This study used a mixed-methods, multi-phase design to develop, implement, and evaluate the Alma peer mentoring program for Spanish-speaking perinatal Latina women. Participants included peer mentors, perinatal women with elevated depressive symptoms, healthcare providers, advisory committee members, and key informants across three regions in Colorado. Data collection combined qualitative interviews and focus groups, iterative feedback on mentoring materials, structured mentoring sessions, program outcome measures, advisory consultations, and case study observations. Quantitative and qualitative data were analyzed to assess feasibility, acceptability, preliminary effectiveness, and implementation factors, informing iterative refinement and culturally grounded adaptation of the program in alignment with the Crown Institute design cycle.

Sona.Dimidjian@colorado.edu

Abrams, L. S., Dornig, K., & Curran, L. (2009). Barriers to Service Use for Postpartum Depression Symptoms Among Low-income Mothers in the United States. Qualitative Health Research, 19, 535.

Chaudron, L. H., Kitzman, H. J., Peifer, K. L., Morrow, S., Perez, L. M., & Newman, M. C. (2005). Prevalence of maternal depressive symptoms in low income Hispanic women. Journal of Clinical Psychiatry, 66(4), 418-423.

Collado, A., Calderón, M., MacPherson, L., & Lejuez, C. (2016). The efficacy of behavioral activation treatment among depressed Spanish-speaking Latinos. Journal of Consulting and Clinical Psychology, 84(7), 651. https://doi.org/10.1037/ccp0000103

Dennis, C. L. (2003a). The effect of peer support on postpartum depression: a pilot randomized controlled trial. Canadian Journal of Psychiatry, 48, 61–70.

Dennis, C. L. (2010). Postpartum depression peer support: Maternal perceptions from a randomized controlled trial. International Journal of Nursing Studies, 47(5), 560-568.

Dennis, C. L., & Chung-Lee, L. (2006). Postpartum depression help-seeking barriers and maternal treatment preferences: A qualitative systematic review. Birth: Issues in Perinatal Care, 33(4), 323-331.

Dimidjian, S., & Vanderkruik, R. (2016). Perspectives on peer-delivered therapy for rural depressed Latina women. (Unpublished master’s thesis). University of Colorado, Boulder.

Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., et al. (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), 658-670.

Ekers, D., Richards, D., McMillan, D., Bland, J. M., & Gilbody, S. (2011). Behavioural activation delivered by the non-specialist: phase II randomised controlled trial. British Journal of Psychiatry, 198(1), 66-72.

Goodman, S. H., Broth, M. R., Hall, C. M., & Stowe, Z. N. (2008). Treatment of postpartum depression in mothers: Secondary benefits to the infants. Infant Mental Health Journal, 29(5), 492-513.

Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal Depression and Child Psychopathology: A Meta-Analytic Review. Clinical Child and Family Psychology Review, 14(1), 1-27.

Kanter, J. W., Santiago-Rivera, A. L., Santos, M. M., Nagy, G., López, M., Hurtado, G. D., & West, P. (2015). A randomized hybrid efficacy and effectiveness trial of behavioral activation for Latinos with depression. Behavior Therapy, 46(2), 177-192.

Lassi, Z. S., Haider, B. A., & Bhutta, Z. A. (2010). Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes. Cochrane Database of Systematic Reviews, (11), 1.

Leger, J., & Letourneau, N. (2014). New mothers and postpartum depression: a narrative review of peer support intervention studies. Health and Social Care in the Community. https://doi.org/10.1111/hsc.12125

Lovejoy, M. C., Graczyk, P. A., O’Hare, E., & Neuman, G. (2000). Maternal depression and parenting behavior: A meta-analytic review. Clinical Psychology Review, 20(5), 561-592.

Patel, V., et al. (2017). The systematic development and randomized evaluation of the Healthy Activity Program, a lay counsellor delivered psychological treatment for severe depression in primary care in India: the PREMIUM study. British Journal of Psychiatry.

Vanderkruik, R., & Dimidjian, S. (2018). [Perspectives on peer-delivered therapy for perinatal depression]. Unpublished manuscript.

Wisner, K. L., Lara-Cinisomo, S., Pinheiro, E. A., & Luther, J. F. (2014). Characteristics of Hispanic women screened for postpartum depression. In S. Lara-Cinisomo & K. L. Wisner (Eds.), Perinatal depression among Spanish-speaking and Latin American women: A global perspective on detection and treatment (pp. 1-13). New York, NY: Springer.

Zayas, L. H., Jankowski, K., & McKee, M. D. (2003). Prenatal and postpartum depression among low-income Dominican and Puerto Rican women. Hispanic Journal of Behavioral Sciences, 25, 370.

This study aimed to develop, implement, and evaluate Alma, a culturally responsive peer mentoring program for Spanish-speaking perinatal Latina women experiencing depression. Alma engages peers with lived experience to provide guidance, support, and BA skills. The project focused on four main goals: developing culturally grounded mentoring and training materials; piloting the program and assessing feasibility, acceptability, and preliminary mental health outcomes; gathering advisory input to inform implementation, scaling, and sustainability; and conducting a case study to identify factors influencing site-specific implementation and broader dissemination.

Perinatal depression and anxiety affect many mothers and can have far-reaching impacts on their well-being, their infants, and their families. Latina women in the United States experience high rates of depressive symptoms, yet they often face substantial barriers to care. These challenges, combined with social isolation, limited access to culturally responsive services, and disrupted support networks, leave many without the help they need during pregnancy and early parenthood. Peer and community-based approaches offer a promising way to close this gap. Peer support can reduce stigma, increase social connection, and help mothers feel understood and supported by someone with shared lived experience. The skills of Behavioral Activation (BA), which focuses on increasing meaningful activities, strengthening social engagement, and building problem-solving skills, have also proven effective and can be delivered by trained peers. Despite strong evidence for both peer support and BA skills, very few programs in the United States are designed specifically for Spanish-speaking Latina mothers. The Alma program was designed to meet this need and to offer a peer-led, culturally grounded model that integrates BA skills with trusted, relationship-driven support. By empowering mothers with practical strategies and strengthening community networks, Alma aims to reduce depressive symptoms, enhance well-being, and improve early family environments.

Embedding peer-to-peer support into the fabric of maternal health.

This project advances the Crown Institute’s mission by expanding equitable, culturally grounded mental health support for mothers, infants, and families who often face significant barriers to care. By training mothers with lived experience to serve as peer mentors, the Alma program builds community capacity and increases access to trusted, strengths-based support for Spanish-speaking Latina women. Through a collaborative design process with community partners, our research aims to promote resilience, reduce isolation, and strengthen early parenting environments that are key foundations for children’s healthy development. Integrating behavioral activation strategies and supporting timely engagement with care, this work investigates the design and delivery of a sustainable, scalable model for improving family well-being across generations.

Principal Investigator(s): Anahí Collado, PhD

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Research Team Members:  Anahí Collado, PhD; Laurel Hicks, PhD,; Samuel Hubley, PhD; Laurel Kordyban; Marlene Palomar; Marta Genovez, PhD; Caitlin McKimmy, MTS, MA.; Joey Levy, MA

Community Partners: Valley Settlement, Aurora Mental Health, El Centro Amistad

Embedding peer-to-peer support into the fabric of maternal health.

Completed

This study used a qualitative approach to explore the potential adaptation of Alma, a culturally responsive peer mentoring program for new and expectant mothers, for those with a history of substance use. In-depth, semi-structured interviews were conducted with participants to gather insights on their experiences, needs, and perceptions of the program. The focus was on understanding the acceptability and perceived effectiveness of Alma’s peer mentoring and behavioral activation strategies in supporting substance use goals alongside professional care. Interview data were analyzed thematically to identify key themes, inform program adaptations, and guide future implementation for this population.

​Anahi.Collado@colorado.edu​

Albarran, C., Heilemann, M., & Koniak-Griffin, D. (2014). Promotoras as facilitators of change: Latinas’ perspectives after participating in a lifestyle behaviour intervention program. Journal of Advanced Nursing, 70(10), 2303–2313. https://doi.org/10.1111/jan.12383

Audrain-McGovern, J., Rodriguez, D., Rodgers, K. and Cuevas, J. (2011), Declining alternative reinforcers link depression to young adult smoking. Addiction, 106: 178-187. https://doi.org/10.1111/j.1360-0443.2010.03113.x.  

Barnard, M. and McKeganey, N. (2004), The impact of parental problem drug use on children: what is the problem and what can be done to help?. Addiction, 99: 552-559. https://doi.org/10.1111/j.1360-0443.2003.00664.x

Expanding the Alma Program: A Peer Mentoring Program for Parents with Depression During the Perinatal Period; IRB Protocol # 21-0206

Parolin, M., & Simonelli, A. (2016). Attachment theory and maternal drug addiction: The contribution to parenting interventions. Frontiers in psychiatry, 7, 152.

Parra-Medina, D., & Messias, D. K. H. (2011). Promotion of Physical Activity Among Mexican-Origin Women in Texas and South Carolina: An Examination of Social, Cultural, Economic, and Environmental Factors. Quest, 63(1), 100–117. https://doi.org/10.1080/00336297.2011.10483668.

This study explored the adaptation of Alma, a culturally responsive peer mentoring program for new and expectant mothers, for those with a history of substance use. In-depth interviews assessed the program’s preliminary acceptability and perceived effectiveness to guide potential adaptations.

For the past seven years, our team has been implementing and evaluating Alma to reduce depression among new and expectant mothers. Feedback from community partners highlights a strong need to support women who use substances during pregnancy and while raising young children. Substance use during this period poses significant risks for both mothers and children, including increased risk of challenges with maternal-child bonding, parenting, and long-term relational development. Alma is a promising approach to support mothers with substance use concerns. By engaging peer mentors and a behavioral activation framework, the program may help women initiate treatment, reduce substance use, and maintain sobriety, while promoting motivation, engagement, and overall well-being.

The Alma Program with Substance Use Goals Around Recovery (SUGAR) study was created to address persistent gaps in support for individuals in substance use recovery, including limited access to culturally responsive care, stigma, and barriers to engagement.

The Alma Program with Substance Use Goals Around Recovery (SUGAR) study was created to address persistent gaps in support for individuals in substance use recovery, including limited access to culturally responsive care, stigma, and barriers to engagement. The Alma Program with SUGAR study aims to promote wellness and recovery by providing peer-led support, practical skills, and community connection, recognizing that when mothers are supported, their families and communities thrive as well.

Principal Investigator(s): Anahí Collado, PhD

Research Team Members: Sona Dimidjian, PhD; Susannah Welch, MA; Pia Long; Kylie Sambirsky

Community Partners: N/A

The Alma Program with Substance Use Goals Around Recovery (SUGAR) study was created to address persistent gaps in support for individuals in substance use recovery, including limited access to culturally responsive care, stigma, and barriers to engagement.

Completed

This study used an open trial methodology in which approximately 200 pregnant and women with children <1 years old were invited to participate in the Alma program. The Alma program was delivered by English and Spanish-speaking peer mentors. Peer mentors were trained by peer mentor trainers with the support of Alma experts. Peer mentor training was guided in part by a digital platform that supports the remote delivery of the Alma program. The Alma program included approximately 6-8 mentoring individual meetings delivered remotely via telephone and/or videoconference.

