American Indian or Alaska Native
100%
Source
Barlow, A., Mullany, B., Neault, N., Billy, T., Hastings, R., Lorenzo, S., ... Walkup, J. T. (2014). A randomized controlled trial of a paraprofessional-delivered, home-visiting intervention: Three-year outcomes for American Indian teen mothers and their children. Manuscript under review.
Model(s) Reviewed
Study Registration
Funding Sources
Support for this research was provided by the National Institute on Drug Abuse.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | High | Established on race/ethnicity and SES; outcomes not feasible to assess at baseline | None |
Notes
Here, we report only the Child Behavior Checklist outcomes not included in the published version of the study (Barlow et al., 2015).
Study Participants
American Indian adolescent females ages 12 to 19 years at conception and at 32 weeks or earlier gestation who resided in one of four participating communities were recruited. The study sample included 322 participants who were randomly assigned to either the Family Spirit group (159) or the control group (163). The average age of participants at baseline was 18.1 years. Sixty percent lived with their parents and slightly more than half lived in two or more homes within the past year. Seventy-seven percent of participants were pregnant with their first child. During pregnancy, 14 percent of participants drank alcohol, 19 percent smoked cigarettes, and 13 percent used marijuana.
Setting
The program was implemented in four tribal communities across three reservations in Arizona.
Home Visiting Services
Family Spirit is a home visiting program for young American Indian pregnant and parenting mothers staffed by American Indian paraprofessionals. The program’s goals are to increase mothers’ parenting knowledge and involvement, mothers’ psychosocial functioning, and children’s emotional and behavioral outcomes. The curriculum includes 43 lessons that cover parenting skills, infant development, and maternal psychosocial development. The frequency of the visits depends upon the stage of the program. One-hour home visits are provided weekly during pregnancy, biweekly visits for the first four months following the child’s birth, monthly from 4 to 14 months postpartum, and then bimonthly until the child’s third birthday. The study did not specify the dosage of services that program participants actually received.
Comparison Conditions
Participants in the control group received transportation to and from prenatal and well-baby visits, information on child care and community resources, and referrals for services.
Were any subgroups examined?
No
Study Participants
American Indian adolescent females ages 12 to 19 years at conception and at 32 weeks or earlier gestation who resided in one of four participating communities were recruited. The study sample included 322 participants who were randomly assigned to either the Family Spirit group (159) or the control group (163). The average age of participants at baseline was 18.1 years. Sixty percent lived with their parents and slightly more than half lived in two or more homes within the past year. Seventy-seven percent of participants were pregnant with their first child. During pregnancy, 14 percent of participants drank alcohol, 19 percent smoked cigarettes, and 13 percent used marijuana.
Setting
The program was implemented in four tribal communities across three reservations in Arizona.
Home Visiting Services
Family Spirit is a home visiting program for young American Indian pregnant and parenting mothers staffed by American Indian paraprofessionals. The program’s goals are to increase mothers’ parenting knowledge and involvement, mothers’ psychosocial functioning, and children’s emotional and behavioral outcomes. The curriculum includes 43 lessons that cover parenting skills, infant development, and maternal psychosocial development. The frequency of the visits depends upon the stage of the program. One-hour home visits are provided weekly during pregnancy, biweekly visits for the first four months following the child’s birth, monthly from 4 to 14 months postpartum, and then bimonthly until the child’s third birthday. The study did not specify the dosage of services that program participants actually received.
Comparison Conditions
Participants in the control group received transportation to and from prenatal and well-baby visits, information on child care and community resources, and referrals for services.
Were any subgroups examined?
No
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
| CBCL mean, Externalizing domain (0-48) (T-score) | 2006-2008 sample, 3 years postpartum | Moderate | 0.01 | Not statistically significant, p = 0.89 |
280 children | Children with CBCL data | ||
| CBCL mean, Internalizing domain (0-72) (T-score) | 2006-2008 sample, 3 years postpartum | Moderate | 0.06 | Not statistically significant, p = 0.57 |
280 children | Children with CBCL data | ||
| CBCL mean, Total Problems (0-200) (T-score) | 2006-2008 sample, 3 years postpartum | Moderate | 0.07 | Not statistically significant, p = 0.52 |
280 children | Children with CBCL data |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- Arizona