Alma: Moms Supporting Moms from Colorado to New Jersey
In 2021, mental health conditions were the leading preventable cause of maternal deaths in the U.S., with nearly one in four new mothers of color experiencing postpartum depression. Despite growing awareness, these disorders remain the most common complication of the perinatal period, disproportionately impacting people of color who often lack access to equitable care.
CHAP’s partnership with the Alma program at the University of Colorado Boulder’s Renee Crown Wellness Institute began in 2022. Alma uses a peer-to-peer approach to maternal mental health, uplifting the lived experiences of birthing people and parents of color. The program recently expanded to New Jersey, led by Family Health Initiatives and bolstered by state funding.
It Started As A ‘Wondering’
“The idea of a peer-to-peer approach came from observing the impact of community-based strategies around the world and feedback from women participating in our U.S. research. It started as a ‘wondering.’ What if our world truly saw and honored the wisdom and dedication of parents in supporting one another?”
Sona Dimidjian
Director, Renée Crown Wellness Institute
Since 2019, the University of Colorado Boulder’s Renée Crown Wellness Institute has been combining science and community to explore how women who have experienced perinatal mood and anxiety disorders—with an emphasis on depression—can be resources to others navigating similar challenges. Through their lived and learned experiences, moms are helping other moms find their way and transforming maternal mental health care in the process through the Alma program.
For director Sona Dimidjian and her colleagues, decades of research focused on the effectiveness of a form of psychotherapy called Behavioral Activation yielded valuable insights into treating and preventing depression, particularly during the transition to parenthood for pregnant and postpartum people.
Behavioral Activation centers on the relationship between the activities a person engages in and the feelings and moods they experience, with the idea that, by changing what they do, a person can change how they feel. Dimidjian conducted Behavioral Activation studies in prenatal care clinics across multiple states. At the same time, she worked with a global research team to adapt the approach for primary care clinics in India. As she traveled back and forth, participants from previous studies expressed their desire to give back, inspired by how much learning about Behavioral Activation had helped them.
Developing The Model—A Participatory Process
“Our peer mentors are mothers themselves and bring their own personal experiences, challenges, and triumphs into their roles. This shared experience creates a deep, authentic connection with the mothers they support, fostering an environment of understanding and trust.”
Anahi Collado
Assistant Research Professor,
Renée Crown Wellness Institute
The idea of using a peer-to-peer approach to address depression came both from observing the impact of community-led strategies around the world and feedback from women participating in Dimidjian’s research. To explore the possibility further, the Crown Institute engaged new and expecting parents in the greater Denver and Boulder areas and rural Colorado. They studied Behavioral Activation together, reflecting on how the approach could be adapted to ensure contextual and cultural relevance.
Recognizing early on that Latinx community members experienced disproportionately high rates of perinatal depression, along with significant barriers to accessing culturally responsive mental health care, the program was also designed in partnership with and for Spanish-speaking mothers—community members who often feel isolated and struggle to navigate a complex healthcare system.
Centering the voices of these parents was crucial in shaping the program’s model. “Historically, there has been a lack of respect for mothers, parents, and individuals struggling with mental health challenges. Women who occupy intersectional identities around race and ethnicity or immigration have been particularly marginalized. Alma aims to change how we see and value expertise by disrupting traditional hierarchies in mental health and healthcare,” says Dimidjian.
“What enhances [the peer-to-peer approach] is that Alma’s tools and techniques are grounded in evidence-based practices, ensuring that the support provided is not only empathetic but also effective. This combination of lived experience and integrating scientifically-validated interventions creates a powerful synergy, making Alma a comprehensive and impactful resource for mothers,” says Anahi Collado, Assistant Research Professor with the Crown Institute.
As Alma’s positive impact on Colorado communities became evident, the Crown Institute considered expanding the program in partnership with another organization that shared similar values, principles, and approaches.
Catalyzing Expansion
“Understanding the value of support that comes from someone who knows what you are going through and where you are coming from—combined with an awareness of the shortages of clinically trained providers treating perinatal mood and anxiety disorders—made the idea of working with the Alma team to expand the program especially exciting.”
Wendy McWeeny
Co-Director, CHAP
According to the Policy Center for Maternal Mental Health, 96% of women of childbearing age in the United States live in areas where maternal mental health providers are lacking. During a 2022 webinar organized by CHAP on maternal mental health and substance use disorders, Dimidjian presented Alma’s peer-to-peer approach. Interest among participants from the New Jersey Department of Health sparked discussions with CHAP Co-Directors Raquel Mazon Jeffers and Wendy McWeeny about replicating the model.
“When we think about the government’s role in improving outcomes for moms, the current levers for change really reside at the state level. States are well positioned to coordinate efforts across the health and social service systems, and we see opportunities for philanthropy to be a uniquely valuable partner in these processes,” says McWeeny.
