≥ 0.05 | footnote162Negative 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 | footnote162Negative value is favorable to the intervention. |
ITSEA - Internalizing domain, % clinically at risk | FavorableUnfavorable or ambiguousNo Effect |
12 months | Family Spirit RCT, 2006-2008 sample | 319 mothers | Adjusted % = 20.27 | Adjusted mean % = 27.16 | OR = 1.61 | HomVEE calculated = -0.23 | Not statistically significant, p ≥ 0.05 | footnote162Negative value is favorable to the intervention. |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
ITSEA Competence domain | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.94 | Adjusted mean = 0.95 | coeff = -0.01 | HomVEE calculated = -0.03 | Not statistically significant, p = >=.10 |
|
ITSEA Competence: Attention | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 1.11 | Adjusted mean = 1.07 | coeff = 0.05 | HomVEE calculated = 0.08 | Not statistically significant, p = >=.10 |
|
ITSEA Competence: Compliance | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.91 | Adjusted mean = 0.84 | coeff = 0.10 | HomVEE calculated = 0.18 | Not statistically significant, p = >=.10 |
|
ITSEA Competence: Empathy | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.66 | Adjusted mean = 0.59 | coeff = 0.09 | HomVEE calculated = 0.15 | Not statistically significant, p = >=.10 |
|
ITSEA Competence: Imitation/play | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 1.08 | Adjusted mean = 1.10 | coeff = -0.03 | HomVEE calculated = -0.05 | Not statistically significant, p = >=.10 |
|
ITSEA Competence: Mastery motivation | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 1.30 | Adjusted mean = 1.34 | coeff = -0.05 | HomVEE calculated = -0.08 | Not statistically significant, p = >=.10 |
|
ITSEA Competence: Prosocial peer relations | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.51 | Adjusted mean = 0.79 | coeff = -0.24 | HomVEE calculated = -0.68 | Not statistically significant, p = >=.10 |
|
ITSEA Dysregulation domain | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.43 | Adjusted mean = 0.49 | coeff = -0.05 | HomVEE calculated = -0.22 | Not statistically significant, p = >=.10 |
|
ITSEA Dysregulation: Eating | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.43 | Adjusted mean = 0.44 | coeff = -0.02 | HomVEE calculated = -0.04 | Not statistically significant, p = >=.10 |
|
ITSEA Dysregulation: Negative emotionality | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.47 | Adjusted mean = 0.48 | coeff = 0.02 | HomVEE calculated = -0.03 | Not statistically significant, p = >=.10 |
|
ITSEA Dysregulation: Sensory sensitivity | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.37 | Adjusted mean = 0.52 | coeff = -0.14 | HomVEE calculated = -0.41 | Not statistically significant, p = >=.10 |
|
ITSEA Dysregulation: Sleep | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.44 | Adjusted mean = 0.53 | coeff = -0.06 | HomVEE calculated = -0.25 | Not statistically significant, p = >=.10 |
|
ITSEA Externalizing domain | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.39 | Adjusted mean = 0.57 | coeff = -0.17 | HomVEE calculated = -0.63 | Statistically significant, p<.05 | footnote182Negative differences favor the program group |
ITSEA Externalizing: Activity/impulsivity | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.69 | Adjusted mean = 0.98 | coeff = -0.27 | HomVEE calculated = -0.65 | Statistically significant, p<.05 | footnote182Negative differences favor the program group |
ITSEA Externalizing: Aggression/defiance | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.27 | Adjusted mean = 0.35 | coeff = -0.06 | HomVEE calculated = -0.29 | Not statistically significant, p = >=.10 |
|
ITSEA Externalizing: Peer aggression | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.13 | Adjusted mean = 0.30 | coeff = -0.23 | HomVEE calculated = -0.68 | Statistically significant, p<.05 | footnote182Negative differences favor the program group |
ITSEA Internalizing domain | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.48 | Adjusted mean = 0.55 | coeff = -0.06 | HomVEE calculated = -0.35 | Not statistically significant, p = >=.10 |
|
ITSEA Internalizing: Depression/withdraw | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.12 | Adjusted mean = 0.15 | coeff = 0.01 | HomVEE calculated = -0.13 | Not statistically significant, p = >=.10 |
|
ITSEA Internalizing: General anxiety | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.20 | Adjusted mean = 0.21 | coeff = 0.01 | HomVEE calculated = -0.04 | Not statistically significant, p = >=.10 |
|
ITSEA Internalizing: Inhibition to novelty | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.73 | Adjusted mean = 0.82 | coeff = -0.09 | HomVEE calculated = -0.24 | Not statistically significant, p = >=.10 |
|
ITSEA Internalizing: Separation distress | FavorableUnfavorable or ambiguousNo Effect |
