Jacobs Foundation

To evaluate the predictors of postpartum depression and to examine the effects of maternal racial identity on postpartum depression among women with low incomes in the United States. We conducted a secondary data analysis using baseline data from the Baby's First Years study, including postpartum women living below the federal poverty line who were recruited from four diverse communities in the United States. Postpartum depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regressions were performed to identify associations between pre-identified postpartum depression risk factors and postpartum depression among participants, followed by predictive margins analyses to elaborate on probability of postpartum depression across different racial identity groups in the sample. The sample included 1,051 postpartum women. Almost one-half of participants identified as Black (45.9%), followed by White (20.7%), American Indian (1.8%), and Asian (1.3%). Prevalence of postpartum depression in the sample was 24%. Financial insecurity and alcohol use were positively associated with postpartum depression, whereas level of education and reported physical health were negatively associated with postpartum depression. Mothers who identified as Black had an 8.3% higher probability of postpartum depression than that of White mothers in the sample. Nurses working with populations with low income should assess social determinants of health to provide holistic mental health care. Women with low incomes should be referred to resources which account for their financial burden. Racial disparities exist in perinatal care, and birth and postpartum mental health outcomes. It is crucial to address the systemic racism faced by Black mothers experiencing postpartum depression.

Children’s and adolescents’ mental health needs emphasize the necessity of a new era of translational research to enhance development and yield better lives for children, families, and communities. Developmental, clinical, and translational research serves as a powerful tool for managing the inevitable complexities in pursuit of these goals. This article proposes key ideas that will strengthen current evidence-based intervention practices by creating stronger links between research, practice, and complex systems contexts, with the potential of extending applicability, replicability, and impact. As exemplified in some of the articles throughout this special issue, new research and innovative implementation models will likely contribute to better ways of assessing and dynamically adapting structure and intervention practice within mental health systems. We contend that future models for effective interventions with children and adolescents will involve increased attention to (a) the connection of research on the developmental needs of children and adolescents to practice models; (b) consideration of informed contextual and cultural adaptation in implementation; and (c) a rational model of evidence-based planning, using a dynamic, inclusive approach with high support for adaptation, flexibility, and implementation fidelity. We discuss future directions for translational research for researchers, practitioners, and administrators in the field to continue and transform these ideas and their illustrations.

This special issue examines essential challenges and successes for developing, implementing, and disseminating evidence-based psychological interventions for child and adolescent development and mental health. The main aims are to identify what evidence is “good enough” for roll-out, if and how interventions need to be adapted to developmental diversity and contextual variation, and how they relate to complex systemic contexts. Themes of the special issue are twofold and first include questions about adoption versus adaptation, in terms of both developmental tailoring and cultural adaptation of existing intervention programs. Second, the issue tackles questions about what systems of support are needed to ensure the system readiness for child and adolescent mental health interventions. We argue that moving from simple adoption to dynamic adaptation and from programs to collaborative systems offers new perspectives for developing and implementing flexible protocols and strategies that allow adapted intervention. The special issue raises broader questions of whether current intervention programs and practices are good enough in moving us from mere adoption to innovation in system readiness, or whether we need to do more before we can claim that interventions are good enough for roll-out.

Strategy execution is at the top of the agenda of many senior executives. Executing a strategy is a complex task during which many roadblocks can occur. The influence of the middle management on successful implementation remains an overlooked aspect. Thus, the author develops an integrated view on how to effectively and successfully involve this key group in the execution.