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APHA Scientific Session and Event Listing

Allison Barlow, MPH, MA, Elena Varipatis Baker, MPH, MSW, Nicole Neault, MPH, Brandii Cowboy, Pauline Fields, Novalene Goklish, Ranelda Hastings, Britta Mullany, PhD, and John Walkup, MD. Center for American Indian Health, Johns Hopkins University, 621 North Washington Street, Baltimore, MD 21205, 410-955-6931, evaripat@jhsph.edu

Background: 46% of American Indian (AI) women begin child bearing during adolescence, compared with 25% of all women in the United States. Since 1995, Johns Hopkins University has partnered with Navajo and Apache tribal communities to design family based outreach interventions for AI teen-formed families. In 2006 this partnership expanded to implement a five-year randomized controlled trial measuring the efficacy of a 27-month home visiting intervention administered by rigorously trained AI paraprofessionals. Methods: 320 pregnant teens will be randomized to receive the Family Spirit (FS) intervention plus Optimized Standard Care (OSC), or OSC alone. FS consists of a 40-session home visiting curriculum administered by AI paraprofessionals to expectant teen mothers from 28 weeks gestation to the baby's second birthday. OSC consists of transportation assistance to 15 recommended prenatal and well-baby visits during the study period, and distribution of health promotion pamphlets. OSC provides needed transportation support to all participants in reservation communities where health access barriers are well documented. Independent evaluators will conduct self-report, interview, and observational assessments at nine points from baseline to the child's third birthday. Medical chart reviews during study period will corroborate findings. Results: Data analyses will describe program impact on parental competence, maternal and child health and behavior outcomes. Conclusions: This evaluation is designed to investigate the impact AI paraprofessional home visitors can have on behavioral and health disparities of AI youth. Study results could inform federal policy decisions regarding the utility of rigorously trained AI paraprofessionals in Indian health systems.

Learning Objectives:

• To understand the study methods used to evaluate a paraprofessional-delivered home visiting program on health and behavior outcomes of American Indian teen mothers and children.
• To understand the benefits of using well trained paraprofessional home visitors in Indian health systems.

Keywords: American Indians, Home Visiting

Presenting author's disclosure statement:

Any relevant financial relationships? No