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Family Spirit


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Since evaluation of the Family Spirit Program began, a body of literature has been published to support it as an evidence-based program. A summary of publications is provided below, along with links to each journal article.


These papers describe characteristics of the Family Spirit intervention and its effectiveness in improving parenting outcomes and mothers’ and children’s emotional and behavioral functioning from pregnancy to 3 years postpartum.

  1. Barlow A, Varipatis-Baker E, Speakman K, et al. Home-visiting intervention to improve child care among American Indian adolescent mothers: A randomized trial. Arch Pediatr Adolesc Med. 2006; 160(11):1101-1107.
  2. Walkup JT, Barlow A, Mullany BC, et al. Randomized controlled trial of a paraprofessional-delivered in-home intervention for young reservation-based American Indian mothers. J Am Acad Child Adolesc Psychiatry. 2009;48(6):591-601.
  3. Barlow A, Mullany B, Neault N, et al. Effect of a Paraprofessional Home-Visiting Intervention on American Indian Teen Mothers’ and Infants’ Behavioral Risks: A Randomized Controlled Trial. American Journal of Psychiatry 2013; 170:83–93.
  4. Barlow A, Mullany B, Neault N, et al. Paraprofessional Delivered, Home-Visiting Intervention for American Indian Teen Mothers and Children: Three-Year Outcomes from a Randomized Controlled Trial. American Journal of Psychiatry. 2015; 172(2):154-162. doi: 10.1176/appi.ajp.2014.14030332.
  5. Rosenstock S, Ingalls A, Foy Cuddy R, et al. Effect of a home-visiting intervention to reduce early childhood obesity among native american children: A randomized clinical trial. JAMA Pediatr. 2020. 


This paper describes the rationale, design, methods, and baseline results of the definitive randomized controlled trial of the Family Spirit Program.

  1. Mullany B, Barlow A, Neault N, et al. The Family Spirit trial for American Indian teen mothers and their children: CBPR rationale, design, methods and baseline characteristics. Prev Sci. 2012; 13(5):504-518. 
  2. Ingalls A, Rosenstock S, Foy Cuddy, R, et al. Family Spirit Nurture (FSN)–a randomized controlled trial to prevent early childhood obesity in American Indian populations: trial rationale and study protocol. BMC Obesity. 2019;6:18. 

Examining Drug Use

This paper describes correlates of meth use in a sample of pregnant American Indian teens from a Family Spirit trial. It focuses on sociodemographic, familial, and cultural factors and use of other drugs.

  1. Barlow A, Mullany B, Neault N, et al. Examining correlates of methamphetamine and other drug use in pregnant American Indian adolescents. American Indian and Alaska Native Mental Health Research. The Journal of the National Center. 2010; 17(1):1-24.


The first editorial was written in response to the 2009 Family Spirit outcomes paper. The author commends Family Spirit researchers for their creative, cost-effective way of addressing the mental health needs of American Indian children and their families. He further addresses the importance of participatory research.

  1. Novins, DK. Participatory Research Brings Knowledge and Hope to American Indian Communities. Journal of the American Academy of Child and Adolescent Psychiatry. 2009; 48(6):585-586.

The second editorial was published in the same American Journal of Psychiatry issue that the 2015 Family Spirit outcomes paper appears in as the cover story. The author acknowledges Family Spirit’s major contribution to the science of early life intervention.

  1. Bullock, A. Getting to the Roots: Early Life Intervention and Adult Health. American Journal of Psychiatry. 2015; 172(2): 108-110. 

Contributions to the Home-Visiting Field 

This article explores lessons learned from the Tribal Maternal and Infant Early Childhood Home Visiting (MIECHV) legislation across four diverse tribal communities. Family Spirit developer, Allison Barlow, is the lead author of the paper.

  1. Barlow, A, McDaniel, JA, Marfani, F, et al. Discovering Frugal Innovations Through Delivering Early Childhood Home-Visiting Interventions in Low-Resource Tribal Communities. Infant Mental Health Journal. 2018; 00(0):1-9.
  2. Ingalls A, Barlow A, Kushman E, et al. (2021). Precision Family Spirit – A Pilot Randomized Implementation Trial of a Precision Home Visiting Approach with Native American families in Michigan: Trial Rationale and Study Protocol. Pilot and Feasibility Studies. 2021; 7(8)