Study Status
Completed
Project Team
Principal Investigator(s): Anahí Collado, PhD
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
Alignment with Crown Institute Vision
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.
Background & Context
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.
Primary Aims
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.
Research Methods
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.
Key Findings & Publications /
Presentations
Publications include:
Vanderkruik, R., & Dimidjian, S. (2019). Perspectives on task-shifting depression care to peers for depressed Latina mothers. Journal of Latinx Psychology, 7, 22-38.
The study explored the feasibility of a peer-delivered therapy model for Latina mothers through focus groups and interviews with mothers and healthcare providers. Findings highlighted stigma, resource limitations, language and transportation barriers, and the importance of trust, cultural competence, and community connection. Participants supported the peer model but emphasized careful attention to supervision, confidentiality, recruitment, retention, and cultural adaptation, underscoring the need for a collaborative, culturally grounded approach.
Collado, A., Hicks, L., Hubley, S., Levy, J., McKimmy, C., Genovez, M., ... & Dimidjian, S. (2025). Using Alma to Alleviate Tristeza Maternal: Preliminary Outcomes of a Peer-Led Behavioral Activation Program Among Latina Mothers. Behavior Therapy, 56(2), 225-240.
The study evaluated Alma, a peer-delivered behavioral activation program for Spanish-speaking Latina mothers with elevated depression. Across 6–8 sessions in community settings, participants reported high satisfaction and showed significant reductions in depression, anxiety, and stress, linked to increased activity engagement. Despite attrition and no control group, results indicate Alma is a culturally responsive, accessible intervention with potential to reduce mental health disparities in this population.
McKimmy, C., Levy, J., Collado, A., Pinela, K., & Dimidjian, S. (2023). The role of Latina peer mentors in the implementation of the Alma program for women with perinatal depression. Qualitative Health Research, 33(5), 359-370.
This paper investigates how Spanish-speaking atina peer mentors, referred to as compañeras, delivered and shaped the implementation of Alma, in the rural mountain West. Using an ethnographic approach grounded in dissemination and implementation science and informed by mujerista feminist theory, the study illustrates that compañeras play a pivotal role not simply as program deliverers but as cultural and relational bridge builders.
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References
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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
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