160452 A Model for program sustainability: The transfer of the Family Spirit home-visiting program for adolescent American Indian parents to tribal public health nursing programs

Tuesday, November 6, 2007

Kristen Speakman, MA, MPH , Center for American Indian Health, Johns Hopkins University, Baltimore, MD
Allison Barlow, MPH, MA , Center for American Indian Health, Johns Hopkins University, Baltimore, MD
Jill Moses, MD, MPH , Division of Public Health, Chinle Service Unit, Chinle, AZ
Tennille Marley, MPH , Johns Hopkins University, Center for American Indian Health, Albuquerque, NM
Louise Yazzie, BS , Johns Hopkins University, Center for American Indian Health, Chinle, AZ
Wilpita Bia, AA , Johns Hopkins University, Center for American Indian Health, Chinle, AZ
Elena Varipatis Baker, MPH, MSW , Center for American Indian Health, Johns Hopkins University, Baltimore, MD
Background: The Family Spirit (FS) program has been developed and field tested since 1998 by Johns Hopkins Center for American Indian Health (JHCAIH) and several southwestern American Indian (AI) tribes. It is a 15-month home visitation program administered by Native paraprofessionals to promote maternal and child health and parent education for adolescent parents. FS has undergone a rigorous evaluation in two subsequent randomized control trials, with a third underway. Findings suggest significant impacts in parenting knowledge, and maternal and child outcomes. In an effort to disseminate the FS program to more tribal communities, JHCAIH partnered with the Indian Health Service (IHS) Chinle Service Unit, located centrally on the Navajo Nation, to design a replication process. Methods: Replication began in March 2006, and phases include formative design, implementation, evaluation and strategic planning for operational sustainability. Results: A local community advisory board has been established to guide the replication process. Two local Navajo outreach staff, trained and employed by JHCAIH, have recruited 40 parent-child dyads (45% of adolescent child-bearing population) in the first year of implementation. The replication partners have identified the IHS Public Health Nursing (PHN) Program as the most viable local platform for FS program transfer. PHN leadership from 7 IHS Service Units now participate in a planning group to design the transfer process. Results of the program transfer plan will be reported. Conclusions: This project describes the process and feasibility of replicating and transferring autonomy for a demonstrated MCH promotion model in an underresourced and cross cultural setting.

Learning Objectives:
Describe the process for transferring an evidence-based home visiting program for American Indian parents to promote maternal and child health and parent education from a research project to a service project overseen by the Indian Health Service Public Health Nursing Program. List and describe the 4 phases of replication and transfer that are being implemented to increase Family Spirit sustainability in the Chinle community and across the Navajo Nation.

Keywords: Home Visiting, Sustainability

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Innovative Topics in Maternal and Child Health
See more of: Maternal and Child Health