Cultural Adaptations of Evidence-Based Home-Visitation Models in Tribal Communities




Vanessa Y. Hiratsuka, Myra E. Parker, Jenae Sanchez, Rebecca Riley, Debra Heath, Julianna C. Chomo, Moushumi Beltangady, and Michelle Sarche

Brief Type

Journal Publication


  • Family Spirit
  • Nurse-Family Partnership (NFP)
  • Parents as Teachers (PAT)


The Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) Program provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations to implement evidence-based home-visiting services for American Indian and Alaska Native (AI/AN) families. To date, only one evidence-based home-visiting program has been developed for use in AI/AN communities. The purpose of this article is to describe the steps that four Tribal MIECHV Programs took to assess community needs, select a home-visiting model, and culturally adapt the model for use in AI/AN communities. In these four unique Tribal MIECHV Program settings, each program employed a rigorous needs-assessment process and developed cultural modifications in accordance with community strengths and needs. Adaptations occurred in consultation with model developers, with consideration of the conceptual rationale for the program, while grounding new content in indigenous cultures. Research is needed to improve measurement of home-visiting outcomes in tribal and urban AI/AN settings, develop culturally grounded home-visiting interventions, and assess the effectiveness of home visiting in AI/AN communities. (author abstract)

Data Collection Methods

  • Focus groups
  • Interviews
  • Program administrative record reviews
  • Surveys or questionnaires



For More Information

Hiratsuka, V. Y., Parker, M. E., Sanchez, J., Riley, R., Heath, D., Chomo, J. C., ... & Sarche, M. (2018). Cultural adaptations of evidence‐based home‐visitation models in tribal communities. Infant Mental Health Journal, 39(3), 265-275. doi: 10.1002/imhj.21708
Author Contact Information:
Vanessa Y. Hiratsuka


  • Program Enhancements, Innovations, and Promising Approaches