Sona.Dimidjian@colorado.edu

Abrams LS, Dornig K, Curran L (2009). Barriers to Service Use for Postpartum Depression Symptoms Among Low-income Mothers in the United States. Qual Health Res, 1z9(535). 

Chowdhary, N., Anand, A., Dimidjian, S., Shinde, S., Weobong, B., Balaji, M., Hollon, S. D., Rahman, A., Wilson, G. T., Verdeli, H., Araya, R., King, M., Jordans, M. J. D., Fairburn, C., Kirkwood, B., & Patel, V. (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 

Dennis, C. L. (2003a). The effect of peer support on postpartum depression: a pilot randomized controlled trial. Can J Psychiatry, 48:61–70. 

Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., Gallop, R., McGlinchey, J. B., Markley, D. K., Gollan, J. K., Atkins, D. C., Dunner, D. L., & Jacobson, N. S. (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), 658–670. https://doi.org/10.1037/0022-006X.74.4.658 

Dimidjian, S., Goodman, S. H., Sherwood, N. E., Simon, G. E., Ludman, E., Gallop, R., Welch, S. S., Boggs, J. M., Metcalf, C. A., Hubley, S., Powers, J. D., & Beck, A. (2017). A Pragmatic Randomized Clinical Trial of Behavioral Activation for Depressed Pregnant Women. Journal of Consulting and Clinical Psychology, 85(1), 26–36. https://doi.org/10.1037/ccp0000151 

The aims of this study are to expand the Alma program using a train-the-trainer model. Alma is a peer mentoring program in which parents who have experienced and recovered from depression during the perinatal period, are trained to provide peer mentoring as a resource for depressed perinatal parents and their communities. The Alma program is a research-based peer-to-peer mentoring program that provides support to new and expectant parents. Alma was developed through the collaboration of researchers, mental health and perinatal care clinicians, community stakeholders, policy experts and women with a personal history of perinatal depression.  

In the expansion of the Alma program, we aim to conduct an evaluation of the Alma peer mentor program delivered virtually through a the train-the-trainer model to assess the responsiveness of the Alma program to perinatal participants and communities and the impact of the Alma program on participant’s mental health during pregnancy and early parenting. 

Depression and anxiety during the perinatal period are significant public health concerns that affect both parents and their children. Rates of depression and anxiety are high, treatment access is low, and the risk of adverse consequences—ranging from obstetric complications to long-term mental health risks for families—are substantial. Many groups, including ethnic minority and low-income women, face additional barriers to receiving care.

Peer support has been widely used around the world to promote maternal health, and strong evidence shows that it can reduce depressive symptoms, increase social support, and improve overall wellbeing. Peer mentors often report personal benefits as well, and peer-led programs tend to align with women’s preferences, especially for those who are hesitant about medication or who rely on informal community networks.

A growing body of research also shows that the skills of behavioral activation (BA)—a practical, skills-based approach to treating depression—can be effectively delivered by trained lay providers and adapted for perinatal populations. BA skills can also be taught through digital self-management tools, offering another accessible path to support.

To build sustainable peer support systems in the U.S., the Train-the-Trainer (TTT) model offers a promising approach. By training peer mentors who can then train others, communities can rapidly increase their capacity to support perinatal women. This model is especially timely given the increased stress, anxiety, and depression experienced by pregnant and postpartum people, and the ongoing need for scalable, community-rooted mental health solutions.

Supporting and guiding greater scalability and sustainability of the Alma program.

This project reflects the Crown Institute’s commitment to supporting the wellbeing of children by caring for the adults who care for them. The Institute’s work centers on practical, community-engaged research that strengthens families and supports mental health across the lifespan. Our study advances this mission by expanding Alma to have a train-the-trainer component (offered English and Spanish). This work is aimed to support and guide greater scalability and sustainability of the program.

Research Faculty: Sona Dimidjian, PhD; Anahi Collado, PhD; Sam Hubley, PhD; Laurel Hicks, PhD; Antonella Onofrietti Magrassi, PhD

Peer Mentors and Trainers: Susannah Welch, MA; Shannon Beckner, BA; Gracia Deras; Isabel Almeida; Pia Long; Tamra Wiser; Lizbeth Clemente; Sondra Teske; Beatriz Ferrufino

Program Managers and Graduate Students: Desiree Bauer, MPH; Joey Levy, MA

Community Partners: Amistad; Everyday Health Group

Supporting and guiding greater scalability and sustainability of the Alma program.

Ongoing

This project used a national, cross-sectional survey to understand the mental health care needs and preferences of new and expectant Latina mothers. Eligible participants were pregnant or up to six months postpartum, preferred to participate in Spanish, and lived anywhere in the United States. Recruitment through large digital parenting platforms enabled broad reach, resulting in more than 2,000 enrolled mothers. Participants completed a 20–25 minute online survey assessing care preferences, stress and discrimination experiences, mental health symptoms, daily activities, and perceptions of the Alma program, and peer support models generally.

Anahi.Collado@colorado.edu

Abrams, L. S., Dornig, K., & Curran, L. (2009). Barriers to service use for postpartum depression symptoms among low-income mothers in the United States. Qualitative Health Research, 19, 535–551.

Callister, L. C., Beckstrand, R. L., & Corbett, C. (2011). Postpartum depression and help-seeking behaviors in immigrant Hispanic women. JOGNN, 40(4), 440–449.

Chaudron, L. H., Kitzman, H. J., Peifer, K. L., Morrow, S., Perez, L. M., & Newman, M. C. (2005). Prevalence of maternal depressive symptoms in low-income Hispanic women. Journal of Clinical Psychiatry, 66(4).

Collado, A., Calderón, M., MacPherson, L., & Lejuez, C. (2016). The efficacy of behavioral activation treatment among depressed Spanish-speaking Latinos. Journal of Consulting and Clinical Psychology, 84(7), 651–657.

Dennis, C. L. (2003). The effect of peer support on postpartum depression: A pilot randomized controlled trial. Canadian Journal of Psychiatry, 48, 61–70.

Dennis, C. (2010). Postpartum depression peer support: Maternal perceptions from a randomized controlled trial. International Journal of Nursing Studies, 47(5), 560–568.

Dennis, C.-L., & Chung-Lee, L. (2006). Postpartum depression help-seeking barriers and maternal treatment preferences: A qualitative systematic review. Birth, 33(4), 323–331.

Dimidjian, S., & Goodman, S. H. (2014). Preferences and attitudes toward approaches to depression relapse/recurrence prevention among pregnant women. Behaviour Research and Therapy, 54, 7–11.

Goodman, J. H. (2009). Women’s attitudes, preferences, and perceived barriers to treatment for perinatal depression. Birth, 36(1), 60–69.

Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review, 14(1), 1–27.

Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Women’s Health, 12(4), 373–380.

Ross, L. E., & McLean, L. M. (2006). Anxiety disorders during pregnancy and the postpartum period: A systematic review. Journal of Clinical Psychiatry, 67(8).

Scope, A., Booth, A., Morrell, C. J., Sutcliffe, P., & Cantrell, A. (2017). Perceptions and experiences of interventions to prevent postnatal depression: A qualitative evidence synthesis. Journal of Affective Disorders, 210, 100–110.

Slomian, J., Honvo, G., Emonts, P., Reginster, J. Y., & Bruyère, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s Health, 15.

Stein, A., Pearson, R. M., Goodman, S. H., Rapa, E., Rahman, A., McCallum, M., Howard, L. M., & Pariante, C. M. (2014). Effects of perinatal mental disorders on the fetus and child. The Lancet, 384(9956), 1800–1819.

Vanderkruik, R., & Dimidjian, S. (2018). Perspectives on task-shifting depression care to peers for depressed Latina mothers. Journal of Latina/o Psychology.

Wisner, K. L., Lara-Cinisomo, S., Pinheiro, E. A., & Luther, J. F. (2014). Characteristics of Hispanic women screened for postpartum depression. In Perinatal Depression Among Spanish-Speaking and Latin American Women. Springer.

Yonkers, K. A., et al. (2001). Onset and persistence of postpartum depression in an inner-city maternal health clinic system. American Journal of Psychiatry, 158(11), 1856–1863.

Zayas, L. H., Jankowski, K. R. B., & McKee, M. D. (2003). Prenatal and postpartum depression among low-income Dominican and Puerto Rican women. Hispanic Journal of Behavioral Sciences, 25(3), 370–385.

This study examined what types of mental health care and support new and expectant Latina mothers in the United States want and feel comfortable using. The survey explored mothers’ preferences for mental health support, their views of the Alma as well as peer-delivered programs in general, and their experiences with stress, discrimination, and daily activities that may shape their needs. By collecting input from Latina mothers nationwide, the study generates insights that can guide the development of responsive, culturally grounded mental health programs and improve access to meaningful support for Latina families.

Depression during the perinatal period poses serious risks for mothers and their children, yet many women, especially those from marginalized communities, do not receive needed support. New and expectant Latina mothers experience particularly high rates of depressive symptoms and face significant barriers to care. Peer- and community-based programs offer a promising approach by providing non-pharmacological, culturally familiar support, but little is known about what types of care Latina mothers prefer. This study addresses that gap by examining mental health care preferences among Latina mothers across the U.S. and exploring their perceptions of Alma, a peer-delivered program designed to improve mood and reduce stress.

This study helps clarify what kinds of support are acceptable, accessible, and meaningful and informs how to provide responsive care for new and expectant mothers.

This project advances the Crown Institute’s mission by expanding equitable, culturally grounded mental health support for mothers, infants, and families who often face significant barriers to care. The study helps clarify what kinds of support are acceptable, accessible, and meaningful and informs how to provide responsive care for new and expectant mothers.

Principal Investigator(s): Anahí Collado, PhD
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Research Team Members: Anahí Collado, PhD; Laurel Hicks, PhD; Samuel Hubley, PhD; Laurel Kordyban; Marlene Palomar; Desiree Bauer, MPH

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Community Partners: Everyday Health Group; BabyCenter en Español

This study helps clarify what kinds of support are acceptable, accessible, and meaningful and informs how to provide responsive care for new and expectant mothers.

Ongoing

We used a three-phase, mixed-method participatory research design. In Phase 1, we conducted focus groups (N = 20) and an online survey (N = 118) to guide the design of Alma, the peer-delivered BA program. In Phase 2, we co-designed the program and training materials with five peers who delivered the program to pregnant depressed women (N = 10). In Phase 3, we conducted a pilot randomized controlled trial (N = 27), comparing the peer-delivered BA program to treatment-as-usual to evaluate acceptability (completion, satisfaction, working alliance), feasibility (delivery quality), and depression symptom severity change.

Sona.Dimidjian@colorado.edu

Stein A, Pearson RM, Goodman SH, et al. Effects of perinatal mental disorders on the fetus and child. Lancet. 2014;384(9956):1800-1819. 

Ko JY, Farr SL, Dietz PM, Robbins CL. Depression and treatment among U.S. pregnant and nonpregnant women of reproductive age, 2005-2009. Journal of Women's Health. 2012;21(8):830-836. 

O'Mahen HA, Flynn HA. Preferences and perceived barriers to treatment for depression during the perinatal period. J Womens Health (Larchmt). 2008;17(8):1301-1309. 

Goodman JH. Women's Attitudes, Preferences, and Perceived Barriers to Treatment for Perinatal Depression. Birth-Issues in Perinatal Care. 2009;36(1):60-69. 

