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Implementation of the "Healthy Moms, Healthy Kids" Program in Head Start: An Application of the RE-AIM QuEST Framework Centering Equity.

Marginalized mothers are disproportionately impacted by depression and face barriers in accessing mental health treatment. Recent efforts have focused on building capacity to address maternal depression in Head Start; however, it is unclear if mental health inequities can be addressed by two-generation programs in Head Start settings. Therefore, this study examined the implementation outcomes and processes of a two-generation program called "Healthy Moms, Healthy Kids" (HMHK) that provided an evidence-based depression treatment to ethnic minority Head Start mothers. Quantitative and qualitative data were collected and merged in a convergent mixed method design in accordance with the RE-AIM Qualitative Evaluation for Systematic Translation (RE-AIM QuEST) framework. Qualitative data included interviews with 52 key stakeholders, including intervention participants and staff members, and 176 sets of meeting minutes from the implementation period. Quantitative data included intervention study data and administrative data. It was difficult for HMHK to reach the target population, with only 16.8% of eligible mothers choosing to participate. However, mothers who participated experienced reductions in depressive symptoms and parenting stress and shared a variety of positive impacts in interviews. The program was also more successful in enrolling Latinx mothers who were Spanish-speaking or bilingual rather than English-speaking and Black/African American mothers, limiting its reach. Providing IPT therapy groups was effective in reducing maternal depressive symptoms and stress for those who enrolled, but additional work should focus on reducing barriers to participation, considering other delivery models to meet participants' needs, and identifying culturally relevant ways to meet the needs of Black mothers.

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“We are that resilience”: Building cultural capital through family child care

Family child care professionals are a critical sector of the early care and education workforce. Utilizing critical race theory and Yosso’s Community Cultural Wealth model, the current study seeks to examine the strengths and assets that family child care professionals of color bring to their early care and education work and to the children and families in their programs. The authors identified evidence of four types of cultural capital (aspirational, familial, navigational, and resistant) in the focus group narratives of family child care professionals of color across four regions in the USA. Their narratives describe an orientation to caring for children and families that counters exclusionary and biased systems. The family child care professionals of color envision themselves as educators and supporters of community advancement in opposition to racialized stereotypes of home-based child care work as babysitting (aspirational capital); they leverage the home as a place for racial healing and sustain intergenerational connections with families through practices of othermothering and an ethic of love (familial capital). The family child care professionals of color describe the ways they enact navigational and resistant capital in their perseverance and participation in licensing and quality systems, despite inequities. The family child care professionals’ counternarratives of family child care work suggest their essential role in societal functioning and well-being. The study’s findings hold implications for (re)defining early care and education quality and (re)designing systems that celebrate and recognize the strengths, resilience, and capacity of family child care professionals of color to support equitable futures for children, families, and communities.

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