The Role of Latina Peer Mentors in the Implementation of the Alma Program for Women With Perinatal Depression

Abstract

This study examines the role that compañeras (peer mentors) play in the implementation of a program, Alma, which was designed to support Latina mothers who are experiencing depression during pregnancy or early parenting and implemented in the rural mountain West of the United States. Drawing from the fields of dissemination and implementation and Latina mujerista (feminist) scholarship, this ethnographic analysis demonstrates how the Alma compañeras facilitate the delivery of Alma by creating and inhabiting intimate mujerista spaces with other mothers and create relationships of mutual and collective healing in the context of relationships de confianza (of trust and confidence). We argue that these Latina women, in their capacity as compañeras, draw upon their cultural funds of knowledge to bring Alma to life in ways that prioritizes flexibility and responsiveness to the community. Shedding light on contextualized processes by which Latina women facilitate the implementation of Alma illustrates how the task-sharing model is well suited to the delivery of mental health services for Latina immigrant mothers and how lay mental health providers can be agents of healing.

Keywords

community and public health culture cultural competence mothers mothering families women’s health gender immigrants migrants depression mental health and illness power empowerment postpartum care reproduction stigma psychology psychological issues

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References

Arvey

S. R.

Fernandez

M. E.

(2012). Identifying the core elements of effective community health worker programs: A research Agenda. American Journal of Public Health, 102(9), 1633–1637. https://doi.org/10.2105/ajph.2012.300649

Behar

(2014). The vulnerable observer: Anthropology that breaks your heart. Beacon Press.

Bernal

D. D.

Elenes

C. A.

Godinez

F. E.

(2006). Chicana/Latina education in everyday life: Feminista perspectives on pedagogy and epistemology. Suny Press.

Bishop

E. C.

Shepherd

M. L.

(2011). Ethical reflections: Examining reflexivity through the narrative paradigm. Qualitative Health Research, 21(9), 1283–1294. https://doi.org/10.1177/1049732311405800

Bloom-Pojar

Barker

(2020). The role of confianza in community-engaged work for reproductive justice. Reflections, 20(2), 84–101. https://reflectionsjournal.net/wp-content/uploads/2020/12/V20.N2.BloomPojarBarker.pdf

Bryant-Davis

Comas-Díaz

(2016). Introduction: Womanist and mujerista psychologies. In Womanist and mujerista psychologies: Voices of fire, acts of courage (pp. 3–25). American Psychological Association. https://doi.org/10.1037/14937-001

Callister

L. C.

Beckstrand

R. L.

Corbett

(2011). Postpartum depression and help-seeking behaviors in immigrant hispanic women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 40(4), 440–449. https://doi.org/10.1111/j.1552-6909.2011.01254.x

Carillo

(2006). Humor casero mujerista—Womanist humor of the home: Laughing all the way to greater cultural understandings and social relations. In Bernal

Elenes

Godinez

Villenas

(Eds.), Chicana/Latina education in everyday life: Feminista perspectives on pedagogy (pp. 181–196). State University of New York Press.

Chibanda

Mesu

Kajawu

Cowan

Araya

Abas

M. A.

(2011). Problem-solving therapy for depression and common mental disorders in Zimbabwe: Piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV. BMC Public Health, 11(1), 828. https://doi.org/10.1186/1471-2458-11-828

10.

Chowdhary

Anand

Dimidjian

Shinde

Weobong

Balaji

Hollon

S. D.

Rahman

Wilson

G. T.

Verdeli

(2016). The healthy activity program lay counsellor delivered treatment for severe depression in India: Systematic development and randomised evaluation. The British Journal of Psychiatry, 208(4), 381–388. https://doi.org/10.1192/bjp.bp.114.161075

11.

Cubellis

Schmid

Von Peter

(2021). Ethnography in health services research: Oscillation between theory and practice. Qualitative Health Research, 31(11), 2029–2040. https://doi.org/10.1177/10497323211022312

12.

Dimidjian

Hollon

S. D.

Dobson

K. S.

Schmaling

K. B.

Kohlenberg

R. J.

Addis

M. E.

Gallop

McGlinchey

J. B.

Markley

D. K.

Gollan

J. K.

(2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74(4), 658. https://doi.org/10.1037/0022-006X.74.4.658

13.

Dyrness

(2007). ‘Confianza is where I can be myself’: Latina mothers’ constructions of community in education reform. Ethnography and Education, 2(2), 257–271https://doi.org/10.1080/17457820701350848

14.

Dyrness

(2011). Mothers united: An immigrant struggle for socially just education. University of Minnesota Press.

15.

Emerson

R. M.

Fretz

R. I.

Shaw

L. L.

(2011). Writing ethnographic fieldnotes (2nd ed.). University of Chicago Press. https://books.google.com/books?id=k83BlbBHubAC

16.

Fereday

Muir-Cochrane

(2006). Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods, 5(1), 80–92. https://doi.org/10.1177/160940690600500107

17.

