Primary Sources: Mapping the Risks for Native Teen Mothers

Photograph of a mother cuddling her infant.

The Family Spirit Trial for American Indian Teen Mothers and Their Children: CBPR Rationale, Design, Methods and Baseline Characteristics” (abstract), Prevention Science, Vol. 13, No. 5, October 2012.

What it’s about: This study describes preliminary findings from the Family Spirit trial, a home-visiting program designed to promote health and healthy behavior and reduce drug use among Native American teen mothers and their children. More than 300 pregnant Native American girls between the ages of 12 and 19 were randomly selected, in a process similar to a coin toss, to receive either the Family Spirit intervention along with standard care (prenatal care and early childhood visits) or standard care alone. The young women  were mostly first-time mothers who became pregnant without meaning to.

In the Family Spirit intervention, trained female professionals from the community visited teen mothers at home once a month or so from the third trimester of pregnancy up to the child’s third birthday. Sessions covered topics including parenting skills, alcohol and drug abuse, and breast-feeding education.

The authors want to find out if Family Spirit can help strengthen young families and break the cycle of poverty, violence and alcohol and drug abuse that afflicts so many Native communities.

Why read it: The authors contend that their ongoing research is the most thorough study yet attempted of behavioral health problems, such as drug and alcohol abuse, among multiple generations of Native Americans. By combining random assignment and other rigorous research design techniques with community participation in the research process, the authors hope to provide a picture of this population that hasn’t been seen in social science studies thus far.

In the authors’ words, “If the Family Spirit intervention is demonstrated to be effective, tribal leaders may have new strategies that are feasible, culturally appropriate and cost-effective to prevent drug abuse and other behavioral challenges in young families.”

Biggest takeaways for youth workers: This first installment of the trial's findings focuses on demographics, such as how old the young women were when they got pregnant, whether they were single or married, whether or not they were in school, and whether or not they smoked, drank or used drugs. The authors found, for instance, that the young women smoked and drank at about the same rate as the national average. But they had much higher rates of using marijuana, meth and crack-cocaine.

Even if they don't serve Native teens, youth workers may want to follow the Family Spirit trial as it develops and stay abreast of its findings on the ways poverty, abuse and alcohol and drug use are passed from generation to generation.

Additional references: The Johns Hopkins Center for American Indian Health, which also partly funded this study, conducted a similar randomized trial in 2002 and a 2009 study to evaluate the effects of the Family Spirit intervention. Skye Bass, an Indian Health Service public health specialist, spoke to NCFY about drug abuse among Native youth.

(Publications discussed here do not necessarily reflect the views of NCFY, FYSB, or the Administration for Children and Families. Go to the NCFY literature database for abstracts of this and other publications.)

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