Family Spirit is an evidence-based early childhood home-visiting program designed for and by American Indian communities. Family Spirit 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. From pregnancy through the child’s 3rd birthday, parents gain knowledge and skills to promote healthy development and positive lifestyles for themselves and their children. Family Spirit addresses intergenerational behavioral health problems, optimizes local cultural assets, and overcomes deficits in the professional health care workforce in low resource communities. Evidence from three randomized controlled trials has documented important results including: increased parenting knowledge and involvement; decreased maternal depression; increased home safety; decreased emotional and behavioral problems of mothers; and decreased emotional and behavioral problems of children. The Family Spirit curriculum modules cover: Prenatal Care, Infant Care, Your Growing Child, Toddler Care, My Family and Me, and Healthy Living.