Battle CL, Salisbury AL, Schofield CA, Ortiz-Hernandez S. Perinatal antidepressant use: Understanding women's preferences and concerns. J Psychiatr Pract. 2013;19(6):443-453. 

Henshaw E, Sabourin B, Warning M. Treatment-seeking behaviors and attitudes survey among women at risk for perinatal depression or anxiety. J Obstet Gynecol Neonatal Nurs. 2013;42(2):168-177. 

ACOG. Screening for perinatal depression: Committee Opinion. American College of Obstetricians and Gynecologists;2015.

Marcus SM, Flynn HA, Blow FC, Barry KL. Depressive symptoms among pregnant women screened in obstetrics settings. J Womens Health. 2003;12(4):373-380. 

Dietz PM, Williams SB, Callaghan WM, Bachman DJ, Whitlock EP, Hornbrook MC. Clinically identified maternal depression before, during, and after pregnancies ending in live births. Am J Psychiatry. 2007;164(10):1515-1520. 

Cohen LS, Altshuler LL, Harlow BL, et al. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA. 2006;295(5):499-507. 

This study aimed to refine the lay counselor BA model for dissemination by peers in obstetric settings. Building on focus group methods used with perinatal women by consultants Patel and Rahman, we examined patient (n = 25) and stakeholder (n = 50) input to inform the use of accessible and engaging language, preferred peer and patient characteristics, frequency, duration, and length of peer BA sessions, and contextual issues such as an emphasis on family involvement and infant well-being to promote engagement. We developed protocols for peer delivery and web-based training, supervision, and fidelity monitoring tools. 

Aim 2: We aimed to test the BA peer delivery web-based training, supervision, and fidelity monitoring tools. We aimed tod train peers (n = 5) and evaluate outcomes in the context of a pre-post open trial with depressed pregnant women (n = 10).  

Aim 3: We aimed to conduct a pilot randomized effectiveness trial, comparing peer delivered BA with usual care (using Phase 2 trained peers) for pregnant women with depression (N=50). 

Untreated depression during pregnancy can have enduring adverse consequences and correlates for women and their children. Although antidepressant medication is the most frequently provided intervention for depression during pregnancy, it is efficacious only as long as it is taken, and when pregnant women discontinue antidepressant medication, they are at risk for relapse. Pregnant women prefer both non-pharmacological treatment and access to such treatment in the obstetric setting; however, access to psychotherapy, especially in obstetric settings, is highly limited. As such, pregnant women and their healthcare providers continue to face the choice between antidepressant medication and no treatment, which is unacceptable, particularly given that efficacious behavioral interventions for depression exist. Further, knowledge that pregnant women consult informal more than professional sources has not yet informed service delivery. The skills of BA are comparable in efficacy to antidepressant medication in the general population and superior to usual care among pregnant women in the reduction of depression, anxiety, and stress, but such skills are not accessible to most pregnant women. Thus, the proposed project has the potential for high impact in solving a major gap in current healthcare, thereby impacting the health of women and their offspring.

Co-designing and investigating a peer-delivered program, Alma, designed to support new and expectant mothers experiencing depression with the skills of Behavioral Activation (BA).

This project reflects the Crown Institute’s commitment to supporting the wellbeing of children by caring for the adults who care for them. The Institute’s work centers on practical, community-engaged research that strengthens families and supports mental health across the lifespan. Our study advances this mission by co-designing and investigating a peer-delivered program, Alma, designed to support new and expectant mothers experiencing depression with the skills of Behavioral Activation (BA).

Principal Investigators: Sona Dimidjian, PhD

Current Team:  Sherryl Goodman, Ph.D.; Sam Hubley, PhD; Robert Gallop, PhD; Rachel Vanderkruik, PhD; Joey Levy, MA; Anahí Collado, PhD; Laurel Hicks, PhD

Community Partners: Kaiser Permanente Colorado: Arne Beck, PhD; Debra Ritzwoller, PhD; Jennifer Boggs, PhD; Angela Plata; Mark Gray; Carsie Nyirenda

Co-designing and investigating a peer-delivered program, Alma, designed to support new and expectant mothers experiencing depression with the skills of Behavioral Activation (BA).

Ongoing

Mixed-methods approach: (i) phenomenological qualitative methods using trauma-informed focus groups and expressive writing to explore lived experiences of identity-associated safety and harm on campus; (ii) longitudinal quantitative approaches to explore relationships among identity, belonging, sexualized and identity-based violence, and their impacts on mental health (e.g., depression, PTSD), health risk behaviors (e.g., alcohol and cannabis use, sexual behavior), and academic success (e.g., class attendance, retention). Informed by this research, we will co-design and study the impact of a campus-based intervention for minoritized identity students focused on leveraging community for reducing disparities in violence, safety, and wellness.

OurCampus@colorado.edu

Coulter, R. W. S., & Rankin, S. R. (2017). College sexual assault and campus climate for sexual- and gender-minority undergraduate students. Journal of Interpersonal Violence, 35(5-6), 1351–1366.

Budge, S. L., Domínguez, S., & Goldberg, A. E. (2019). Minority stress in nonbinary students in higher education: The role of campus climate and belongingness. Psychology of Sexual Orientation and Gender Diversity, 7(2), 222–229.

Wilson, L. C., & Liss, M. (2020). Safety and belonging as explanations for mental health disparities among sexual minority college students. Psychology of Sexual Orientation and Gender Diversity, 9(1), 110–119.

Strayhorn, T. L. (2021). Exploring ethnic minority first-year college students’ well-being and sense of belonging: A qualitative investigation of a brief intervention. American Journal of Qualitative Research, 6(1), 42–58.

Galán, C. A., et al. (2021). Exploration of experiences and perpetration of identity-based bullying among adolescents by race/ethnicity and other marginalized identities. JAMA Network Open, 4(7), e2116364.

Coulter, R. W. S., et al. (2017). Prevalence of past-year sexual assault victimization among undergraduate students: Exploring differences by and intersections of gender identity, sexual identity, and race/ethnicity. Prevention Science, 18(6), 726–736.

Walton, G. M., & Cohen, G. L. (2007). A question of belonging: Race, social fit, and achievement. Journal of Personality and Social Psychology, 92(1), 82–96.

Loyd, A. B., et al. (2022). Investigating longitudinal associations between racial microaggressions, coping, racial/ethnic identity, and mental health in Black girls and women. Journal of Research on Adolescence, 32(1), 69–88.

Pittman, D. M., et al. (2017). The cost of minority stress: Risky alcohol use and coping-motivated drinking behavior in African American college students. Journal of Ethnicity in Substance Abuse, 18(2), 1–22.

Wilson, S. M., et al. (2016). Minority stress is longitudinally associated with alcohol-related problems among sexual minority women. Addictive Behaviors, 61, 80–83.

Goldberg, A. E., et al. (2019). Trans students who leave college: An exploratory study of their experiences of gender minority stress. Journal of College Student Development, 60(4), 381–400.

Graham, J., & McClain, S. (2019). A canonical correlational analysis examining the relationship between peer mentorship, belongingness, impostor feelings, and Black collegians’ academic and psychosocial outcomes. American Educational Research Journal, 56(6), 2333–2367.

Backhaus, I., et al. (2019). Sexual assault, sense of belonging, depression and suicidality among LGBQ and heterosexual college students. Journal of American College Health, 69(4), 1–9.

Grocott, L. R., et al. (2023). Social support as a buffer of the association between sexual assault and trauma symptoms among transgender and gender diverse individuals. Journal of Interpersonal Violence, 38(1-2), 1738–1761.

1. Elevate the voices and lived experiences of minoritized identity students in furthering our understanding of identity-related safety, belonging, and harm.  

2. Identify risk and protective factors, barriers and obstacles, and strengths that are critical for fostering a safe and inclusive community that allows for equitable access to education and well-being.  

3. Identify pathways of risk and resilience in students’ adjustment to college trajectories.  

4. Co-design a campus-based intervention with students and partners to leverage community in mitigating barriers to wellness and reducing disparities in violence and harm.

Undergraduate students from historically oppressed and systematically minoritized identities (e.g., racial, ethnic, sex/gender, sexual orientation, and intersectional minoritized identities) have significant barriers to social belonging and connection on higher education campuses that are predominantly White, cisgender, and heterosexual. Additionally, these students often experience sexualized and identity-based violence at higher rates than their majority-identified counterparts, which further exacerbates barriers to belonging and disparities in education and wellness.

Fostering a community to create equitable access to education and well-being.

The Also Our Campus project is a community-engaged program of research that elevates the voices and lived experiences of individuals of minoritized identities on the CU Boulder campus around sexualized and identity-based harm. Understanding minoritized identity students’ experiences with safety, harm, and belonging on campus can help us leverage protective factors against these experiences and reduce the unique barriers to safety among these individuals. Collaboration with campus and community organizations allows for systemic insight into risk and protective factors, barriers and obstacles, and strengths that are critical for fostering a safe and inclusive community that allows for equitable access to education and well-being.

Principal Investigator: Chelsea Kilimnik, PhD

Research Team Members: Sofia Barnes-Horowitz, BA; Kit Ganzle; Tatum Hendrick; Alexandra Liepmann; Donna Mejia, MFA; Sachi Rohilla; Meghan Densmore; Lori Brookman; Cass Lewis,;Sarah Bensreiti

Community Partners: Office of Institutional Equity and Compliance; CU Boulder, Office of Victim Assistance; CU Boulder

Fostering a community to create equitable access to education and well-being.

Ongoing

Undergraduate psychology students enrolled in a field placement course were trained as Body Project peer-leaders and invited to participate in the study; 14 of 22 trained peer-leaders took part. Training was delivered in two formats: an intensive 2-day workshop led by a Body Project Collaborative staff member, and a distributed, multi-week training led by the course professor with ongoing consultation. Across both semesters, training covered core content, including the thin ideal, its costs, and strategies to challenge appearance pressures and “fat talk.” The study used two 45-minute focus groups each semester (one post-training, one after group facilitation) to explore peer-leaders’ views on training strengths and needed improvements. Focus groups were recorded, transcribed, and analyzed to identify and refine themes about training strengths and areas for improvement, resulting in nine final themes.

Sona.Dimidjian@colorado.edu

Becker, C. B., Smith, L. M., & Ciao, A. C. (2006). Peer facilitated eating disorders prevention: A randomized effectiveness trial of cognitive dissonance and media advocacy. Journal of Counseling Psychology, 53, 550–555. doi:10.1037/0022-0167.53.4.550

Becker, C. B., Wilson, C., Williams, A., Kelly, M., McDaniel, L., & Elmquist, J. (2010). Peer facilitated cognitive dissonance versus healthy weight eating disorders prevention: A randomized comparison. Body Image, 7, 280–288. doi:10.1016/j.bodyim.2010.06.004

The overall aim of the study was to describe peer-leaders’ perceptions of their training needs and preferences to deliver prevention programs.

The Body Project is a cognitive-dissonance intervention that is effective in improving body satisfaction for high school and college aged women. The Body Project can be implemented by trained peers, thus increasing its potential for broad and cost-effective dissemination. Little is known, however, about peer-leaders’ perceptions of their training needs and preferences to deliver prevention programs.

Strengthening a proven, peer-led intervention that improves body satisfaction among high school and college-aged women.

