Substance Abuse & Mental Health Services Administration

The Substance Abuse and Mental Health Services Administration (SAMHSA)

Inter-Tribal Council of Michigan: Maajtaag Mnobmaadzid (Healthy Start) Program

Maajtaag Mnobmaadzid (Healthy Start) Program provides services, education, and support for Native families and promotes the development of comprehensive, accessible, and acceptable perinatal systems at eight tribal and two urban American Indian sites. The Healthy Start program provides case management to pregnant and postpartum women and their infants through two years of age. Key components include home visiting, individualized education, referral, follow-up, and community education.

Maajtaag Mnobmaadzid is one of only six Healthy Start projects funded nationally that specifically target Native and indigenous populations in the United States. Women of reproductive age and infants are targeted for recruitment into Healthy Start, especially those infants at-risk for developmental delays (such as infants born prematurely or at a low birth weight) or with special needs (such as Down syndrome, cerebral palsy, congenital heart defects, or other health conditions that require specialized care).

There is currently no clear picture of the extent to which the program is impacting mothers’ substance abuse or reducing their children’s risk for substance abuse later in life. Pregnancy and the postpartum period constitute a valuable "window of opportunity" for facilitating behavior change, making it an optimal period for addressing substance abuse prevention.

Funding from SAMHSA’s Service to Science Subcontract to Build Evaluation Capacity of Evidence-Based Interventions will be used to describe Maajtaag Mnobmaadzid’s service-delivery model, begin a process for identifying those aspects of the program that contribute to or produce program outcomes, and improving the quality of data collected on substance abuse behavior and risk indicators. Evaluation enhancements will help program staff assess the impact of substance abuse behaviors on the reproductive health outcomes among Healthy Start women, infants, and children. These enhancements include:

  • Conducting focus groups with past and current participants, and key informant interviews with program staff, to describe the Healthy Start program using a theoretically- and practically-informed model that better meets the needs of Native American women and infants served
  • Analyzing existing data from clinical and self-report assessments, identifying appropriate substance abuse data collection tools and protocols, and revising screening tools to enhance the program’s capacity to document the relationship between women’s program participation and their substance abuse behaviors
  • Identifying and enhancing an evaluation design that is most appropriate for determining which program elements contribute to the outcomes of interest and implications for program improvement


Lisa Abramson
Service to Science Coordinator/Healthy Start Evaluator
Inter-Tribal Council of Michigan
2956 Ashmun Street
Sault Sainte Marie, Michigan 49783
Phone: 906-632-6896