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Family Spirit Program is Aimed at Assisting New Parents

by Georgianna Old Elk, Acting Program Coordinator for CHRs

The Family Spirit Program Exit Disclaimer: You Are Leaving  is an evidence-based, culturally tailored home-visit intervention delivered by Community Health Representatives (CHRs) as a core strategy to support young Native families who have infants and children ages 0 to 3 years old. Parents gain knowledge and skills to promote healthy development of their preschool-aged children.

The CHR program is a community-based outreach program, staffed by a cadre of well-trained, medically-guided, tribal and Native community people who provide a variety of health services within American Indian/Alaska Native communities. IHS hosted a five-day Family Spirit Program certification training session for CHRs from March 27 to 31 in Albuquerque, New Mexico.

The Family Spirit Program focuses on:

  • Increasing parenting knowledge and skills
  • Addressing maternal psychosocial risks that could interfere with positive child-rearing, including drug and alcohol use; depression; education and employment; and domestic violence
  • Promoting optimal physical, cognitive social and emotional development
  • Preparing children for early school success
  • Ensuring children get recommended well-child visits and health care
  • Linking families to community services to address specific needs
  • Promoting parents’ and children’s life skills and behavioral outcomes across the lifespan

The Family Spirit Program has been rigorously evaluated by the Johns Hopkins Center for American Indian Health in partnership with the Navajo Nation, White Mountain Apache and San Carlos Apache tribal communities. The Family Spirit is the largest, most rigorous and only evidence-based early childhood home visiting program designed specifically for American Indian communities.

Family Spirit CHR Class of 2017, after 5-day training session in Albuquerque, New Mexico.
Family Spirit CHR Class of 2017, after 5-day training session in Albuquerque, New Mexico.

Evidence from randomized controlled trials showed the following outcomes:


  • Increased maternal knowledge
  • Increased parent self-efficacy
  • Reduced parent stress
  • Improved home safety attitudes

Maternal Outcomes

  • Decreased maternal depression
  • Decreased substance use
  • Fewer behavior problems in mothers

Child Outcomes

  • Fewer behavior problems in children through age three
    • Predicts lower risk of substance use and behavioral health problems over the life course

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Georgianna Old Elk, Acting Program Coordinator for CHRs
Georgianna Old Elk is the acting program coordinator for CHRs and public health advisor in the IHS Division of Behavioral Health. She is an enrolled member of the Ft. Peck Assiniboine and Sioux tribes of Montana.