This study contributes to the flourishing and well-being of young people by strengthening a proven, peer-led intervention that improves body satisfaction among high school and college-aged women. By examining peer-leaders’ training needs and preferences, it identifies concrete ways to enhance the quality, reach, and sustainability of the Body Project, a cost-effective prevention program that can be widely disseminated in school and campus settings. The resulting recommendations can improve how educators, campus staff, and peer-leaders are prepared to deliver programs, ultimately fostering healthier body image, reducing risk for eating disorders, and supporting mental health in youth.

Principal Investigator(s): Sona Dimidjian, PhD

Research Team Members: Samantha Strife, PhD; Rachel Vanderkruik, PhD

Strengthening a proven, peer-led intervention that improves body satisfaction among high school and college-aged women.

Completed

We are currently conducting the second phase of The Crown Institute Participatory Research Approach, which focuses on identifying and understanding needs to inform co-design. We utilized a mixed-methods approach that included virtual focus groups (N = 17) to explore cultural relevance and guide curriculum adaptations, as well as a non-randomized open trial with Latina adolescents and emerging adults (N = 200) to evaluate feasibility and preliminary effectiveness.

Anahi.Collado@colorado.edu‍

Antonella.Onofrietti@colorado.edu‍

LatinaStrong@colorado.edu

Ayala, G. X., Mickens, L., Galindo, P., & Elder, J. P. (2007). Acculturation and body image perception among Latino youth. Ethnicity and Health, 12(1), 21–41.

Cachelin, F. M., Veisel, C., Barzegarnazari, E., & Striegel-Moore, R. H. (2000). Disordered eating, acculturation, and treatment-seeking in a community sample of Hispanic, Asian, Black, and White women. Psychology of Women Quarterly, 24(3), 244–253.

Jackson, F. F. J., Chapa, S., Lee, J., & Davis, K. A. (2019). Body image dissatisfaction among women of color: Examining the influence of cultural messages. Journal of Cultural Marketing Strategy, 3(2), 131–151.

Neumark-Sztainer, D. (2005). “I’m, Like, SO Fat!”: Helping your teen make healthy choices about eating and exercise in a weight-obsessed world. New York, NY: The Guilford Press.

Paxton, S. J., Neumark-Sztainer, D., Hannon, P. J., & Eisenberg, M. E. (2006). Body dissatisfaction prospectively predicts depressive mood and low self-esteem in adolescent girls and boys. Journal of Clinical Child & Adolescent Psychology, 35(4), 539–549. doi:10.1207/s15374424jccp3504_5

Our research is focused on the overall aim of developing and evaluating a culturally responsive version of the mind.body.voice. (m.b.v.) curriculum for Latina adolescents and emerging adults (ages 13–22). We are addressing the following specific aims:  

• To explore the cultural relevance of the m.b.v. curriculum with Latina adolescents and young adults.  

• To assess the feasibility and acceptability of the adapted m.b.v.-LatinaStrong program; to examine preliminary effects on primary outcomes of body image satisfaction, disordered eating, internalization of appearance ideals, and sense of belonging and secondary outcomes of anxiety and depression; and to explore the extent to which acculturation and perceived discrimination moderate preliminary indicators of effectiveness.

Body dissatisfaction affects over 50% of teenage girls across racial and ethnic groups, and is linked to disordered eating, depression, and low self-esteem (Neumark-Sztainer, 2005; Paxton et al., 2006). Latina adolescents and emerging adults report high rates of body dissatisfaction and have elevated rates of bulimia nervosa and use of unhealthy weight control behaviors (Jackson et al., 2019; Ayala et al., 2007; Cachelin et al., 2000). Despite this risk, culturally responsive prevention programs tailored to Latina youth are scarce.

This research study focuses on the experiences of Latina girls and young women.

This study contributes to the wellness of young people with a focus on improving body satisfaction, resisting harmful appearance ideals, and building self-confidence and community connection among Latina adolescents and emerging adults.

Principal Investigator(s): Anahí Collado, PhD

Research Team Members: Desiree Bauer, MPH; Antonella Onofrietti Magrassi, PhD; Diego Vidaurre; Ilse Amateco; Ana Carcoba; Karen Guardado; Airy Porras; Beatriz Sanchez

This research study focuses on the experiences of Latina girls and young women.

Completed

We conducted a randomized controlled trial (RCT), randomizing participants to the m.b.v. curriculum or “business-as-usual” control to examine changes in proximal and distal outcomes, including to decrease negative body judgment, to decrease internalized negative cultural messages about appearance, to increase body awareness and sense of agency, to increase positive self-regard, to improve mental health and wellness (disordered eating behavior, depression, anxiety, loneliness, and negative affect), and to improve school performance and experience (grades, attendance, school engagement and belonging). To examine barriers and facilitators to the “real-world” implementation of m.b.v., we will conduct an open trial to evaluate the effectiveness of the curriculum among middle school and high school women in a club format.

hmbv@colorado.edu

Fritzson, A. E., Schrag, B. H. C., Park, B., Strife, S., Peña Teeters, L. A., Lischwe, E. H., Bell, G. B. M., Herron, W. B., & Dimidjian, S. (2024). Enhancing body image satisfaction and well-being among early adolescents: Feasibility and preliminary outcomes of the mind. body. voice. program. Eating behaviors, 53, 101875. https://doi.org/10.1016/j.eatbeh.2024.101875

Mellinger, C., Fritzson, A., Park, B., & Dimidjian, S. (2023). Developing the Sense of Belonging Scale and Understanding Its Relationship to Loneliness, Need to Belong, and General Well-Being Outcomes. Journal of Personality Assessment, 106(3), 347–360. https://doi.org/10.1080/00223891.2023.2279564

Herbstreit, D., Fritzson, A. E., Strife, S., Park, B., Dimidjian, S., & Kilimnik, C. D. (In Review). Investigating adolescent girls’ written narratives of body image and appearance biases: A qualitative analysis of letters to a younger girl. Journal of Adolescent Research.

Erickson, Miriam Clayton, Christopher Mellinger, Bernadette Park, and Sona Dimidjian. “Stereotypes About Who Is Affected by Eating Disorders Disadvantage Risk Perception for Black Girls and Women.” Sex Roles 90, no. 8 (August 2024): 1075–98. https://doi.org/10.1007/s11199-024-01496-9.

Vanderkruik, R., Conte, I., & Dimidjian, S. (2020). Fat talk frequency in high school women: Changes associated with participation in the Body Project. Body image, 34, 196–200. https://doi.org/10.1016/j.bodyim.2020.06.002

Vanderkruik, R., Gist, D., & Dimidjian, S. (2020). Preventing eating disorders in young women: An RCT and mixed-methods evaluation of the peer-delivered Body Project. Journal of Consulting and Clinical Psychology, 88(12), 1105–1118. https://doi.org/10.1037/ccp0000609

Vanderkruik, R., Strife, S., & Dimidjian, S. (2017): Lessons learned from training peer-leaders to conduct Body Project workshops, Eating Disorders, DOI:10.1080/10640266.2017.1308733

This project builds on our earlier study in which we developed and evaluated the mind. body. voice. (m.b.v.) curriculum for young women in middle and high school and during the transition to college. The aim of the current study is to conduct a hybrid trial Type 1 in which we address the primary aim of testing the effectiveness of the m.b.v. program and the secondary aim of describing contexts of implementation.

Body image dissatisfaction is widespread among girls and young women and strongly linked to disordered eating as well as other mental health and wellness concerns. The mind.body.voice. (m.b.v.) curriculum aims to address this need by building community, countering appearance pressures, strengthening self-connection, and fostering agency through peer-facilitated learning.

Promotes youth wellness by fostering body acceptance, agency, and leadership, reducing risk of disordered eating, and advancing interdisciplinary participatory design through collaborative, youth-informed research with real-world impact.

This study contributes to the wellness of young people with a focus on promoting body acceptance, fostering agency and leadership, and decreasing risk of disordered eating. The mind.body.voice. study also embodies the commitment to interdisciplinary participatory design, demonstrating how collaboration with participants translates our mission and vision into meaningful, real-world impact.

Principal Investigator and Research Faculty: Sona Dimidjian, PhD; Anahí Collado, PhD; Antonella Onofrietti Magrassi, PhD; Jazmyne Peters, PhD; Samantha Strife, PhD

‍Community Partners: Boulder Valley School District; Girls Inc.

Promotes youth wellness by fostering body acceptance, agency, and leadership, reducing risk of disordered eating, and advancing interdisciplinary participatory design through collaborative, youth-informed research with real-world impact.

Ongoing

Study 1: We will conduct a proof-of-concept open trial study to evaluate them.b.v. GLU program among Colorado Black girls and femmes between the ages of 11and 22 (N=50).

Study2: We will conduct a qualitative phenomenological study to explore how colorism impacts Black girls and femmes in the context of appearance biases (N=15) using interviews and focus groups.

Jazmyne.Peters@colorado.edu

Awad, G. H.,  Norwood, C., Taylor, D. S., Martinez, M., McClain, S., Jones, B., Holman, A.,  & Chapman-Hilliard, C. (2015). Beauty and Body Image Concerns Among African American College Women. Journal of Black Psychology, 41(6),  540–564.  

Cotter,  Elizabeth W., et al. “An Investigation of Body Appreciation, Ethnic Identity,  and Eating Disorder Symptoms in Black Women.” Journal of Black Psychology,  vol. 41, no. 1, Feb. 2015, pp. 3–25. SAGE Journals, https://doi.org/10.1177/0095798413502671.

Gordon K. H.,  Castro Y., Sitnikov L., Holm-Denoma J. M. (2010). Cultural body shape ideals  and eating disorder symptoms among White, Latina, and Black college women. Cultural Diversity & Ethnic Minority Psychology, 16, 135-143.

Hesse-Biber  S., Livingstone S., Ramirez D., Barko E. B., Johnson A. J. (2010). Racial  identity and body image among black female college students attending predominately white colleges. Sex Roles, 63, 697-711. Crossref. Web  of Science.

King, K. A.,  Vidourek, R. A., & Wager, D. I. (2012). Family history, body image, and  disordered eating: An exploratory study. Journal of Experiential  Psychotherapy, 15(2), 17–23.

Mbilishaka,  Afiya M., & Apugo Danielle (2020) Brushed aside: African American women’s narratives of  hair bias in school, Race Ethnicity and Education, 23(5), 634-653. DOI: 10.1080/13613324.2020.1718075.

Neumark-Sztainer,  D. (2005). “I’m, Like, SO Fat!”: Helping your teen make healthy choice about  eating and exercise in a weight-obsessed world (1 ed.). New York, NY: The  Guilford Press.  

Paxton, S.  J., Neumark-Sztainer, D., Hannon, P. J., & Eisenberg, M. E. (2006). Body  dissatisfaction prospectively predicts depressive mood and low self-esteem in adolescent girls and boys. Journal of Clinical Child & Adolescent  Psychology, 35(4), 539–549. doi:10.1207/s15374424jccp3504_5  

Rogers Wood  N. A., Petrie T. A. (2010). Body dissatisfaction, ethnic identity, and  disordered eating among African American women. Journal of Counseling Psychology, 57, 141-153. 

Schooler D.,  Monique Ward L., Merriwether A., Caruthers A. (2004). Who’s that girl:  Television’s role in the body image development of young White and Black women. Psychology of Women Quarterly, 28, 38-47.

