toddler boy puts arms around dad

Model Profiles

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2023 Yearbook

Family Spirit

Family Spirit is an evidence-based, culturally tailored home visiting program of the Johns Hopkins Center for American Indian Health. The model promotes optimal health and well-being for parents and their children. It combines the use of paraprofessionals from the community as home visitors and a culturally focused, strengths-based curriculum as a core strategy to support young families. Parents gain knowledge and skills to promote healthy development and positive lifestyles for themselves and their children.

What is the model’s approach to providing home visiting services?

Home visits take place weekly until the child is 3 months old, every other week until the child is 6 months old, monthly until the child is 22 months old, and then every other month until the child is 3 years old. Services are provided for 39 months (prenatally until the child is 3 years old). Family Spirit recommends families initiate services prenatally, preferably at or before the 28th week of pregnancy.

Family Spirit’s service population includes the following:

  • Expectant caregivers
  • Caregivers 24 years old and under
  • Families of Native American heritage

Who is implementing the model?

Home Visitors

Family Spirit was implemented by 141 home visitors in 2021. The model recommends at least a high school diploma or GED and/or 2 or more years of related work experience for home visitors. Family Spirit recommends a caseload of up to 20-25 families for each full-time home visitor (100% full-time equivalent), depending on the stage of enrollment for each participant.


Family Spirit was implemented by 66 supervisors in 2021. The model recommends at least a college degree and/or relevant work experience for supervisors.

Where is the model implemented?

Family Spirit operated in 56 local agencies across 18 states in 2021.


Families Served Through Evidence-Based Home Visiting in 2021

home visits provided
including 6,775 virtual visits
families served
children served


Family Spirit envisions a future where every community, regardless of socioeconomic status, will have access to an evidence-based, culturally-competent early childhood home-visiting model that employs local paraprofessionals to promote optimal health and well-being for parents and young children in their communities.


Family Spirit began in 1995 as the Share Our Strengths program at the Johns Hopkins Center for American Indian Health. Share Our Strengths was developed in partnership with the Navajo, White Mountain Apache, and San Carlos Apache tribal communities to support the tribes’ mothers and young children. In 1998, the Johns Hopkins Center for American Indian Health began offering a fatherhood program in tandem with Share Our Strengths. These two programs merged to become the Family Strengthening program. Family Strengthening was rigorously evaluated by Johns Hopkins Center for American Indian Health in partnership with participating tribal communities in a series of randomized control trials. The developers then expanded the curriculum to address families’ needs prenatally until their child’s third birthday. Family Spirit, as it is implemented today, began in 2006 and evolved from these rigorous evaluations. To date, Family Spirit has been replicated in over 150 communities in 23 states.