Albizu University is a private university with its main campus in San Juan, Puerto Rico, a branch campus in Miami, Florida, and an additional instructional location in Mayagüez, Puerto Rico. It focuses on psychology, health, education, and human services..
Background: In the United States, only 15% of women with postpartum behavioral health (BH) conditions receive timely treatment. Peer support, an evidence-based strategy deploying nonclinical individuals with lived experience to provide support, may improve postpartum BH service delivery and can serve as a critical linkage for individuals who lose care access through prenatal structures. Yet, implementation barriers have hindered integration and scaling of postpartum peer support. We conducted a scoping review to synthesize implementation strategies for postpartum peer support interventions. Methods: Eleven interventions were identified through comprehensive searches of four databases. The study analysis identified contextual factors and implementation outcomes according to the Practical, Robust Implementation and Sustainability Model framework. Results: Successful programs incorporated flexible delivery formats, consistent supervision, and structured peer training to support fidelity while accommodating participant needs. Feasibility and acceptability were high among both participants and peer supporters; however, reach remained limited by exclusion of non-English-speaking individuals and those without technology access. Implementation was further influenced by local public health infrastructure, availability of clinical supervision, and societal norms. Sustainability challenges, including cost and integration within existing health systems, were common. Conclusions: While peer support interventions may improve postpartum depressive symptoms, their reach to vulnerable populations and sustainability are limited. Further work is needed to strengthen the implementation of peer support interventions in limited-resource communities and non-English-speaking populations. Tailored strategies include adaptation of intervention components to local contexts, enhancing supervision of peer supporters, and identification of sustainable models for integration within existing systems.
Mothers with a history of cumulative adversity (adverse experience throughout a lifetime) can face unique challenges in maintaining mental stability when compounded with other stressors during the perinatal period (pregnancy and postpartum). Such stressors can be having infants admitted to the Neonatal Intensive Care Unit (NICU), where stress levels often escalate due to the separation from their newborn and feelings of uncertainty regarding their child’s health. This study assessed cumulative adversity levels among 200 Latina mothers with NICU-admitted infants between 2017 and 2022 in Puerto Rico. Mothers were contacted between 1 to 8 weeks after their infants’ NICU admission and interviewed using a structured psychological assessment protocol that included the 6-item Spielberger State Trait Anxiety Index (STAI-6), the Parental Stressor Scale: NICU (PSS: NICU), the Patient Health Questionnaire (PHQ-9) for depression severity, and the Cumulative Stressor Inventory (CSI) for cumulative adversity in the 12 months before childbirth. Most participants were low-income, high school-educated mothers receiving government assistance. While anxiety (STAI-6, M = 6.26, SD = 3.9) and depression levels (PHQ-9, Mean = 5.4, SD = 4.8) were low, moderate NICU-related stress was reported (PSS: NICU, Mean = 90.7, SD = 44.06). Regression analyses revealed that cumulative stress is moderately associated with maternal psychological symptoms, including anxiety, depression, and NICU-related stress (R = 0.47, R2 = 0.22, p < 0.05; f (1,173) = 9.44, p < 0.001). Higher cumulative adversity (environmental hazards, economic hardships, unsafe neighborhoods, among others) is associated with NICU-related stress within this population. Early psychological interventions and continuous support are essential to mitigating effects of the NICU experience in mothers that have faced cumulative adversity experiences prior to childbirth and postpartum.
Abstract The Middle East and North Africa is a culturally, religiously, politically, and socially diverse region; there are various related beliefs, norms, and practices regarding gender. In this chapter, we discuss the influence of colonialism and foreign influence, Islam, and cultural values such as honor on gender-related issues in the region. We examine gendered behavior and related stereotypes such as gender-based violence, female genital cutting, and male guardianship. We also explore the ways gender norms, attitudes, and beliefs impact access to healthcare, education, and political involvement. We end the chapter discussing how globalization, via the internet and digital spaces, is having positive and negative impacts on gender equality in the region.
AIMS:This study addressed gaps in community resilience (CR) literature by building on recent trans and nonbinary (TNB) CR models from an intersectional perspective to explore how Latinx TNB communities strategize to promote healthy functioning for their members amid ongoing healthcare stressors. METHODS:In this secondary reflexive thematic analysis of a larger mixed-method sequential study, we analysed 40 semi-structured interviews and two focus groups with 15 participants (n = 55). Our analysis was grounded in cultural community resilience, the Multidimensional Model of TNB Resilience, and the Minority Stress Model. RESULTS:We identified four themes: (1) First Things First: Survival; (2) Connection with Purpose; (3) Agents of Change and Source of Strength; and (4) Knowledge is Power. Strategies included fostering sense of community, accessing community clinics, participating in community activities, and sharing information about TNB health. CONCLUSION:Findings encourage the mobilization of resources and advocate for changes to address the oppression faced by Latinx TNB communities.