Fitts

McClure

(2015). Building social capital in Hightown: The role of confianza in Latina immigrants’ social networks in the New South. Anthropology & Education Quarterly, 46(3), 295–311. https://doi.org/10.1111/aeq.12108

18.

Flick

(2018). Triangulation in data collection. In Roulston

Choi

(Eds.), The SAGE handbook of qualitative data collection (pp. 527–544). London: SAGE Publications Ltd.

19.

Folkes

(2018). Being the intrusive ‘double outsider’inside Welsh family homes: Insights from researcher positionality. In: How Do We Belong? Researcher Positionality Within Qualitative Inquiry: Proceedings of 4th Annual Qualitative Research Symposium. University of Bath, Bath, pp. 49–59. ISBN 0861971973.

20.

Fulton

B. D.

Scheffler

R. M.

Sparkes

S. P.

Auh

E. Y.

Vujicic

Soucat

(2011). Health workforce skill mix and task shifting in low income countries: A review of recent evidence. Human Resources for Health, 9(1), 1. https://doi.org/10.1186/1478-4491-9-1

21.

Futch

V. A.

Fine

(2014, 2014/01/02). Mapping as a method: History and theoretical commitments. Qualitative Research in Psychology, 11(1), 42–59. https://doi.org/10.1080/14780887.2012.719070

22.

Gilgun

(2013). Grounded theory, deductive qualitative analysis, and social work research and practice. In: Fortune

A. E.

Reid

W. J.

Miller Jr

R. L.

(Eds.), Qualitative research in social work: Columbia University Press.

23.

Gloria

A. M.

Castellanos

(2016). Latinas poderosas: Shaping mujerismo to manifest sacred spaces for healing and transformation. In Bryant-Davis

Comas-Díaz

(Eds.), Womanist and mujerista psychologies: Voices of fire, acts of courage (pp. 93–119). American Psychological Association. https://doi.org/10.1037/14937-005

24.

González

Moll

L. C.

Amanti

(2006). Funds of knowledge: Theorizing practices in households, communities, and classrooms. Routledge.

25.

Hoeft

T. J.

Fortney

J. C.

Patel

Unützer

(2018). Task-sharing approaches to improve mental health care in rural and other low-resource settings: A systematic review. The Journal of Rural Health, 34(1), 48–62. https://doi.org/10.1111/jrh.12229

26.

Jull

Giles

Graham

I. D.

(2017). Community-based participatory research and integrated knowledge translation: Advancing the co-creation of knowledge. Implementation Science, 12(1). https://doi.org/10.1186/s13012-017-0696-3

27.

Katsiaficas

Futch

V. A.

Fine

Sirin

S. R.

(2011). Everyday hyphens: Exploring youth identities with methodological and analytic pluralism. Qualitative Research in Psychology, 8(2), 120–139. https://doi.org/10.1080/14780887.2011.572743

28.

Kyngäs

(2020). Inductive content analysis (pp. 13–21). Springer International Publishing. https://doi.org/10.1007/978-3-030-30199-6_2

29.

Lange

K. W.

(2021). Task sharing in psychotherapy as a viable global mental health approach in resource-poor countries and also in high-resource settings. Global Health Journal, 5(3), 120–127. https://doi.org/10.1016/j.glohj.2021.07.001

30.

Langley

Wolstenholme

Cooke

(2018). ‘Collective making’ as knowledge mobilisation: The contribution of participatory design in the co-creation of knowledge in healthcare. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-3397-y

31.

LeCompte

M. D.

Schensul

J. J.

(2010). Designing and conducting ethnographic research: An introduction (2nd ed.). Rowman & Littlefield Publishers, Inc.

32.

Markee

(2013). Emic and etic in qualitative research (pp. 404–427). The encyclopedia of applied linguistics.

33.

Mathison

(1988). Why triangulate? Educational Researcher, 17(2), 13–17. https://doi.org/10.3102/0013189X017002013

34.

Maxwell

J. A.

(2012). Qualitative research design: An interactive approach (41). Sage publications.

35.

McCorkel

J. A.

Myers

(2003). What difference does difference make? Position and privilege in the field. Qualitative Sociology, 26(2), 199–231. https://doi.org/10.1023/a:1022967012774

36.

Mendel

Meredith

L. S.

Schoenbaum

Sherbourne

C. D.

Wells

K. B.

(2008, 2008/03/01). Interventions in organizational and community context: A framework for building evidence on dissemination and implementation in health services research. Administration and Policy in Mental Health and Mental Health Services Research, 35(1), 21–37. https://doi.org/10.1007/s10488-007-0144-9

37.

Mundorf

Shankar

Moran

Heller

Hassan

Harville

Lichtveld

(2018). Reducing the risk of postpartum depression in a low-income community through a community health worker intervention. Maternal and Child Health Journal, 22(4), 520–528. https://doi.org/10.1007/s10995-017-2419-4

38.

Nygreen

Saba

Moreno

A. P.

(2016). Mujerista research: Integrating body, emotion, spirit, and community. In: Bryant-Davis

Comas-Díaz

(Eds.), Womanist and mujerista psychologies: Voices of fire, acts of courage (pp. 41–65). Washington, DC: American Psychological Association.

