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:
Family Spirit®
| Screening decision | Screening conclusion | HomVEE procedures and standards version |
|---|---|---|
| Passes screens | Eligible for review | Version 1 |
| Rating | Design | Attrition | Baseline equivalence | Compromised randomization | Confounding factors | Valid, reliable measure(s) |
|---|---|---|---|---|---|---|
| Moderate | Randomized controlled trial | High | Established on race/ethnicity and SES; outcomes not feasible to assess at baseline | None | None | Not assessed in manuscripts reviewed before 2021 |
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. |
| Intervention 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. |
| Subgroups examined |
This field lists subgroups examined in the manuscript (even if they were not replicated in other samples and not reported on the summary page for this model’s report). Subgroups are not listed for manuscripts reviewed before 2021. |
| Funding sources | Support for this research was provided by the National Institute on Drug Abuse. |
| Author affiliation | Ms. Barlow is part of the team that developed this model. Dr. Walkup was affiliated with the Center for American Indian Health at the Johns Hopkins Bloomberg School of Public Health, where the team that developed this model is based. |
| Peer reviewed | Peer reviewed status is not listed for manuscripts reviewed before 2021. |
Study Registration:
Clinicaltrials.gov Identifier: NCT00373750
Findings that rate moderate or high
| Rating | Outcome measure | Effect | Sample | Timing of follow-up | Sample size | Intervention group | Comparison group | Group difference | Effect size | Statistical significance | Notes |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Moderate | CBCL mean, Externalizing domain (0-48) (T-score) | FavorableUnfavorable or ambiguousNo Effect |
Children with CBCL data | 2006-2008 sample, 3 years postpartum | 280 children | Adjusted mean = 42.45 | Adjusted mean = 42.59 | Mean difference = -0.14 | Study reported = 0.01 | Not statistically significant, p = 0.89 |
Negative value is favorable to the intervention.
|
| Moderate | CBCL mean, Internalizing domain (0-72) (T-score) | FavorableUnfavorable or ambiguousNo Effect |
Children with CBCL data | 2006-2008 sample, 3 years postpartum | 280 children | Adjusted mean = 44.23 | Adjusted mean = 44.91 | Mean difference = -0.68 | Study reported = 0.06 | Not statistically significant, p = 0.57 |
Negative value is favorable to the intervention.
|
| Moderate | CBCL mean, Total Problems (0-200) (T-score) | FavorableUnfavorable or ambiguousNo Effect |
Children with CBCL data | 2006-2008 sample, 3 years postpartum | 280 children | Adjusted mean = 44.00 | Adjusted mean = 44.79 | Mean difference = -0.79 | Study reported = 0.07 | Not statistically significant, p = 0.52 |
Negative value is favorable to the intervention.
|