The overarching aim of the present project is to study the impacts of the mind.body.voice. Girls Like Us (m.b.v. GLU)  program for Black girls and femmes using an open trial (Study 1) of the adapted curriculum for Black girls and femmes, while simultaneously engaging participants in a phenomenological inquiry (Study 2) to understand how a particular factor  – colorism – impacts Black girls and femmes in the context of appearance biases. 

Dissatisfaction with body image is highly prevalent among girls and women, with over 50% of teenage girls across all ethnic/racial groups in the U.S. engaging in unhealthy weight control behaviors, such as skipping meals, vomiting, and taking laxatives  (Neumark-Sztainer, 2005). Negative body image is significantly correlated with disordered eating (King et al., 2012; Stice, 2007) and is a risk factor for depressed mood and low self-esteem among girls (Paxton et al.,  2006). Moreover, eating disorders have the highest mortality rate among mental illnesses (Neumark-Sztainer, 2005).  The lived experiences of girls of color are frequently overlooked in mental health research and wellness practices, resulting in a lack of understanding of the unique experiences of Black girls and women as it pertains to eating concerns and body image. More recent studies have found evidence indicating factors such as belonging to a marginalized group, experiences of discrimination, and conflicts between their cultural norms vs. the cultural expectations of dominant groups significantly contribute to Black girls’ and women’s susceptibility to disordered eating behaviors and body satisfaction (Awad, G. H., et. al.,  2015; Gordon et al., 2010).    

Recognizing that Black girls and femmes experience these cultural conflicts and discrimination from a young age is crucial for early intervention and support. Black girls are often forced  to assimilate in response to microaggressions, colorism, racism, and discrimination, which continue into their adult lives (Mbilishaka &  Apugo, 2020).

Recent literature has identified protective factors against eating concerns and body dissatisfaction for Black girls and women. Notably, a strong association with one’s ethnic group has been shown to correlate with decreased internalization of the thin ideal,  beliefs or concerns related to eating, shape, or weight, and correlates with an increased likelihood of body satisfaction (Cotter, et.al., 2013;  Hesse-Biber et al., 2010; Rogers Wood & Petrie, 2010; Schooler et al., 2004). Alternatively, Black girls and women who reject Black cultural values and instead internalize Eurocentric beauty standards report increased body image and eating concerns (Awad, G.H.,  et. al., 2015).

One crucial consideration when working with traditionally underserved and underrepresented communities in the U.S. is the need to culturally adapt or modify intervention protocols to serve their needs. We are seeking to extend the mbv curriculum to an underserved community in the U.S.: young Black girls and femmes. A primary goal of the current research is to learn with the same community we seek to serve what cultural adaptations are necessary. Thus, in the present studies,  we will examine the impacts on perception of appearance biases (i.e.,  colorism), self-esteem, and other variables associated with participating in the m.b.v. GLU Program sessions. 

This research study tests the impact of the mind.body.voice. Girls Like US program, adapted with a focus on Black girls and femmes.

This study contributes to the wellness of young people through testing the impact of the mind.body.voice. Girls Like  Us (m.b.v. GLU) program, adapted with a focus on Black girls and femmes, and to understand how a particular factor – colorism – impacts Black girls and femmes in the context of appearance bias.

Principal Investigator: Jazmyne Peters, PhD

Research Team Members: Kidde Kokole; Amida Nigena, MA; Alison Ofori

This research study tests the impact of the mind.body.voice. Girls Like US program, adapted with a focus on Black girls and femmes.

Ongoing

This study used a mixed-methods, longitudinal design to evaluate the efficacy of delivering the mind, body, and voice components of the As You Are program through an online platform and to examine the extent to which selected components (appearance bias awareness, mindfulness skills, and their combined delivery) protect against harmful effects of appearance-focused social media exposure. Participants were young women ages 18–24 from across the United States.

Data collection included three online phases. First, participants completed a baseline assessment of body image, body appreciation, and related constructs. In the second phase, participants were randomly exposed to the assigned  core components followed by idealized social media content, after which they completed questionnaires assessing immediate cognitive, emotional, and body image responses. The final phase included a follow-up assessment to evaluate short-term changes and the persistence of intervention effects.

Quantitative and qualitative data were collected at each stage and analyzed to assess feasibility, acceptability, preliminary effectiveness, and implementation considerations. These findings will guide iterative refinement of a potential virtual version of the program, ensuring it meets the needs of young people in diverse digital contexts.

Anahi.Collado@colorado.edu

Fardouly, J., Willburger, B.K., & Vartanian, L.R. (2018). Instagram use and young women’s body image concerns and self-objectification: Testing mediational pathways. New Media & Society, 20(4), 1380-1395. 

Fritzson, A. E., Schrag, B. H., Park, B., Strife, S., Teeters, L. A. P., Lischwe, E. H., ... & Dimidjian, S. (2024). Enhancing body image satisfaction and well-being among early adolescents: Feasibility and preliminary outcomes of the mind. body. voice. program. Eating Behaviors, 53, 101875.

Neumark-Sztainer, D. (2005). Can we simultaneously work toward the prevention of obesity and eating disorders in children and adolescents? International Journal of Eating Disorders, 38(3), 220-227. 

Tiggemann, M. & Slater, A. (2014). NetTweens: The internet and body image concerns in preteenage girls. Journal of Early Adolescence, 34(5), 606-620.

This study aims to evaluate the efficacy of delivering the mind, body, and voice components of the As You Are program through an online platform and to examine the extent to which selected components protect adolescents from harmful effects of appearance-focused social media exposure.

Young women experience high rates of body dissatisfaction and unhealthy weight-control behaviors, with more than half reporting harmful practices such as skipping meals or purging. Social media has become a major driver of these concerns; platforms like Instagram and TikTok expose youth to idealized appearance imagery, promote comparison, and reinforce narrow beauty norms. These pressures are especially influential during adolescence and early adulthood, developmental period characterized by heightened sensitivity to peer evaluation and emerging identity exploration. Despite the growth of prevention programs, little is known about the extent to which these programs protect young women from the ongoing impact of appearance-focused social media exposure, a critical gap given that teens spend several hours per day engaging with highly curated digital content.

The present study seeks to address this gap by evaluating core components of the As You Are curriculum, particularly appearance bias awareness, mindfulness skills, and their combined delivery to determine how exposure to idealized social media content shapes adolescents’ interpretations and emotional responses, and the extent to which these strategies offer protection. By testing these components independently and in combination, the project aims to identify the mechanisms of protection that are most effective for young people navigating today’s social media landscape, thereby advancing prevention science in ways that reflect contemporary digital realities.

Evaluates the feasibility and efficacy of delivering the As You Are program’s mind, body, and voice components online, and examines whether selected components protect adolescents from the harmful effects of appearance-focused social media exposure.

This project advances the Crown Institute’s vision by promoting environments in which young people can develop healthy relationships with themselves and their communities by  addressing how to shield young people from the digital pressures that shape body image and mental health. The findings inform scalable, youth-centered tools that empower adolescents to navigate social media with confidence and compassion, contributing to a world where every young person feels supported to flourish.

Principal Investigator(s):  Anahi Collado, PhD

‍Research Team Members:  Kylie Sambirsky; Bree McCarty, BA‍

Community Partners: N/A

Evaluates the feasibility and efficacy of delivering the As You Are program’s mind, body, and voice components online, and examines whether selected components protect adolescents from the harmful effects of appearance-focused social media exposure.

Ongoing

The study uses multimodal testimonios to explore student experiences and support culturally sustaining pedagogies through ethnographic qualitative methods of data collection and analysis.

Teeters@colorado.edu

Adriana.Alvarez@ucdenver.edu

Ladson-Billings, G. (1995). Toward a theory of culturally relevant pedagogy. American Educational Research Journal, 32(3), 465–491.

Moll, L. C., Amanti, C., Neff, D., & Gonz´alez, N. (1992). Funds of knowledge for teaching: Using a qualitative approach to connect homes and classrooms. Theory Into Practice, 31(2), 132–141. https://doi.org/10.1080/00405849209543534 National Research Council. (2012). A framework for K-12 Science Education: Practices.

Esteban-Guitart, M. (2012). Towards a multimethodological approach to identification of funds of identity, small stories and master narratives. Narrative Inquiry, 22 (1), 173–180. https://doi.org/10.1075/ni.22.1.12est

Hogg, L., & Volman, M. (2020). A synthesis of funds of identity research: Purposes, tools, pedagogical approaches, and outcomes. Review of Educational Research, 90(6), 862-895.

1. How can schools create structures with and for youth that support their well-being? 2. How can multimodal testimonios support students in identifying distrust and articulating a sense of belonging?

2. How can multimodal testimonios support students in identifying distrust and articulating a sense of belonging?

3. How can multimodal testimonios support educators and leaders in schools in enacting culturally sustaining pedagogies? 4. How can educators use multimodal approaches and pedagogies to identify and integrate funds of identity and knowledge into classroom learning?

4. How can educators use multimodal approaches and pedagogies to identify and integrate funds of identity and knowledge into classroom learning?

The relationships children have with their parents and teachers, and the environmental contexts of home and school play a critical role in how children develop socially, emotionally, and cognitively (National Scientific Council on the Developing Child, 2012). In the context of schools, the impact of positive relationships on well-being has been well documented (Berger et al., 2019; Roehlkepartain et al., 2017; Roorda et al., 2017). Relationships that are characterized by trust and belonging can positively contribute to well-being (Morsillo & Prilleltensky, 2007; Snyder et al., 2003). As schools seek to design enduring programs and pedagogical practices of support, it is critical that the experiences, cultures, and perspectives of young people are valued and incorporated as a guiding strength into the design of the programs and pedagogies themselves (Teeters et al., 2022).

Reimagining schools to cultivate trust and belonging for all students.

This study explores how schools can foster belonging and trust for students and communities. It emphasizes pedagogical approaches that center students’ lives and experiences through multimodal approaches, especially for those from culturally and linguistically diverse backgrounds.

Principal Investigator(s): Leah Peña Teeters, PhD; Adriana Alvarez,PhD

Research Team Members: Elena Aranda; Polet Carrasco; Emily Gleason; Deena Gumina; Mónica Lozano; Iris Morales; Adria Padilla-Chavez; Michelle Shedro, MA; Kathy Schultz, PhD; Blanca Trejo Aguilera; Mabel Weber; Julia C. Zigarelli, PhD

Reimagining schools to cultivate trust and belonging for all students.

Closed

The CU Well Brain Study is a longitudinal neuroimaging study. Participants complete an in-person baseline session, including a clinical diagnostic interview, behavioral tasks, self-report surveys, and a neuroimaging scan (fMRI). Self-report survey data is collected every 3 months from participants for one year following their in-person session. At 12 months, one year after baseline, participants complete their final survey timepoint and a remote clinical diagnostic interview assessing the past year.

Roselinde.Kaiser@colorado.edu

Visit our website to learn more: https://www.colorado.edu/lab/raddlab/

American College Health Association. (2017).

American College Health Association-National College Health Assessment II: Undergraduate Student Reference Group Executive Summary Fall 2016. Hanover, MD: American College Health Association.

Colorado Department of Public Health and Environment. (n.d.).

