Does attachment style influence social support or the other way around? A longitudinal study of Early Head Start mothers.

Understanding the association between attachment style and social support is important for informing programs that seek to improve outcomes for families by intervening with either or both of these systems. The present study examines whether increasing levels of social support among 181 low-income, primarily African American mothers leads to changes in their self-reported attachment style, or whether attachment style influences the extent to which they perceive others as supportive. Results suggest that whereas scores on the avoidant attachment dimension were relatively stable and led to decreasing perceptions of social support over time, scores on the anxious dimension were more malleable, at least under conditions of low stress. For mothers who experienced fewer stressful life events, increasing social support led to decreased attachment anxiety over time. However, when life stress was high, social support had no such positive influence. Implications for the need to attend to mothers' attachment styles in providing appropriate and effective intervention are discussed.

Root shock revisited: perspectives of early head start mothers on community and policy environments and their effects on child health, development, and school readiness.

Racial differences in school readiness are a form of health disparity. By examining, from the perspective of low-income minority families participating in an Early Head Start study, community and policy environments as they shape and inform lived experiences, we identified several types of social and economic dislocation that undermine the efforts of parents to ready their children for school. The multiple dislocations of community triggered by housing and welfare reform and "urban renewal" are sources of stress for parents and children and affect the health and development of young children. Our findings suggest that racial differences in school readiness result not from race but from poverty and structural racism in American society.

Infant mental health and family support: Contributions of Early Head Start to an integrated model for community-based early childhood programs.

This paper analyzes the experiences of an Early Head Start (EHS) program in adopting and implementing an infant mental health (IMH) approach in its work with community families. Through qualitative methods (participant observation, qualitative interviews, and case studies), we examined the strategies used, and the challenges encountered, by program staff as they applied IMH principles in their home-visiting interventions with families whose lives involve significant economic, social, and psychological stressors. Our study identified four elements crucial to an effective IMH initiative: (1) teamwork, especially the use of transdisciplinary teams to review family cases, (2) reflective supervision, (3) development of an integrated and empathic understanding of the child's needs and the parent's challenges in meeting those needs, and (4) a dynamic ecological understanding of children, families, and communities in which psychosocial and socioeconomic factors are viewed as mutually important and interactive. We argue that each of these elements both builds on and enhances long-standing dimensions of this EHS program's family support approach, creating an innovative and integrated model of IMH and family support that could prove of value in many community-based programs serving children and families whose emotional health is affected by everyday experiences of economic and social inequality.

"Come and take a walk": listening to Early Head Start parents on school-readiness as a matter of child, family, and community health.

We explored the perspectives and experiences of low-income, predominantly African American families regarding children's school-readiness. Our research, which involved qualitative interviews, ethnographic case studies, and "photovoice" methods, focused on families participating in the national evaluation of Early Head Start. While valuing academic skills, study parents emphasized the importance of social and emotional health in regard to both children's and parents' readiness to begin school. These developments are especially critical given the challenges parents perceive in local school environments. On the basis of a social ecology framework, we argue that psychological and environmental dimensions of school-readiness are public health matters and that understanding the perspectives of low-income and minority parents on such issues is a critical aspect of health communication dedicated to eliminating health disparities.

Parents, practitioners, and researchers: community-based participatory research with early head start.

Community-based participatory research (CBPR) is an approach to research and evaluation that is receiving increased attention in the field of public health. Our report discusses the application of this approach to research and evaluation with an Early Head Start (EHS) program in Pittsburgh, Pa. Our primary purpose is to illustrate the key elements that contributed to effective collaboration among researchers, EHS practitioners, and parents of EHS children in the conduct of the study. The focus is not on research findings but on research process. Our goal is to make the practices of CBPR visible and explicit so they can be analyzed, further developed, and effectively applied to a range of public health issues in a diversity of community contexts.