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Family Spirit

Frequently Asked Questions 


Where is Family Spirit being replicated?

Family Spirit is now in 16 states, serving 92 reservation-, rural-, and urban-based communities. Replication efforts are scheduled throughout the year. 


How much does it cost to bring Family Spirit to my community?

Family Spirit is free to the families who participate, but there is a fee associated with becoming a Family Spirit affiliate. We discuss costs with each program as part of the replication process.


Does the Affiliate Fee ever expire?

This is a one-time fee for Family Spirit affiliates. However, membership to FS Connect expires after 3 years, and there is a renewal fee. FS Connect includes access to technical assistance and other services that enable continuing access to Family Spirit.

What is offered through FS Connect?

FS Connect is a series of services designed to make access to Family Spirit resources easy and efficient. Key features and benefits include: technical assistance from the Family Spirit Leadership Team for 3 years after completion of the Family Spirit Training; Quarterly Check-ins with an Affiliate Liaison who can assist with troubleshooting and answering questions during implementation of the Family Spirit Program; Family Spirit quarterly newsletter with updates about the program and other relevant news, publications, and information from the maternal and child health field; connection to other Family Spirit affiliates for knowledge sharing; and quarterly, topic-based webinars. In the future, we plan to expand FS Connect offerings.


Who are the families that are enrolled in Family Spirit affiliate programs?

Family Spirit is the only evidence-based home visiting program that was developed in partnership with several tribes specifically for American Indian communities. American Indian communities are rich in culture and tradition, and Family Spirit is designed to draw on those strengths in our approach to working with families. 

While the model was originally designed for American Indian communities, the curriculum is comprehensive and adaptable enough for any community. Read more about who currently replicates Family Spirit by going to Our Affiliates. 


Who provides program services to families?

Family Spirit uses American Indian paraprofessionals as the core strategy for delivering services. Paraprofessionals typically come from the community in which they serve and are therefore already invested in raising the health status of families living there. Their knowledge of the local culture, practices, and language helps to overcome the barriers that non-Natives may face. There are certain traits that Family Spirit thinks a home visitor should embody including flexibility, dependability, and adaptability, along with strong interpersonal and communication skills.

While we have strong evidence to support the effectiveness of paraprofessionals, the program does not exclude licensed professionals from using the curriculum (e.g. nurses, social workers, midwives). Read more about who provides Family Spirit services to families by going to Our Affiliates.


How many families can each home visitor serve?

Family Spirit recommends a caseload of 20-25 families for each full-time home visitor, depending on the stage of enrollment for each participant and assuming that families reside in close proximity to the home visitor. The caseload may be less if there is significant travel associated with home visits. Frequency of home visits is more intensive in the prenatal and newborn stage and spaces out in the post-partum months. 


What are the evaluation requirements?

Family Spirit has always prided itself on respecting tribal sovereignty and attitudes towards collecting data about tribal members. Therefore, we do not require rigorous outcome data to be reported back to us. We do recommend several evaluation tools that sites should implement and provide access to almost all of these tools as part of the affiliate package. 

We do, however, require certain process data to be reported back to us on a quarterly basis. We ask for information about number of families enrolled, recruitment strategies, implementation, and more.  Contact us to receive a more complete overview of what is required during the quarterly check-ins. 


How do I get started?

There are several steps that take place before a Family Spirit affiliate can begin program implementation. Please review Becoming an Affiliate to learn more. 


Do affiliates ever make adaptions to the model to fit their needs?

Family Spirit is designed to be flexible. However, depending on the scope of adaptation to the Family Spirit model, we cannot guarantee the same outcomes that were in found in the evaluation trials. Furthermore, the outcomes in our evaluation trials were based on sequential, one-on-one home visits. Changes to the model have to be discussed further with an Affiliate Liaison for approval. 


What training is available for Family Spirit, and when and where is it offered?

In our experience disseminating and evaluation Family Spirit, we’ve learned that the power of the program lies in the training and capacity-building of staff to effectively deliver Family Spirit. It is a unique curriculum that cannot be self-taught, and we therefore cannot disseminate the curricular sets without providing thorough training.

Family Spirit training is held throughout the year on-site and quarterly at our central office in Albuquerque, New Mexico. Learn more about what is involved in this week-long training session here .

Quarterly webinars are also offered to provide continuing education and skill building to enhance program delivery.

How much does it cost to attend the Family Spirit Training?

The cost of the training varies depending on where it is conducted. Some of the considerations that go into cost negotiation include:

  • Travel and per diem expenses of two Senior Trainers (for on-site training sessions)
  • Cost of food and location for trainees (if applicable)
  • Training materials and other administrative costs
  • Technical assistance
  • Continuing education administrative fee (if applicable)

Which continuing education units (CEUs) apply to the Family Spirit Training?

The Family Spirit Training is now accredited through the American Public Health Association (APHA) as a provider of CEUs for CME, CNE, and CHES. For an additional cost, trainees are eligible to receive up to 27 credits.



Can we adapt the training agenda to fit the unique needs of our site?

When an affiliate determines that they would like to host an on-site training, a Senior Trainer/Affiliate Liaison will meet several times with the host site to develop a suitable training agenda that will consider the unique needs of the affiliate program.

Can we us Family Spirit to serve children up to age 5?

Family Spirit is designed for children from age 0 to 3. If an affiliate chooses to enroll families prenatally, the mother will enroll around 28 weeks gestation (or earlier) and continue with Family Spirit through the child’s 3rd birthday. Family Spirit is happy to help affiliates develop a transition plan between Family Spirit and another home visiting program that serves children from age 3 to 5. Please contact us to discuss further and learn about our recommendations for serving children up to age 5.


Is the Family Spirit Program approved to use with MIECHV funding?

Yes, Family Spirit is approved as a MIECHV evidence-based program.


How does the Family Spirit Program complement the Baby-Friendly Hospital Initiative?

Family Spirit is supportive of the Baby-Friendly Hospital Initiative and has tailored our training session to acknowledge “baby-friendly” clinics and hospitals. During the Family Spirit Training, Senior Trainers will provide basic breastfeeding education, including: breastfeeding basics, benefits of breast milk, proper latching, and basic troubleshooting. If an affiliate works with a “baby-friendly” clinic or hospital, we will also discuss what the expectant mother may encounter at a “baby-friendly” clinic or hospital, such as: immediate skin-to-skin contact with the newborn, immediate attempts at breastfeeding, and supportive, one-on-one counseling from a Lactation Consultant.

Can we use Family Spirit lessons in a group setting?

Some Family Spirit affiliates offer lessons in a group setting. This is completely acceptable, but Family Spirit also wants to emphasize that the outcomes reported in our evaluation trials are based on a sequential, one-on-one home visiting structure.


Are there required policies and procedures that each affiliate must abide by?

The Family Spirit Program is a resource for affiliates to use to improve maternal and child health outcomes in their communities. As such, we will gladly provide suggestions and technical assistance on program implementation but decisions on specific program policies and procedures are made strictly at a program level. Family Spirit Senior Trainers also provide support on recommended policies and procedures to think about during the training session, and we have a policies and procedures manual template that we can provide to interested affiliates. Ultimately, however, the affiliate is responsible for deciding on which policies, procedures, and program goals work best for them.