Methods: Participants were 119 mothers and their children, who were randomized by Head Start site to the study’s intervention (n=49) and control (n=70) groups. Mothers were 33.6 years of age on average (SD = 6.3), 81% were Latina, and 55% identified Spanish as their preferred language. Children were 4.2 years old on average (SD = 0.6) and the majority were boys. A 12-week IPT group was offered and therapists were supervised by the model developer. Mothers completed questionnaires on depressive symptoms (Center for Epidemiologic Studies Depression Scale; CES-D), parenting stress (Parenting Stress Index), social support (Duke-UNC Functional Social Support scale), parenting attitudes (Parental Behavior Inventory), and parent-child interaction (Keys to Interactive Parenting Scale) at intake, upon completion of the group, and at 6-month follow-up. To assess intervention effects, linear mixed-effect models (via SAS Proc Mixed) and generalized linear mixed-effect models (via SAS Proc Glimmix) were used to analyze whether the trajectories for continuous and dichotomized outcomes, respectively, differed between intervention and control conditions from baseline to 6-month follow-up.
Results: Participants in the treatment group showed a significant decrease in depression scores (β time= - 4.59, p<0.05; p for time*group interaction p<0.05) compared to the control group. In the treatment group, CES-D scores declined on average from 20.3 at baseline to 14.4 at the 3-month follow-up, and then declining further at six-month follow-up. The intervention group also showed a significant improvement in parenting stress (β time= - 6.77, p<0.05; p for time*group interaction <0.05), compared to the control group. The trajectories of change between the treatment and control groups did not significantly differ for the outcomes of maternal social support, parenting attitudes, or parent-child interaction. Lastly, dose-response effects of the intervention were observed for maternal depressive symptoms, parenting stress, confidant social support, and parental hostility.
Conclusions and Implications: This study supports the effectiveness of IPT-G in reducing depressive symptoms and parenting stress for a population of ethnic minority Head Start mothers. A strong dose effect was also evidenced, with mothers who attended more groups experiencing greater symptom reduction. These findings are particularly noteworthy since the sample was overwhelmingly Latina, with two-thirds being first generation immigrants. Future research should explore the null effects on parenting. Overall, findings suggest that IPT-G can be scaled within Head Start and also adapted to other settings that serve low income mothers.