175850 A model for capacity building and program sustainability: Training and implementation to transfer a home-visiting program for Adolescent American Indian parents to tribal public health nursing programs

Monday, October 27, 2008

Kristen Lynne Speakman, MA/ MPH , Center for American Indian Health, Johns Hopkins University, Albuquerque, NM
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
Crystal Kee , Center for American Indian Health, Johns Hopkins, Chinle, AZ
Wilpita Bia, AA , Johns Hopkins University, Center for American Indian Health, Chinle, AZ
Louise Yazzie, BS , Johns Hopkins University, Center for American Indian Health, Chinle, AZ
Adella Begaye , Division of Public Health, Chinle Service Unit, Chinle, AZ
Audrey Solimon, MPH , Private Consultant, Ozark, MO
Elena Varipatis-Baker , Center for American Indian Health, Johns Hopkins University, Baltimore, MD
Background: The Family Spirit (FS) program is a 15-month home visitation program administered by Native paraprofessionals to promote maternal and child health and parent education for adolescent parents. Since 1998 FS has been developed, field tested and evaluated by Johns Hopkins University Center for American Indian Health (CAIH) and several southwestern American Indian (AI) tribes through two 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, CAIH partnered with the Indian Health Service (IHS) Chinle Service Unit on the Navajo Nation to design a replication process through the Public Health Nursing (PHN) Program. 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 was established to guide the replication process. Three local Navajo outreach staff, trained and employed by CAIH, have recruited 64 parent-child dyads in the first two years of implementation. The replication partners identified the IHS PHN Program as the most viable local platform for FS program transfer. PHN leadership from seven IHS Service Units currently participate in a planning group to design the transfer process. Results of the program transfer plan and training of PHNs and paraprofessional staff will be reported. Conclusions: This project describes the process and feasibility of replicating and transferring autonomy for a demonstrated MCH promotion model serving AI adolescent parents in an underresourced and cross-cultural setting.

Learning Objectives:
Describe the process for replicating and 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 home visiting program sustainability in the Chinle community and across the Navajo Nation.

Keywords: Navajo, Public Health Nursing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the field program manager of the Family Spirit program.
Any relevant financial relationships? No

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.

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