FAMILY SPIRIT READINESS TOOL
INSTRUCTIONS: All interested Family Spirit affiliates must fill out the form below completely prior to
going through the contracting process. This form is helpful for potential affiliates and the Family Spirit
leadership team to gauge readiness for model implementation and to address any gaps identified in
advance of the training to ensure program success. Please return to us by email at
familyspirit@jhu.edu. Thank you and we look forward to working with you!
Date:
Name of Program:
Name/Title of Primary Contact:
Email:
Phone:
Address (street, city, state, zip):
1. How did you hear about the Family Spirit Program?
PROGRAM INFORMATION: The following questions will help us get a better understanding of how
Family Spirit will fit into your organization and how the program will be supported financially. These
questions may also offer your team additional points for consideration as you prepare for
implementation.
2. Which Tribes do you work with?
3. What type of organization will house your Family Spirit Program? (e.g., Head Start, Public
Health Nursing, Social Services, etc.)
4. Please provide a brief description of your organization.
5. How do you plan to use the Family Spirit curriculum?
6. Will the Family Spirit Program be incorporated into existing services?
If yes, please describe how:
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If yes, please describe how much time will be devoted to Family Spirit activities:
7. How is your program currently being funded?
8. How long do you have funding for?
PROGRAM STAFFING: The next set of questions relates to staffing for your Family Spirit Program. It
is important to think through your program’s capacity. We recommend a caseload of up to 20-25
families per full-time home visitor. This may fluctuate depending on the commuting distance to home
visits. We also recommend 6-10 home visitors per supervisor. These details can be discussed further
as we move forward in the contracting process.
9. Who will manage the Family Spirit implementation at your site? More specifically, who will
supervise the Health Educators and ensure they are teaching the Family Spirit curriculum with
high quality and managing cases appropriately?
10. How many Health Educators will be devoted to Family Spirit activities?
11. Who are the Health Educators that will be using the Family Spirit curriculum and what is their
level of education and work experience?
12. How many families per year do you anticipate serving with Family Spirit?
13. What age range will you serve? (Please consider age of the mothers and age of the children.)
Mothers:
Children:
ENROLLING FAMILIES: The questions below will help you begin thinking about recruiting families,
starting implementation, and graduating participants. Making these decisions early on will help create
program cohesion and, ultimately, increase participant retention in Family Spirit.
14. How will you recruit families into your home-visiting program? How will you emphasize
prenatal recruitment?
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15. When do you anticipate beginning to serve families with Family Spirit?
16. How will your site define a graduate of the Family Spirit Program?
PROGRAM EVALUATION: This is an importance component of the work you will be doing in the
communities you serve. The Evaluation Planning Tool will set you up for success around data
collection and analysis.
17. Do you plan to collect data or conduct any evaluation for your home visiting program? If yes,
please complete our Evaluation Planning Tool (provided upon receipt of this document).
18. Who will be managing your data collection and/or evaluation? Are you working with an
external evaluator?
19. Will you need technical assistance with program evaluation?
PROGRAM FIDELITY: Fidelity is the degree to which an affiliate “stays true” to the Family Spirit
model, as implemented during the randomized controlled trials, in an effort to replicate the same
outcomes that were seen in the trials. Although there are no formal requirements from us around
fidelity, we encourage all affiliates to think through their capacity and need for emphasis on fidelity to
the model. This can be discussed further as we move forward in the contracting process.
20. Existing Family Spirit affiliates fall at different points along the fidelity spectrum below. As a
team, decide on your site’s anticipated level of fidelity and indicate that below by circling a
number on the spectrum.
1
2
3
4
5
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PROGRAM SUSTAINABILITY: Sustainability refers to the continuation of Family Spirit work after
your current funding period has ended. We ask all of our affiliates to begin thinking about
sustainability of the program early on.
21. What are your plans for sustaining program activities beyond the terms of your current funding
source?
Additional Comments:
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