12 months old | Mothers enrolled 2002-2004 | 65 children | Adjusted mean = 0.84 | Adjusted mean = 1.02 | coeff = -0.17 | HomVEE calculated = -0.52 | Statistically significant, p<.05 | footnote182Negative differences favor the program group |
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 |
footnote162Negative 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 |
footnote162Negative 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 |
footnote162Negative value is favorable to the intervention. |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
---|---|---|---|---|---|---|---|---|---|---|
ITSEA Competence domain (proportion clinically at risk (>10%)) | FavorableUnfavorable or ambiguousNo Effect |
2006-2008 sample, 3 years postpartum | Children with ITSEA data | 288 children | Unadjusted mean = 0.24 | Unadjusted mean = 0.23 | Mean difference = 0.01 | HomVEE calculated = 0.03 | Not statistically significant, p = 0.78 | |
ITSEA Dysregulation domain (proportion clinically at risk (>10%)) | FavorableUnfavorable or ambiguousNo Effect |
2006-2008 sample, 3 years postpartum | Children with ITSEA data | 288 children | Unadjusted mean = 0.10 | Unadjusted mean = 0.15 | Mean difference = -0.04 | HomVEE calculated = -0.23 | Not statistically significant, p = 0.08 | footnote162Negative value is favorable to the intervention. |
ITSEA Externalizing domain (proportion clinically at risk (>10%)) | FavorableUnfavorable or ambiguousNo Effect |
2006-2008 sample, 3 years postpartum | Children with ITSEA data | 288 children | Unadjusted mean = 0.17 | Unadjusted mean = 0.24 | Mean difference = -0.07 | HomVEE calculated = -0.24 | Statistically significant, p = 0.03 | footnote162Negative value is favorable to the intervention. |
ITSEA Internalizing domain (proportion clinically at risk (>10%)) | FavorableUnfavorable or ambiguousNo Effect |
2006-2008 sample, 3 years postpartum | Children with ITSEA data | 288 children | Unadjusted mean = 0.10 | Unadjusted mean = 0.15 | Mean difference = -0.05 | HomVEE calculated = -0.27 | Statistically significant, p = 0.04 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative 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 | footnote162Negative value is favorable to the intervention. |
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 |
footnote162Negative 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 | footnote162Negative 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 |
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 | footnote162Negative value is favorable to the intervention. |
Outcome measure | Effect | Follow-up timing | Sample | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance |
---|---|---|---|---|---|---|---|---|---|
Change in maternal involvement - 2 months | FavorableUnfavorable or ambiguousNo Effect |
2 months postpartum | Mothers enrolled 2002-2004 | 125 mothers | Adjusted mean = 1.10 | Adjusted mean = 1.20 | coeff = -0.60 | HomVEE calculated = -0.04 | Not statistically significant, p = >=.10 |
Change in maternal involvement - 12 months | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Mothers enrolled 2002-2004 | 82 mothers | Adjusted mean = 1.00 | Adjusted mean = 0.60 | coeff = 0.22 | HomVEE calculated = 0.15 | Not statistically significant, p = >=.10 |
Change in maternal involvement - 6 months | FavorableUnfavorable or ambiguousNo Effect |
6 months postpartum | Mothers enrolled 2002-2004 | 115 mothers | Adjusted mean = 1.30 | Adjusted mean = 1.20 | coeff = -0.15 | HomVEE calculated = 0.03 | Not statistically significant, p = >=.10 |
Change in parenting knowledge - 12 months | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Mothers enrolled 2002-2004 | 82 mothers | Adjusted mean = 26.60 | Adjusted mean = 15.20 | coeff = 13.92 | HomVEE calculated = 0.86 | Statistically significant, p<.01 |
Change in parenting knowledge - 2 months | FavorableUnfavorable or ambiguousNo Effect |
2 months postpartum | Mothers enrolled 2002-2004 | 125 mothers | Adjusted mean = 3.20 | Adjusted mean = 2.60 | coeff = 3.10 | HomVEE calculated = 0.06 | Not statistically significant, p ≥ 0.05 |
Change in parenting knowledge - 6 months | FavorableUnfavorable or ambiguousNo Effect |
6 months postpartum | Mothers enrolled 2002-2004 | 115 mothers | Adjusted mean = 23.80 | Adjusted mean = 12.80 | coeff = 13.46 | HomVEE calculated = 0.81 | Statistically significant, p<.01 |
Home Observation for Measurement of the Environment - 12 months | FavorableUnfavorable or ambiguousNo Effect |
12 months postpartum | Mothers enrolled 2002-2004 | 82 mothers | Adjusted mean = 37.10 | Adjusted mean = 37.40 | coeff = -0.04 | HomVEE calculated = -0.04 | Not statistically significant, p = >=.10 |
Home Observation for Measurement of the Environment - 6 months | FavorableUnfavorable or ambiguousNo Effect |
6 months postpartum | Mothers enrolled 2002-2004 | 115 mothers | Adjusted mean = 32.50 | Adjusted mean = 33.40 | coeff = -1.27 | HomVEE calculated = -0.14 | Not statistically significant, p = >=.10 |
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, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.