Family Spirit Home Visiting Program in American Indian Communities Reduces Drug Use in Pregnant Teens


In partnership with the Navajo, White Mountain Apache and San Carlos Tribes, the Johns Hopkins Center for American Indian Health has been conducting three successive randomized controlled trials to assess the Family Spirit intervention’s impact on parenting and maternal and child health and behavior outcomes.

Research findings from the third and largest trial were published last month and provide strong evidence for the effectiveness of home visiting programs on a range of outcomes.

In the most recent study, 322 pregnant teens were randomly assigned to receive optimized standard care — transportation to prenatal and well-baby clinic visits, pamphlets about childcare, and other resources and referrals to local services — or optimized standard care plus a program of 63 in-home education sessions, known as Family Spirit.

In the Family Spirit intervention, home visits occurred weekly through the last trimester of pregnancy, biweekly until four months after the baby’s birth, monthly from months four through 12, and then bimonthly until the child turned three. A key to the program’s success was utilizing local community health workers instead of more formally educated nurses.

Before beginning the study, the researchers noted that the teens had high rates of substance use in their lifetime (more than 84 percent). The researchers found that mothers in the Family Spirit group were less likely to use illegal drugs, be depressed, or experience behavior problems than those in the control group.

Read more about the study on the Johns Hopkins Bloomberg School of Public Health website.

Read the study abstract on PubMed or download the full study from The American Journal of Psychiatry.

For more on home visiting programs and FASD prevention, see earlier posts:


Barlow, A., Mullany, B., Neault, N., Goklish, N., Billy, T., Hastings, R., Lorenzo, S., Kee, C., Lake, K., Redmond, C., Carter, A., Walkup, J.T. (2014). Paraprofessional-Delivered Home-Visiting Intervention for American Indian Teen Mothers and Children: 3-Year Outcomes From a Randomized Controlled Trial. The American Journal of Psychiatry. doi: 10.1176/appi.ajp.2014.14030332. [Epub ahead of print]