Turning the Tide: How Family Spirit is Transforming Lives of Pregnant American Indian Teens

Providing pregnant American Indian teens with intensive parenting and health education through Family Spirit reduced their drug use, depression, and behavioral issues. It also set their young children on track to fulfill emotional and behavioral milestones that they might not have otherwise reached.

The research conducted by the Johns Hopkins Bloomberg School of Public Health also indicates that it might be more affordable to hire local community health educators rather than more formally trained nurses to counsel young, at-risk mothers. This would also give high school graduates from the same impoverished communities much-needed employment. The study was carried out in four American Indian villages in the Southwest, but the researchers say that other low-income populations across the country could probably duplicate its results.

The American Journal of Psychiatry released a report on the findings on October 10.

Lead author of the study Allison Barlow, MPH, PhD, associate director of the Center for American Indian Health at the Johns Hopkins Bloomberg School of Public Health, says, “We have turned the tide. For years in public health, we have been working on immunizations and other medical interventions to set the course for the health of disadvantaged children, and we have turned the tide.” The current load is associated with multigenerational behavioral health issues, substance misuse, depression, and parent-to-child domestic violence. This intervention can assist us in ending that depressing loop.”

Of all the racial or ethnic groups in the nation, American Indian teenagers have the highest rates of teen pregnancy, drug abuse, suicide, and high school dropout.

Family Spirit’s Impact: How Intensive Education Transformed Lives and Improved Outcomes for Expecting American Indian Teens

In this research, 322 American Indian teens who were expecting were randomized to receive either optimized standard care (which included transportation to prenatal and well-baby clinic visits, informational booklets about childcare options and other resources, and referrals to nearby services) or optimized standard care in addition to a 63-session in-home education program called Family Spirit. Throughout the last trimester of the pregnancy, biweekly visits took place until four months after the baby was born, monthly visits took place from months four through twelve, and then bimonthly visits continued until the child turned three.

The courses included child reading, breastfeeding, feeding and sleeping routines, and life skills like budgeting, conflict resolution, and drug abstinence.
Before the study, 84% of teens used drugs, 32% had depression, 57% dropped out, and 51% relocated frequently.

Mothers in the Family Spirit group had lower rates of depression, behavioral issues, and substance use than those in control. Kids in the Family Spirit group were less likely to show early signs of conduct issues, anxiety, or sadness. Kids in this group were calmer, had better eating and sleeping habits, and achieved behavioral and emotional milestones. The study tracked the mothers and kids until the children turned three.

Empowering Local Heroes: How Community Workers Are Transforming Parenting and Child Development

John Walkup, MD, reports a consistent pattern of success across various outcome measures in the study’s findings. “A child’s early years are very important. “We teach moms effective caregiving and coping mechanisms for stress and challenges to enhance their parenting skills.”

Barlow continues, “Using workers from the local community is key to the program’s success.” In the poorest communities, finding suitable jobs is challenging, but increasing the workforce can make a significant impact.

People with little formal education but extensive life experience and a strong desire to give back can become change agents. With the right training, they can help address difficult issues in their communities.

Federal Funding Boosts Family Spirit: A Proven Solution for At-Risk Communities

The Affordable Care Act allocated $1.5 billion for evidence-based home-visiting programs, with 3% designated for tribal communities. This funding supports the development and health of at-risk children across states.

According to Barlow, many current initiatives have not evaluated low-resource communities, including American Indians, recent immigrants, and military families. This gap highlights the need for effective programs in these groups.

Other programs have failed to show reductions in mental health problems and drug use among mothers. This emphasizes the importance of assessing and improving interventions for better outcomes in these populations.

Family Spirit’s success in addressing these issues through local community workers is a promising model. Moreover, it demonstrates how targeted support and proper training can make a difference in overcoming significant challenges.

According to Barlow, Family Spirit has received approval from the U.S. Department of Health and Human Services as an evidence-based program, making it eligible for federal funding.