The Family Spirit Trial for American Indian Teen Mothers and Their Children: CBPR Rationale, Design, Methods and Baseline Characteristics

The Family Spirit Trial for American Indian Teen Mothers and Their Children: CBPR Rationale, Design, Methods and Baseline Characteristics

The purpose of this paper is to describe the rationale, design, methods and baseline results of the Family Spirit trial. The goal of the trial is to evaluate the impact of the paraprofessional-delivered “Family Spirit” home-visiting intervention to reduce health and behavioral risks for American Ind...

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Bibliographic Details
Published in:Prevention science Vol. 13; no. 5; pp. 504 - 518
Main Authors: Mullany, Britta, Barlow, Allison, Neault, Nicole, Billy, Trudy, Jones, Tanya, Tortice, Iralene, Lorenzo, Sherilynn, Powers, Julia, Lake, Kristin, Reid, Raymond, Walkup, John
Format: Journal Article
Language:English
Published: Boston Springer US 01-10-2012
Springer Nature B.V
Subjects:
Adolescent
Adult
Behavior
Child and School Psychology
Child development
Children
Cigarettes
Clinical trials
Design
Drug abuse
Drug use
Early motherhood
Ethnic groups
Families & family life
Health disparities
Health Psychology
Humans
India
Indians, North American
Intervention
Interventionism
Low income groups
Medicine
Medicine & Public Health
Minority & ethnic groups
Mothers
Native North Americans
Paraprofessionals
Parenting
Parents & parenting
Participatory research
Pilot Projects
Prevention
Public Health
Race
Risk
Southwestern United States
Substance use
Teenage pregnancy
U.S.A
Young Adult
Southwestern United States
United States > US
Substance use
Parenting interventions
Randomized trial
Home-visiting
American Indian
Teen parenting
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Summary:The purpose of this paper is to describe the rationale, design, methods and baseline results of the Family Spirit trial. The goal of the trial is to evaluate the impact of the paraprofessional-delivered “Family Spirit” home-visiting intervention to reduce health and behavioral risks for American Indian teen mothers and their children. A community based participatory research (CBPR) process shaped the design of the current randomized controlled trial of the Family Spirit intervention. Between 2006 and 2008, 322 pregnant teens were randomized to receive the Family Spirit intervention plus Optimized Standard Care, or Optimized Standard Care alone. The Family Spirit intervention is a 43-session home-visiting curriculum administered by American Indian paraprofessionals to teen mothers from 28 weeks gestation until the baby’s third birthday. A mixed methods assessment administered at nine intervals measures intervention impact on parental competence, mother’s and children’s social, emotional and behavioral risks for drug use, and maladaptive functioning. Participants are young (mean age = 18.1 years), predominantly primiparous, unmarried, and challenged by poverty, residential instability and low educational attainment. Lifetime and pregnancy drug use were ~2–4 times higher and ~5–6 times higher, respectively, than US All Races. Baseline characteristics were evenly distributed between groups, except for higher lifetime cigarette use and depressive symptoms among intervention mothers. If study aims are achieved, the public health field will have new evidence supporting multi-generational prevention of behavioral health disparities affecting young American Indian families and the utility of indigenous paraprofessional interventionists in under-resourced communities.
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ISSN:1389-4986
1573-6695
DOI:10.1007/s11121-012-0277-2