Evaluation of a Health Education Intervention to Improve Parental Knowledge and Attitudes About Chronic Stress and Depression Among Head Start Families

Abstract

Background. Chronic stress and depression disproportionately affect families experiencing poverty, and likely contribute to disparities in early childhood developmental outcomes. Developing strategies to address chronic stress and depression may help mitigate these disparities. Early Head Start (EHS) and Head Start (HS) programs provide an important platform to address the disproportionate burden of stress and mental health issues experienced by EHS/HS families. However, few low-literacy, broad, scalable interventions improve parents’ knowledge and attitudes around these topics. Objectives. We examined parents’ knowledge and attitudes regarding stress and depression before and after a train-the-trainer (TTT) intervention delivered to 28 EHS/HS agencies across the United States. Methods. Following a TTT workshop, 18 agencies chose to deliver the stress training to 1,089 parents and 5 chose to deliver the depression training to 670 parents. Participating parents completed paper assessments at baseline and 3 months following the training. Paired T-tests and chi-square analyses tested whether responses significantly improved over time. Results. At baseline, 37.2% of parents reported feeling stressed most of the time and 13.4% reported feeling depressed most of the time. Following the trainings and reinforcement activities, parents’ knowledge, attitudes and self-reported behaviors significantly improved, including willingness to seek help for depression, avoidance of negative health-risk behaviors and utilization of healthy stress management practices. At follow up, 18.6% of parents reported feeling stressed most of the time and 11% reported feeling depressed. Conclusion. Findings suggest this low-literacy TTT approach is potentially a promising health promotion intervention with broad dissemination potential.

Community-Academic Partnership

“…Using TTT educational materials co-developed by community-academic partners and delivered by “trusted locals” was an effective model to engage and teach participants. Previous evidence also demonstrated that TTT is a useful health education tool and format for sustained community-based education 13-15 . Similar to this study, Guerrero et al 15 described the effectiveness of using low-literacy educational materials such as slides, a brochure, and handouts.…”

“…Previous evidence also demonstrated that TTT is a useful health education tool and format for sustained community-based education 13-15 . Similar to this study, Guerrero et al 15 described the effectiveness of using low-literacy educational materials such as slides, a brochure, and handouts. In addition, the findings of this study and previous literature suggest that videos may improve health literacy challenges 9,13 …”

“…A community-academic partnership was formed to increase families' and community members' knowledge about and use of PEOLC services in a rural area of East Tennessee. The partnership included an interdisciplinary team of church and community members (15), pastors (2), interprofessional health care providers (5), academics (9), and county extension agents (3) that collaborated to use best practices, research, cultural knowledge, and expertise to co-design the training intervention.…”

“…1 Studies have demonstrated the effectiveness of using train-the-trainer (TTT) models 13,14 and culturally acceptable faith-based interventions in communities to disseminate health information, promote chronic disease management, improve community health, and ensure intervention sustainability. 13,[15][16][17] Researchers reported that health education should be co-developed with community partners to reflect people's values and ensure cultural and theological acceptability. [16][17][18] However, community/faith-based partner involvement varied considerably.…”

Caregiver stress and social determinants of health in key populations: immigrant parents, parents of children with medical complexity, and adolescent parents

“…Parents immigrating to the United States from Korea recently reported increased stress if they encountered language barriers or could not meet their child's educational needs [13 ▪ ,3 ▪▪ ]. Local action to ameliorate parental stress, centered in early childhood educations centers, has been shown recently to reduce caregiver stress and depression levels [14 ▪ ]. Parental education access is especially key as it relates to immigrant and adolescent parents.…”