Mamas Saludables, Familias Saludables [Healthy Moms, Healthy Families]: Support Group Designed for Latinas with Postpartum Depression Symptoms

Purpose for the program: This presentation will describe the design, implementation, and evaluation of an innovative postpartum depression support group for primarily low-income and Spanish-speaking Latinas. The theoretically grounded, evidence-based, and culturally specific program, Mamas Saludables – Familias Saludables [Healthy Moms, Healthy Families] is in its second year of service.

Proposed change: The Surgeon General reported that racial and ethnic biologic differences in depression do not exist. Instead, ethnicity more likely serves as a proxy variable for factors that do influence mental health. Among others, being poor, the type of neighborhood in which one resides, not having access to care, or not having culturally sensitive care providers are problems in the U.S. that lead to disparities in access and treatment and greater disease burden among some ethnic groups compared to whites. Despite these disparities, the majority of community-based intervention efforts for depression during childbearing have not demonstrated efficacy across cultural, ethnic, or racial groups. To address this disparity, Healthy Moms, Healthy Families was designed for a group that does not access traditional mental health services.

Implementation, outcomes and evaluation: A comprehensive literature review identified the strongest contributors to postpartum depression and strategies to consider when creating an ongoing support group. Care provider and participant preferences were gathered prior to implementation. Social support was selected as the structure for the curriculum. Principles of cultural leveraging guided identification of weekly topics, methods to convey support, and program evaluation strategies.  

The experienced group leader was bicultural and bilingual, and familiar to the participants through interactions during clinic visits. The postpartum support group program, consisting of 12 educational topics, was implemented using a flexible structure that facilitated the development of informal support networks among participants.  Throughout the program, participant needs were assessed and the program was adapted, as needed, to meet the majority of participants’ needs. Participant satisfaction was high as indicated by >100 client contacts during the first year. While educational handouts were popular, advice from other mothers was highly valued.

Implications for nursing practice: While demonstration and evaluation projects similar to Mamas Saludables – Familias Saludables will not address diagnosis and management of depression requiring medications and therapy, the needs of new mothers who are experiencing less severe depression symptoms or those who will not or cannot access formal psychological treatment can be met through community-based programs. This may be one of the steps needed to extend the reach of mental healthcare services, particularly for multicultural or multilinguistic groups.

Keywords: postpartum depression, support, Hispanic, cultural leveraging, evidence-based