Erikson Institute, Chicago, IL, USA.
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
Adm Policy Ment Health. 2024 Jan;51(1):69-84. doi: 10.1007/s10488-023-01312-8. Epub 2023 Oct 28.
Marginalized mothers are disproportionately impacted by depression and face barriers in accessing mental health treatment. Recent efforts have focused on building capacity to address maternal depression in Head Start; however, it is unclear if mental health inequities can be addressed by two-generation programs in Head Start settings. Therefore, this study examined the implementation outcomes and processes of a two-generation program called "Healthy Moms, Healthy Kids" (HMHK) that provided an evidence-based depression treatment to ethnic minority Head Start mothers.
Quantitative and qualitative data were collected and merged in a convergent mixed method design in accordance with the RE-AIM Qualitative Evaluation for Systematic Translation (RE-AIM QuEST) framework. Qualitative data included interviews with 52 key stakeholders, including intervention participants and staff members, and 176 sets of meeting minutes from the implementation period. Quantitative data included intervention study data and administrative data.
It was difficult for HMHK to reach the target population, with only 16.8% of eligible mothers choosing to participate. However, mothers who participated experienced reductions in depressive symptoms and parenting stress and shared a variety of positive impacts in interviews. The program was also more successful in enrolling Latinx mothers who were Spanish-speaking or bilingual rather than English-speaking and Black/African American mothers, limiting its reach.
Providing IPT therapy groups was effective in reducing maternal depressive symptoms and stress for those who enrolled, but additional work should focus on reducing barriers to participation, considering other delivery models to meet participants' needs, and identifying culturally relevant ways to meet the needs of Black mothers.
受抑郁影响的边缘化母亲比例过高，她们在获得心理健康治疗方面面临障碍。最近的努力集中在为 Head Start 中的母亲抑郁问题提供解决能力；然而，在 Head Start 环境中，两代人计划是否可以解决心理健康不平等问题还不清楚。因此，本研究考察了一项名为“健康妈妈，健康宝宝”（HMHK）的两代人计划的实施结果和过程，该计划为少数族裔 Head Start 母亲提供了基于证据的抑郁治疗。
采用定量和定性数据收集方法，并按照 RE-AIM 定性评估系统转化（RE-AIM QuEST）框架进行融合。定性数据包括对 52 名利益攸关方的访谈，包括干预参与者和工作人员，以及实施期间的 176 组会议记录。定量数据包括干预研究数据和管理数据。
HMHK 很难接触到目标人群，只有 16.8%的符合条件的母亲选择参加。然而，参加的母亲经历了抑郁症状和育儿压力的减轻，并在访谈中分享了各种积极的影响。该计划也更成功地招募了讲西班牙语或双语而不是英语的拉丁裔母亲和非裔美国母亲，限制了其覆盖面。
为参加者提供 IPT 治疗小组在减少母亲的抑郁症状和压力方面是有效的，但应进一步努力减少参与障碍，考虑其他交付模式以满足参与者的需求，并确定与文化相关的方式来满足黑人母亲的需求。