Vital statistics program. https://cdphe.colorado.gov/center-for-health-and-environmental-data/registries-and-vital-statistics/vital-statistics-program

Colorado Health Institute. (n.d.). https://www.coloradohealthinstitute.org/

The primary aim of the CU Well Brain study is to test prospective brain biomarkers of wellness in CU students. We hypothesize that (a) students characterized by biomarkers reflecting higher cognitive regulation, adaptive reward sensitivity, and better stress coping, will demonstrate better wellness over time in the form of academic success and lower symptoms of depression and anxiety; and (b) students who experience more wellness promoters (positive social support, physical activity, self-care) will demonstrate better wellness over time, but students who experience more wellness detractors (social, physical, or financial stress) will demonstrate lower wellness over time especially if they are also characterized by biomarkers of lower self-regulation, lower reward sensitivity, and poorer stress coping.

Consistent with the idea that stress-related mental illness is an important – and growing – concern on campus, a 2016 survey of students by the American College Health Association found that more than half of students reported feeling hopeless (52.7%), and more than a third (39.1%) reported severe depression in the past year. Further, Colorado is ranked among the top ten states in the USA for rates of depression and suicide (colorado.gov/pacific/cdphe/vital-statistics-program; coloradohealthinstitute.org). At CU and at colleges across the country, the demand for mental health services are expanding.

Investigating brain biomarkers to understand and promote college-student wellness.

‍

The study will investigate brain biomarkers that predict student wellness over the course of important college transitions, with special attention to biomarkers that reflect reward sensitivity and stress coping.

Principal Investigator: Rosi Kaiser, PhD

Research Team Member: Madeline Firestone, BA

Investigating brain biomarkers to understand and promote college-student wellness.

Ongoing

With a team of educators from Boulder Valley School District and the Northeast Colorado BOCES, and contemplative experts, we co-designed an online certificate that includes four courses that aim to support educators in cultivating compassion for self and others and bringing such knowledge and skill into their schools as leaders. The Cultivating Compassion & Dignity in Ourselves and Our Schools graduate certificate is available through the University of Colorado Boulder’s Teacher Leadership Program. We researched the co-design process for creating the four-course certificate with educators, examining how participating in the co-design process fostered an understanding of compassion and promoted new ideas about how to respond skillfully to suffering in schools. In addition, we have conducted research and evaluation on educators’ participation in the digital certificate to examine their overall satisfaction with the program, to understand the extent to which engaging in the certificate impacts educator wellness and leadership, and to use the knowledge gained to make refinements to the content and structure of the certificate.

Ashley.Potvin@colorado.edu

EdWeek Research Center. (2024). The teachers are not all right: Improving mental well-being of teachers and their students. Third Annual Merrimack College Teacher Survey 2024 Results. https://www.edweek.org/products/whitepaper/the-teachers-are-not-all-right-improving-the-well-being-of-teachers

Kraft, M. A., & Lyon, M. A. (2024). The rise and fall of the teaching profession: Prestige, interest, preparation, and satisfaction over the last half century. American Educational Research Journal, 61(6), 1192–1236. https://doi.org/10.3102/00028312241276856

Learning Policy Institute. (2024). 2024 update: What's the cost of teacher turnover? https://learningpolicyinstitute.org/product/2024-whats-cost-teacher-turnover

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Pew Research Center. (2024, April). What’s It Like To Be a Teacher in America Today? https://www.pewresearch.org/social-trends/wp-content/uploads/sites/3/2024/04/ST_24.04.04_teacher-survey_report.pdf

The Compassion & Dignity for Educators Project brings together Crown Institute researchers and practitioners, PK-12 educators, and Compassion Institute contemplative experts. From these many sources of expertise, we are designing and studying programs and practices to support educators in developing greater capacities for compassion for self and others, in bringing these skills into their daily interactions, in leading compassionate change in their school communities, and in flourishing and finding joy in their work. How can we help educators cultivate inner resources and address suffering in schools in ways that recognize the dignity of youth, their families and communities, and educators?

Educators today are facing unprecedented levels of stress, burnout, and diminishing professional satisfaction—conditions that demand programs centered on compassion and well-being. Nationally, teachers’ job satisfaction has fallen 26% over the past decade, reaching a 50-year low (Kraft & Lyon, 2024), and surveys show 77% of teachers experience frequent stress, 68% feel overwhelmed, and only 33% are very satisfied with their jobs (Pew Research Center, 2024).  Moreover, in 2024 61% reported that the mental health of teachers in their schools worsened in the last year, and 42% said it negatively affected their teaching (EdWeek Research Center Survey, 2024). In Colorado, 52% of schools struggled to fill vacancies (Learning Policy Institute, 2024). These realities underscore an urgent need for programs that help educators cultivate compassion for themselves—and in turn design more humane, supportive policies and school environments for everyone.

Leading compassionate change in school communities by supporting educators.

All educators and students teach, learn, lead, and grow in schools and classrooms characterized by compassion and dignity.

Principal Investigators: Sona Dimidjian, PhD; Bill Penuel, PhD; Ashley Potvin, PhD

Research Team Members: Marisa Mendoza-Maurer, PhD; Michelle Shedro, MA; Michele D. Simpson, JD

Community Partners: Compassion Institute; Boulder Valley School District; Northeast Colorado BOCES; Roaring Fork School District

Leading compassionate change in school communities by supporting educators.

Ongoing

Irene McHenry, Kay Edstene, and Tom Farquhar. Embracing the Tension [microform]: The Evidence for Conflict as the Locus of Moral Growth. A Study of Moral Growth in Friends High Schools / (place of publication not identified) ERIC Clearinghouse. 1998. [https://libcat.colorado.edu/Record/b6145627]

Donna Mejia TEDx How a ‘Fumble Forward’ can help us connect: https://www.youtube.com/watch?v=tavnOncCOzE

Neuhaus, Jessamyn. (ed), Picture a professor: interrupting biases about faculty and increasing student learning. Morgantown: West Virginia University Press, [2022]. pp 237-25

Fumble Forward for adults is fully developed and has been shared in both academic publications and a TEDx talk for general audiences. It functions best as a participatory workshop series. Originator Donna Mejia delights in visiting communities to share the framework and practice together in the community.

The K-8 version of Fumble Forward has been shared with afterschool youth programs, and was the subject of a psychology thesis by CU Boulder Bachelor’s student Bailey Anderson in 2024.  Additional youth partnerships are welcomed to further adapt the framework to a variety of learners in all age groups.

Communication, Cultural Theory, Critical Race Theory, Diplomacy, Psychology, Social Science, Cultural Anthropology, Gender Studies, Performing and Visual Arts, Media Studies, Religious Studies, History

Fumble Forward provides a rapidly accessible approach to confusion, tension, and disagreement regardless of a participant’s age, education, or identity.

Fumble Forward research seeks to situate and understand the assumptions and power dynamics of any exchange. Rather than scripted approaches, research aims to provide a transformative perspective for participants. In this way, situating the framework for K-12 and adult learners is a living laboratory for how we encounter each other, how we factor in our own temperament and genius, and how our cultural learning flavors our social expectations.

Exploring tools and frameworks for the practice of welcoming uncertainty.

Fumble Forward aims to empower confident and honest participation in human exchange, meaningfully reducing the intimidation that can arise with unfamiliarity or learning new information. Contemporary learners (both youth and adults) evince exasperation with the unpleasant ugliness of online commentaries and inflammatory rhetoric dominating public exchanges. Fumble Forward re-centers curiosity, questioning, and a renewal of learning together and from each other. The toolkit aims to redirect mounting tension into a springboard for mutual insight.

Fumble Forward aims to provide tools and frameworks for the practice of welcoming uncertainty, practicing intellectual humility, and remaining curious in cultural collisions. In 1998, Iren McHenry (et. Al) pointed to the important potential of community tension in the learning and internalization one’s moral understanding, indicating the best climate for moral growth “seems to be one in which students are not afraid to speak up, where they are taught the skill of listening to others and are provided the time and encouragement for self-reflection.” Fumble Forward aims to ease the social discomfort and power dynamics that can arise when disagreement, difference, and confusion are present in any learning situation.

Exploring tools and frameworks for the practice of welcoming uncertainty.

Fumble Forward is a framework for encountering the unknown, the unexpected, or perhaps the all-too-familiar in life. Together, we practice building better questions in our interchanges and explorations—setting aside our assumptions to welcome a space of true learning in our communication.

InsideU is a collaboratively designed Social Emotional Learning (SEL) program based on participatory methodologies and translational approaches focused on connecting emotion science with community wisdom. The development of InsideU also draws on entertainment education theory which proposes that engaging narratives can be highly effective approaches for providing widescale health education (Moyer-Gusé, 2008). Implementation frameworks guide formal rollouts and program evaluations of InsideU in real-world local afterschool settings such as Boys and Girls Clubs.

hubley@colorado.edu

Hubley, S., Moldow, E., Robbins, C., Harper, B., Martin, C., & Zhou, S. (2020). The impact of entertainment education for social and emotional learning in elementary schools. American Journal of Health Education, 51(5), 299–309. https://doi.org/10.1080/19325037.2020.1795751  

Jones, J. M., Lee, L. H., Zigarelli, J. C., & Nakagawa, Y. S. (2017). Culturally-responsive adaptations in evidence-based treatment: The impact on client satisfaction. Contemporary School Psychology, 21(3), 211–222. https://doi.org/10.1007/S40688-016-0118-6 Niebaum, J.  

C., Chevalier, N., Guild, R. M., & Munakata, Y. (2021). Developing adaptive control: Age-related differences in task choices and awareness of proactive and reactive control demands. Cognitive, Affective, & Behavioral Neuroscience, 21, 561–572. https://doi.org/10.3758/s13415-020-00832-2

Aim 1: Create a free and highly engaging SEL resource to help kids learn about emotions in a fun and familiar context.

Aim 2: Create InsideU content and supportmaterials like facilitator guides within a participatory approach that centers collaborative design with children and community members.

Aim 3: Conduct program evaluations and research studies to evaluate InsideU’s acceptability, feasibility, and effectiveness.

On October 19, 2021, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association jointly declared a national emergency in child and adolescent mental health. The US Surgeon General declared youth mental health an urgent public health issue.  

Entertainment-based social-emotional learning offers an innovative, engaging tool to address this crisis by helping young people build emotional awareness and coping skills early in life.

Helping kids understand emotions through an app inspired by characters from the Disney/Pixar film Inside Out.

InsideU aligns with the Crown Institute’s vision by promoting emotional well-being through entertainment-based social-emotional learning. As a free, digital resource, InsideU offers an accessible and enjoyable way for kids, families, and educators to explore and understand emotions.

Principal Investigator: Sam Hubley, PhD

Research Team Members: Julia C. Zigarelli, PhD; Ryan Guild; Sam Daley; Lily Fletcher; Matt Goodwin; Tyler Grimes; Morgan Jmohnson; Tara Knight, MFA; Boys & Girls Clubs Metro Denver Mental Health Team; Emma Piper-Burket; Danielle Ponder, Gianni Tills; Zach Volheim

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Helping kids understand emotions through an app inspired by characters from the Disney/Pixar film Inside Out.

Ongoing

Design-based research and participatory action research approach. Students, educators, and researchers co-create curriculum and activities in storytelling, hip-hop, and field recordings. Mixed qualitative data collected via interviews, class observations, and student-created artifacts. Arts-based and ethnographic methods analyze narrative processes and cultural wealth practices.