When the New Jersey Department of Health decided to pilot the program with an additional component geared towards moms for whom substance use has been an issue, the CHAP team was excited to support the effort, providing a grant to the Crown Institute so they could be involved in New Jersey’s proposal development and review processes. By March 2024, Alma was ready to launch in New Jersey bolstered by $2 million in New Jersey Department of Health funding.
“Maternal mental health, because of its layers, is very complex. All these changes that happen—hormone changes, sleep changes, and changes to social support and family support—are different from person to person. With Alma, there is this sense of community, of social support. It’s also unique that you can be in a therapeutic relationship with a provider and be in Alma at the same time.”
Cathy Butler-Witt
Director of Public Health Programs,
Family Health Initiatives
Dedicated to helping nonprofits and public agencies build healthier communities, New Jersey-based Family Health Initiatives saw how a peer-to-peer program serving birthing people of color could enhance the local mental health landscape.
Director of Public Health Programs, Cathy Butler-Witt, and her colleague, Associate Director of Behavioral Health, Quinn Ingemi, worked with the Crown Institute team to establish the program’s foundation when they received the Department of Health grant. To strengthen the pilot, they also engaged licensed mental health professionals, and evaluators from The College of New Jersey. When Yvette Pittman, Family Health Initiatives’ Assistant Director for the Alma program, joined the team, she and Butler-Witt trained on the model themselves. From there, the New Jersey program’s first peer mentors were hired.
The Crown Institute has remained a key collaborator, committed to ensuring the expansion’s success. Collado highlights the significance of the state-to-state partnership: “I’ve been particularly involved as part of the training team, and it has been incredibly rewarding to witness firsthand how the Alma peer trainers and mentors embrace their roles and pass on their knowledge and experience to new generations of peers. This process of training and mentorship is truly at the heart of Alma’s success. It ensures that each new peer mentor is well prepared to provide vital support to their community, fostering a strong, knowledgeable network of individuals dedicated to maternal mental health. Being part of this transformative process, where experienced peers empower and guide newcomers, is a highlight and reinforces the positive impact Alma is having on families across New Jersey.”
Meeting Needs in New Jersey
“Alma is designed to empower moms, equip them with new coping skills and help them manage their busy lives. Emotions come in waves, but the Alma model and tools can help any mom, in any situation, whether they’re feeling depressed, sad or stressed—right now or not.”
Yvette Pittman
Assistant Director, Alma Program
Family Health Initiatives
Alma currently operates in southern New Jersey with full-time and part-time peer mentors, as well as Spanish-speaking mentors for moms in partnership with the Puerto Rican Action Committee. Each mentor brings her own lived experience to the role. “Some of our mentors have worked in this field. Some are parent ambassadors, so they already volunteer and support moms in the community, and they are aware of resources or services out there. The most important thing to me is that our peer mentors feel they have all the tools they need so they can provide the best support to other moms,” says Pittman.
Peer mentors meet weekly with participating moms, blending in-person and virtual sessions focused on support and Behavioral Activation skill-building. Throughout this time—typically between 6 and 8 weeks—the Crown Institute’s peer mentors regularly collaborate with the Family Health Initiatives team to review progress and ensure the New Jersey model meets community needs. These reflective sessions also allow Pittman to connect peer mentors with the licensed mental health professionals involved in the program when additional resources or clinical perspectives are needed.
At enrollment, participating moms complete forms assessing the severity of their depression and anxiety—an activity peer mentors repeat during each session. According to Pittman, the data gathered so far shows Alma is making a difference. As moms work with their peer mentors, their depression and anxiety levels are decreasing. Evaluators from The College of New Jersey are also tracking the program’s short- and long-term impacts.
Looking Forward
The Alma team in Colorado continues to observe multiple levels of impact within the program. “At the heart,” says Dimidjian, “are the benefits for new and expecting parents and their children’s future development, guided by the strength and lived experiences of the peers. The broader goal is to change the way mental health, family support, and the transition to parenthood is considered and perceived—honoring parents’ dignity and inherent capacities—recognizing the wisdom within communities that have been ignored, obscured, or marginalized.”
As Family Health Initiatives enters the second year of its pilot, supported by a grant from the New Jersey Department of Health, the Alma program is poised for expansion. By June 2025, the program intends to reach 400 mothers, welcoming participants in northern New Jersey through a partnership with the Central Jersey Family Health Consortium, while also launching its perinatal substance use disorder component.
For everyone involved, the Alma model and cross-state partnership offer powerful examples of what is possible when communities are engaged in shaping systems of care, stakeholders across sectors collaborate, and philanthropy leverages its unique resources to help locally-driven innovations spread nationwide.