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

Model effectiveness research report last updated: 2022

Effects shown in research

Child development and school readiness

Findings rated high

Family Spirit®
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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
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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 % = 15.80 Adjusted mean % = 18.67 OR = 1.37 HomVEE calculated = -0.12 Not statistically significant, p ≥ 0.05
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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
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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 % = 13.69 Adjusted mean % = 20.62 OR = 1.88 HomVEE calculated = -0.30 Not statistically significant, p ≥ 0.05
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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
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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 % = 20.27 Adjusted mean % = 27.16 OR = 1.61 HomVEE calculated = -0.23 Not statistically significant, p ≥ 0.05
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Negative value is favorable to the intervention.

Findings rated moderate

Family Spirit®
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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
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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 HomVEE calculated = -0.65 Statistically significant, p<.05
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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 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
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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 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
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Negative differences favor the program group
Family Spirit®
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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
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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
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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
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Negative value is favorable to the intervention.
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 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
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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 HomVEE calculated = -0.24 Statistically significant, p = 0.03
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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 HomVEE calculated = -0.27 Statistically significant, p = 0.04
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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
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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
Submitted by user on
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
Submitted by user on
Negative value is favorable to the intervention.
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