Marlene.Palomar@colorado.edu

N/A

Investigate how hip-hop-based pedagogy supports youth well-being and identity formation. Examine mechanisms by which co-created learning spaces influence engagement. Explore which program components most effectively engage students and help build skills and knowledge. Assess broader community and cultural impact.

Students of color continue to experience disproportionate school exclusion, lower access to culturally-relevant arts instruction, and worse mental-health indicators than peers, creating an urgent need for culturally-grounded programs that build belonging and resistance. Lyripeutics could produce a scalable, culturally-grounded model for arts-based learning that improves Black and Brown youth’s social-emotional wellbeing, agency, and school engagement while demonstrating how hip-hop practices can serve as rigorous pedagogical tools for learning and healing.

Exploring how hip hop practices can as serve as pedagogical tools for learning and healing.

Sustaining culturally-specific, community-led learning initiatives faces structural barriers, unstable funding streams, institutional regulations and gatekeeping in schools, and broader political and policy pressures that have rolled back or constrained DEI-oriented programming. Traditional education systems often favor standardized testing and rigid curriculum, which can further marginalize students whose strengths lie in creative, culturally-informed or collaborative modes of learning.

Principal Investigator: Kalonji Nzinga, PhD

Exploring how hip hop practices can as serve as pedagogical tools for learning and healing.

Completed

Participants were undergraduate students who enrolled in the Mindful Campus Program (MCP) from 2021 to 2022. MCP is an 8-session mindfulness and compassion program for undergraduates that promotes individual and collective well-being through experiential learning. Participants who consented to study procedures completed baseline (T1) surveys before participating in MCP, self-report surveys after their participation in MCP (T2), and a final set of surveys approximately three months following their completion of MCP (T3). Surveys measured program engagement and satisfaction, mindfulness, compassion, mental health and wellness, and qualitative feedback at each time point.

Caitlin.Mckimmy@colorado.edu

LeViness, P., Gorman, K., Braun, L., Koenig, L., & Bershad, C. (2019). The Association for University and College Counseling Center Directors Annual Survey: 2019. Association for University and College Counseling Center Directors. Retrieved from https://www.aucccd.org

Galante, J., Friedrich, C., Dawson, A. F., Modrego-Alarcón, M., Gebbing, P., Delgado-Suárez, I., Gupta, R., Dean, L., Dalgleish, T., White, I. R., & Jones, P. B. (2021). Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials. PLOS Medicine, 18(1), e1003481. https://doi.org/10.1371/journal.pmed.1003481

Verhaeghen, P. (2023). Mindfulness and Academic Performance Meta-Analyses on Interventions and Correlations. Mindfulness. https://doi.org/10.1007/s12671-023-02138-z

Worsley, J. D., Pennington, A., & Corcoran, R. (2022). Supporting mental health and wellbeing of university and college students: A systematic review of review-level evidence of interventions. PLOS ONE, 17(7), e0266725. https://doi.org/10.1371/journal.pone.0266725

We used a longitudinal, open trial design across three time points to address key aims such as: To what extent is the Mindful Campus Program associated with participant engagement and satisfaction, and with improvements in mindfulness, compassion, and wellness outcomes. Additionally, we explore to what extent does attendance in the Mindful Campus Program moderate changes in mindfulness, compassion, and wellness outcomes.

College students experience significant mental health concerns, with more than 60% meeting criteria for at least one mental health condition in 2020 — a significant increase from prior years (Lipson et al., 2022). At the same time, many campus counseling centers are overburdened, often lacking the capacity to meet rising student needs (LeViness et al., 2019). There is an important opportunity for mindfulness and compassion practice to support student mental health and wellness and address gaps in existing campus resources. Additionally, programs that are developed with meaningful input from the students they aim to serve offer the possibility of being relevant and accessible.

Co-designing and studying an innovative mindfulness-based program, with and for college students.

Mindfulness programs designed with and for undergraduate students can be powerful tools for building resilience, connection, and mental health. When rooted in compassion and adapted to real campus life, these programs can help students not only cope with stress but also flourish academically, socially, and emotionally.

Principal Investigator(s): Sona Dimidjian, PhD

Research Team: Caitlin McKimmy, MTS, MA; Winnie Zhuang, PhD; Sofia Barnes-Horowitz; Kourtney Kelly; Cody Moxam

Co-designing and studying an innovative mindfulness based program–with and for college students.

Ongoing

Participants: Undergraduate students at CU Boulder reporting elevated social anxiety or public speaking fears.

Design Features:

- Initial screening via online survey and phone interview.

- Randomized assignment to one of four intervention conditions.

- Group-based exposure workshops.

- Baseline, follow-up, and post-intervention measures, with exit interviews.

Alane.Schmelkin@colorado.edu

Mateo.Chavez@colorado.edu

Hawes, M. T., Szenczy, A. K., Klein, D. N., Hajcak, G., & Nelson, B. D. (2022). Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic. Psychological Medicine, 52(14), 3222–3230. doi:10.1017/S0033291720005358  

Heimberg, R. G., & Becker, R. E. (2002). Cognitive-behavioral group therapy for social phobia: Basic mechanisms and clinical strategies. Guilford Press

Jefferies, P., & Ungar, M. (2020). Social anxiety in young people: A prevalence study in seven countries. PloS one, 15(9), https://doi.org/10.1371/journal.pone.0239133 

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602. https://doi.org/10.1001/archpsyc.62.6.593 

Masia-Warner, C., Klein, R. G., Dent, H. C., Fisher, P. H., Alvir, J., Albano, A. M., & Guardino, M. (2005). School-based intervention for adolescents with social anxiety disorder: results of a controlled study. Journal of Abnormal Child Psychology, 33(6), 707–722. https://doi.org/10.1007/s10802-005-7649-z

O’Day, E. B., & Heimberg, R. G. (2021). Social media use, social anxiety, and loneliness: A systematic review. Computers in Human Behavior Reports, 3, Article 100070. https://doi.org/10.1016/j.chbr.2021.100070 

Olfson, M., Guardino, M., Struening, E., Schneier, F. R., Hellman, F., & Klein, D. F. (2000). Barriers to the treatment of social anxiety. The American journal of psychiatry, 157(4), 521–527. https://doi.org/10.1176/appi.ajp.157.4.521 

Szuhany, K. L. & Simon, N. M. (2022). Anxiety disorders: A Review. JAMA, 328(24), 2431- 2445. https://doi.org/10.1001/jama.2022.22744

Xiao, Z., & Huang, J. (2022). The relation between college students’ social anxiety and mobile phone addiction: the mediating role of regulatory emotional self-efficacy and subjective well-being. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.861527

This study uses a Multiphase Optimization Strategy (MOST) framework to systematically identify the most impactful elements of the intervention.

Primary Aim: Examine which components of a group-based exposure intervention—Peer Status and Common Humanity—are most effective in reducing social anxiety symptoms.

Secondary Aims: Compare exposure, common humanity, and peer workshop groups on psychosocial outcomes. Gather post-intervention feedback to improve workshop design, delivery, and participant experience.

Social anxiety affects a significant portion of young adults, with prevalence rates estimated between 14% (Szuhany & Simon, 2022) and 1 in 3 (Jeffries & Ungar, 2020). Symptoms often emerge during adolescence and early adulthood (Kessler et al., 2005), making college students a critical population for early intervention. Barriers such as fear of judgment and financial inaccessibility (Olfson et al., 2000) limit many students from seeking treatment. This study aims to fill a key gap by developing a low-cost, peer-supported, group-based approach to social anxiety treatment, especially relevant in the wake of the COVID-19 pandemic’s lingering social effects (Hawes et al., 2023) and problematic social media use (O’Day & Heimberg, 2021).

Examining the effectiveness of a group-based exposure intervention for social anxiety in young adults.

While focused on young adults, the OASIS Study contributes to a broader understanding of how social connection, peer support, and exposure-based interventions can reduce social anxiety. Findings may ultimately inform the design of group-based mental health programs that can be adapted for adolescents, families, and school-based settings, enhancing access to evidence-based tools for social anxiety management.

Principal Investigator(s): Joanna Arch, PhD

Research Team Members: Alane Burger, PhD; Mateo Chavez

‍Community Partners: Peer co-facilitators and participating CU Boulder undergraduate students

Examining the effectiveness of a group-based exposure intervention for social anxiety in young adults.

Ongoing

The project uses a community-based participatory research (CBPR) design. Year 1 included focus groups with patients and providers to guide co-design. Year 2 involves peer mentor training and pilot testing with 40 participants. Year 3 will scale program implementation to 100 participants. Data include qualitative feedback, pre/post measures on mental and physical health, and continuous adaptation using community insights.

Anahi.Collado@colorado.edu

Antonella.Onofrietti@colorado.edu

Program.SanaMente@gmail.com

Hispanic/Latinx. National Alliance on Mental Illness (NAMI). Accessed August 13, 2025. https://www.nami.org/your-journey/identity-and-cultural-dimensions/hispanic-latinx/

Cabassa LJ, Zayas LH, Hansen MC. Latino adults’ access to mental health care. Adm Policy Ment Health. 2006;33(3):316-330. doi:10.1007/s10488-006-0040-8

Pro G, Brown C, Rojo M, Patel J, Flax C, Haynes T. Downward national trends in mental health treatment offered in Spanish: state differences by proportion of Hispanic residents. Psychiatr Serv. 2022;73(11):1232-1238. doi:10.1176/appi.ps.202100614

Morales DA, Barksdale CL, Beckel-Mitchener AC. A call to action to address rural mental health disparities. J Clin Transl Sci. 2020;4(5):463-467. doi:10.1017/cts.2020.42

Moyce S, Thompson S, Metcalf M, et al. Rural Hispanic perceptions of mental health: a qualitative study. J Transcult Nurs. 2022;33(3):346-354. doi:10.1177/10436596211070592

Blewett LA, Smaida SA, Fuentes C, Zuehlke EU. Health care needs of the growing Latino population in rural America: focus group findings in one midwestern state. J Rural Health. 2003;19(1):33-41. doi:10.1111/j.1748-0361.2003.tb00539.x

Gomez S, Blumer V, Rodriguez F. Unique cardiovascular disease risk factors in Hispanic individuals. Curr Cardiovasc Risk Rep. 2022;16(7):53-61. doi:10.1007/s12170-022-00692-0

Ortega AN, Feldman JM, Canino G, Steinman K, Alegría M. Co-occurrence of mental and physical illness in US Latinos. Soc Psychiatry Psychiatr Epidemiol. 2006;41(12):927-934. doi:10.1007/s00127-006-0121-8

Aguayo-Mazzucato C, Diaque P, Hernandez S, et al. Understanding the growing epidemic of type 2 diabetes in the Hispanic population living in the United States. Diabetes Metab Res Rev. 2019;35(2):e3097. doi:10.1002/dmrr.3097

Pereira RI, Cervantes L. Reducing the burden of CKD among Latinx. Clin J Am Soc Nephrol. 2021;16(5):812-814. doi:10.2215/CJN.12890820

Castañeda SF, Buelna C, Giacinto RE, et al. Cardiovascular disease risk factors and psychological distress among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prev Med. 2016;87:144-150. doi:10.1016/j.ypmed.2016.02.032

The study will:

Co-develop and evaluate a culturally responsive peer-led mental health and lifestyle intervention.

Examine trainingfeasibility for peer mentors with lived experience. Assess whether the program is acceptable, engaging, and culturally resonant.

