Recent studies indicate that 30% of Latina women in the United States are living with clinically significant depressive and anxiety symptoms, and that these rates increase with time spent in the United States. Latina immigrants are particularly vulnerable to depression and anxiety due to the many social and economic stressors they face, including: high levels of poverty, low levels of education, family obligations, language barriers, and social isolation. Latina immigrants suffering from depression and anxiety are also less likely to access and utilize quality mental health care, due to lack of health insurance, few culturally and linguistically competent providers, and stigma associated with seeking mental health care. Community-based interventions that increase coping strategies and provide social support can help reduce mental health disparities among Mexican immigrant women. The proposed study aims to address National Institute of Health priorities by testing the efficacy of the Amigas Latinas Motivando el Alma (ALMA) intervention in a randomized waitlist control trial. ALMA is an 8-week program offered in a group format to teach women new coping strategies and enhance their social ties and social support to prevent and reduce their depression and anxiety.
Aim 1 of the proposed study is to refine the ALMA intervention and study procedures to ensure they are culturally-relevant, using information gained from focus groups and cognitive interviews with Mexican immigrant women.
Aim 2 is to determine the efficacy of the ALMA intervention to reduce depressive and anxiety symptoms using a randomized waitlist control study design. We will recruit women from community-based organizations serving Latino immigrants to participate in the program, which will be offered in community settings. We will assess process outcomes of recruitment, retention, fidelity, and participant satisfaction through observations and in- depth interviews with participants. We will assess the efficacy of the intervention by comparing changes in women?s depressive and anxiety symptoms in the intervention and waitlist control groups at four time points (pre-intervention, post-intervention, 3 months, 6 months).
Aim 3 is to assess the potential impact of the intervention on both individual (stigma, stress, coping strategies) and interpersonal (social support, social ties) factors, and whether the impact of the intervention is mediated by these factors. The research team includes investigators in psychology, medicine, social work and public health, as well as community-based organizations serving Mexican immigrants. The study uses rigorous methods to test an innovative program that integrates both culturally relevant and evidenced-based strategies to address significant mental health disparities in a high-risk and underserved population. Findings will help inform future research and practice. Given the growth of the Latino population, identifying interventions that reduce mental health disparities among Mexican immigrant women can have a significant public health impact.
Mexican immigrant women are at increased risk for poor mental health and have limited access to mental health care. This randomized control trial study will test whether an eight-week program to increase coping strategies and social support can prevent and reduce depression and anxiety among Mexican immigrant women in a community setting.