39.

O'Mahen

H. A.

Woodford

McGinley

Warren

F. C.

Richards

D. A.

Lynch

T. R.

Taylor

R. S.

(2013). Internet-based behavioral activation—treatment for postnatal depression (Netmums): A randomized controlled trial. Journal of Affective Disorders, 150(3), 814–822. https://doi.org/10.1016/j.jad.2013.03.005

40.

Øvretveit

(2011). Understanding the conditions for improvement: Research to discover which context influences affect improvement success. BMJ Quality & Safety, 20(Suppl 1), i18–i23. https://doi.org/10.1136/bmjqs.2010.045955

41.

Padmanathan

De Silva

M. J.

(2013). The acceptability and feasibility of task-sharing for mental healthcare in low and middle income countries: A systematic review. Social Science & Medicine, 97, 82–86. https://doi.org/10.1016/j.socscimed.2013.08.004

42.

Palinkas

L. A.

(2014). Qualitative and Mixed Methods in Mental Health Services and Implementation Research. Journal of Clinical Child & Adolescent Psychology, 43(6), 851–861. https://doi.org/10.1080/15374416.2014.910791

43.

Patel

Weobong

Weiss

H. A.

Anand

Bhat

Katti

Dimidjian

Araya

Hollon

S. D.

King

Vijayakumar

Park

A. L.

McDaid

Wilson

Velleman

Kirkwood

B. R.

Fairburn

C. G.

(2017). The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: A randomised controlled trial. The Lancet, 389(10065), 176–185. https://doi.org/10.1016/s0140-6736(16)31589-6

44.

Robert

(2013). Participatory action research: Using experience-based co-design to improve the quality of healthcare services. In Understanding and using health experiences–improving patient care. Oxford Academic. 138–150.

45.

Scott

D. A. H.

Grant

S. M.

(2017, 2017 Nov 07). A meta-ethnography of the facilitators and barriers to successful implementation of patient complaints processes in health-care settings. Health expectations: An international journal of public participation in health care & health Policy, 21(2), 508–517. https://doi.org/10.1111/hex.12645

46.

Singla

D. R.

Lawson

Kohrt

B. A.

Jung

J. W.

Meng

Ratjen

Zahedi

Dennis

C.-L.

Patel

(2021). Implementation and effectiveness of nonspecialist-delivered interventions for perinatal mental health in high-income countries. JAMA Psychiatry, 78(5), 498. https://doi.org/10.1001/jamapsychiatry.2020.4556

47.

Sleath

West

Tudor

Perreira

King

Morrissey

(2005). Ethnicity and depression treatment preferences of pregnant women. Journal of Psychosomatic Obstetrics & Gynecology, 26(2), 135–140. https://doi.org/10.1080/01443610400023130A

48.

Teeters

L. A.

Dimidjian

(2019). The promise of a participatory approach in clinical Psychology. Clinical Psychological Science, 7(1), 60–62. https://doi.org/10.1177/2167702618805082

49.

Teeters

L. A.

Jurow

A. S.

(2018). Relationships de Confianza and the organisation of collective social action. Ethnography and Education, 13(1), 84–99. https://doi.org/10.1080/17457823.2016.1271992

50.

Tomlinson

Rotheram-Borus

M. J.

Scheffler

Le Roux

(2018). Antenatal depressed mood and child cognitive and physical growth at 18-months in South Africa: A cluster randomised controlled trial of home visiting by community health workers. Epidemiology and Psychiatric Sciences, 27(6), 601–610. https://doi.org/10.1017/s2045796017000257

51.

Vanderkruik

Dimidjian

(2018). Perspectives on task-shifting depression care to peers for depressed Latina mothers. Journal of Latina/o Psychology. Advance online publication. https://doi.org/10.1037/lat0000104

52.

Villenas

S. A.

(2005). Latina literacies in convivencia: Communal spaces of teaching and learning. Anthropology and Education Quarterly, 36(3), 273–277. https://www.jstor.org/stable/3651395

53.

Villenas

S. A.

(2006). Mature Latina adults and mothers. In Bernal

D. D.

Elenes

C. A.

Godinez

F. E.

(Eds.), Chicana/Latina education in everyday life: Feminista perspectives on pedagogy and epistemology (pp. 143–146). State University of New York Press.

54.

Villenas

S. A.

Godinez

F. E.

Bernal

D. D.

Elenes

C. A.

(2006). Chicanas/Latinas building bridges. In Chicana/Latina education in everyday life: Feminista perspectives on pedagogy and epistemology (pp. 1–9).

55.

Wallerstein

Duran

(2010). Community-based participatory research contributions to intervention research: The intersection of science and practice to improve health equity. American Journal of Public Health, 100(S1), S40–S46. https://doi.org/10.2105/ajph.2009.184036

56.

Wilkinson

Joffe

Yardley

(2004). Qualitative data collection: Interviews and focus groups. In: Marks

D. F.

Yardley

(Eds.), Research Methods for Clinical and Health Psychology (pp. 39–55): SAGE Publications.

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