Evaluate reductions in depression, anxiety, and stress.

Explore improvements in activity levels, self-efficacy, and chronic disease management.

Spanish-speaking Latino/a/e individuals experience a high burden of untreated mental health conditions such as depression, anxiety, and chronic stress, yet receive fewer services due to structural inequities. They also face elevated rates of physical health conditions—including cardiovascular, kidney, and metabolic disease—driven by both biological and social determinants. Rural Latino/a/e communities navigate additional barriers including stigma, limited Spanish-speaking providers, poverty, and discrimination. Despite this need, there remains a lack of culturally grounded integrated behavioral health interventions tailored specifically to this population.

Developing and implementing a peer-led, culturally responsive mental health intervention for those experiencing chronic diseases.

This study supports Spanish‑speaking Latino/a/e individuals with chronic disease by co‑developing a culturally responsive, peer‑led program focused on emotional well‑being and chronic disease management. Findings inform equitable, community‑driven approaches that can benefit families and broader underserved communities.

Principal Investigators: Anahí Collado, PhD; Antonella Onofrietti Magrassi, PhD

Research Team Members: Desi Bauer, MPH; Gracia Deras; Diego Vidaurre  

Community Partners: La Clínica del Pueblo

Developing and implementing a peer-led, culturally responsive mental health intervention for those experiencing chronic diseases.

Ongoing

We used a longitudinal, two-arm, single-blind, pragmatic randomized effectiveness trial to investigate our study aims. We enrolled pregnant women who were currently or recently taking antidepressant medication, had at least two prior episodes of depression, and were currently not in a depressive episode. We followed participants from early pregnancy through six months postpartum.

Sona.Dimidjian@colorado.edu

Khadka, N., Fassett, M. J., Oyelese, Y., Mensah, N. A., Chiu, V. Y., Yeh, M., Peltier, M. R., & Getahun, D. (2024). Trends in Postpartum Depression by Race, Ethnicity, and Prepregnancy Body Mass Index. JAMA Network Open, 7(11), e2446486. https://doi.org/10.1001/jamanetworkopen.2024.46486

Pearson, R. M., Carnegie, R. E., Cree, C., Rollings, C., Rena-Jones, L., Evans, J., Stein, A., Tilling, K., Lewcock, M., & Lawlor, D. A. (2018). Prevalence of Prenatal Depression Symptoms Among 2 Generations of Pregnant Mothers: The Avon Longitudinal Study of Parents and Children. JAMA Network Open, 1(3), e180725. https://doi.org/10.1001/jamanetworkopen.2018.0725

Dimidjian, S., & Goodman, S. H. (2014). Preferences and attitudes toward approaches to depression relapse/recurrence prevention among pregnant women. Behaviour Research and Therapy, 54, 7–11. https://doi.org/10.1016/j.brat.2013.11.008

Cohen, L. S., Altshuler, L. L., Harlow, B. L., et al. (2006). Relapse of Major Depression During Pregnancy in Women Who Maintain or Discontinue Antidepressant Treatment. JAMA, 295(5), 499–507. https://doi.org/10.1001/jama.295.5.499

This study investigated the extent to which a digital Mindfulness-Based Cognitive Therapy program, Mindful Mood Balance for Moms (MMB for Moms) can help pregnant women with a history of depression who were treated with antidepressant medication stay well throughout pregnancy and the postpartum period.  

Aim 1: To test the relative risk for depressive relapse and reduction of symptom burden between women randomized to MMB for Moms or UC.  

Aim 2: To explore the specific benefit of MMB for Moms relative to antidepressant medication discontinuation and questions regarding

personalization that are of strong interest to pregnant women and their healthcare providers

Aim 3: To test the extent to which MMB for Moms engages putative targets.

Postpartum depression (PPD) diagnosis rates increased from 9.4% in 2010 to 19.0% in 2021 (Khadka et al., 2024). Maternal depression occurs as frequently during pregnancy as it does during the postpartum period (Pearson et al., 2018). The majority of pregnant women report a preference to avoid antidepressant use during pregnancy (Dimidjian & Goodman, 2014), and among women with recurrent depression who were treated successfully with antidepressant medication during pregnancy, approximately half discontinued during pregnancy, with relapse rates significantly higher among those who discontinued than among those who maintained (Cohen et al., 2006).

Studying the impact of mindfulness on depression relapse prevention among pregnant women with a history of depression.

This project reflects the Crown Institute’s commitment to supporting the wellness of children by caring for the adults who care for them. The Crown Institute focuses on practical, community-engaged research that strengthens families and improves mental health across the lifespan. Our study contributes this mission by testing an accessible, digital program, Mindful Mood Balance for Moms (MMB for Moms) to help prevent depression from returning during pregnancy and early parenting.

Principal Investigator(s): Sona Dimidjian, PhD; Lee S. Cohen

Current Research Team:  Laurel M. Hicks, PhD; Chris Mellinger, PhD; Joey Levy, MA; Anne Fritzson, MA; Robert Gallop; Sherryl H. Goodman, PhD; Zindel Segal, PhD; Marlene Freeman, MD; Kalin Ellison, BS; Katherine Anne Yu Dunn; Laurel Kordyban, BA; Charlotte Clifford, BA; Eileen Nolan, BA; Rachel Vanderkruik, PhD; Rebecca Wales, MD

Community Partners: Everyday Health Group

Studying the impact of mindfulness on depression relapse prevention among pregnant women with a history of depression.

Ongoing

Partnership using participatory action research (PAR) cycles: interviews, qualitative surveys, oral histories.

kirshner@colorado.edu

Asmar, M. (2023, December 27). Denver schools are investing in teaching techniques like finger breathing. Here’s what that means. Chalkbeat Colorado. https://www.chalkbeat.org/colorado/2023/12/08/upstream-mental-health-tools-for-high-schools-denver-federal-covid-money/

Ramos, G., Delgadillo, D., Fossum, J., Montoya, A. K., Thamrin, H., Rapp, A., Escovar, E., & Chavira, D. A. (2021). Discrimination and internalizing symptoms in rural Latinx adolescents: An ecological model of etiology. Children and Youth Services Review, 130, 106250. https://doi.org/10.1016/j.childyouth.2021.106250

Baldridge, B. J. (2014). Relocating the deficit: Reimagining Black Youth in neoliberal times. American Educational Research Journal, 51(3), 440–472. https://doi.org/10.3102/0002831214532514

Ginwright, S. A. (2015). Radically healing Black lives: A love note to justice. New Directions for Student Leadership, 2015(148), 33–44. https://doi.org/10.1002/yd.20151

Develop and refine a framework for enacting, implementing, and assessing healing justice in high schools and youth programs serving marginalized youth. Launch a research-practice collective guided by community-based participatory research and networked improvement communities to document healing justice in practice and improve implementation.

Recent efforts by Colorado school districts to invest federal pandemic relief funds in mental health and wellness are an important step forward (Asmar, 2023). Addressing mental health inequities means not only improving access, but also transforming how mental health is conceptualized and how treatment is delivered (Ramos et al., 2022). Those who want to access more targeted psychological supports are often met with interventions grounded in Western ideals of individualism (Chavez et al., 2016), ignore racial oppression (Cokley, 2005; Comas-Díaz et al., 2019), and reproduce deficit assumptions (Baldridge, 2014).

Strengthening the ecosystem of healing justice youth organizations in the Colorado Front Range.

This project will strengthen the ecosystem of healing justice youth organizations in the Colorado Front Range. Healing justice prioritizes culturally-rooted approaches to healing and well-being while simultaneously working to transform the institutions and systems that cause harm (Ginwright, 2015; Page & Woodland, 2023).

Principal Investigator(s): Ben Kirshner, PhD; Alexis Hunter; Beatriz Salazar-Núñez; Solicia Lopez

‍Research Team Members: Barbara Akuoko, undergraduate student, CU Boulder

Strengthening the ecosystem of healing justice youth organizations in the Colorado Front Range.

Ongoing

Using a mixed methods approach, data collected through surveys, student and educator focus groups, and interviews was used to investigate key questions related to student mental health. Surveys were administered in a cross-sectional design to students, educators, and families.

Michelle.Reininger@colorado.edu

Centers for Disease Control and Prevention. (2024). Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023. U.S. Department of Health and Human Services. https://www.cdc.gov/yrbs/dstr/index.html

Office of the Surgeon General. (2021). Protecting Youth Mental Health: The U.S. Surgeon General’s Advisory. https://www.hhs.gov/sites/default/files/surgeon-general-youth-mentalhealth-advisory.pdf

Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. https://www.samhsa.gov/data

Sekhar, D. L., Baiden, P., Li, T., Crutchfield, J. M., Lehman, E. B., & Demidenko, M. I. (2021). Screening in high schools to identify, evaluate, and lower depression among adolescents: A randomized clinical trial. JAMA Network Open, 4(11), e2131836. https://doi.org/10.1001/jamanetworkopen.2021.31836

Colorado Department of Public Health & Environment. (2023). Estimated SUD Encounters per Adult Age 18+ (potential SUD HPSA map). https://cdphe.maps.arcgis.com/apps/SimpleViewer/index.html?appid=9f17f6155cde42aab58b0ccf65a179d5

Health Resources and Services Administration. (2025). Medically underserved areas/health professional shortage areas (HPSA). https://data.hrsa.gov/tools/shortage-area

In the context of our Research Practice Partnership with Boulder Valley School District, we sought to develop an understanding of the state of student mental health in the district learning from the perspectives of students themselves, educators, and families. Using the Crown Institute’s research design cycle, the first year of this project aimed to identify and understand bright spots and opportunities for growth in order to identify areas for collaborative design and recommendations for action.

It is well documented that mental health concerns among youth in the United States have risen over the last decade (CDC, 2024) and that youth mental health has been identified as a national public health challenge (Office of the Surgeon General, 2021). Recent data indicate that more than one-third of adolescents experiencing mental health concerns do not receive the services they need (Substance Abuse and Mental Health Services Administration, 2020). And yet, even amid these challenges, young people continue to demonstrate an incredible vision for the future and capacity for change.

Schools have been increasingly recognized as critical environments for both supporting youth mental health and identifying mental health issues early (Sekhar et al., 2021). In Colorado, although there have been some improvements in mental health outcomes in recent years, youth mental health remains a top concern statewide (Colorado Department of Public Health & Environment, 2023). In Boulder County specifically, access to behavioral health services remains limited, with persistent gaps in provider availability (Health Resources and Services Administration, 2025).

Listening to the wisdom of students, teachers, and families.

By listening to the wisdom of students, teachers, and families, we can ensure schools are not only places of learning but also communities of care. When every voice helps shape the path forward, we can imagine schools where mental health and wellness are woven into the fabric of daily life, and every young person has the foundation to flourish.

Principal Investigators: Julia C. Zigarelli, PhD; Michelle Reininger, PhD

‍Research Team Members: Christopher Mellinger, PhD; Antonella Onofrietti Magrassi, PhD; Anahi Collado, PhD; Ashley Potvin, PhD; Leah Peña Teeters, PhD; Kachine Kulick, PhD; Michelle Shedro, MA; Michele D. Simpson, JD; Chloe Nowak; Diego Vidaurre; Youth Advisory Council (High School Students)  

Community Partners: Boulder Valley School District

Listening to the wisdom of students, teachers, and families.

Ongoing