Elevated rates of depressive symptoms have been well-documented among low-income mothers, including Latinas who are at high risk for living in poverty. However, Latinos have consistently been found to underutilize mental health services when these services are needed for such disorders as depression. Despite maternal depression in this group representing a disparity in health and functioning for both Latino mothers and their children, there is a lack of effective intervention strategies to decrease this health disparity. One way to address this disparity is by delivering services through Promotoras, lay health workers who are familiar with the neighborhood, culture, language and social status of immigrant Latinas. This proposal will examine the effectiveness of a preventive intervention for postpartum Latina women in decreasing symptoms of minor depression and will explore how treatment of these mothers may affect their parenting of and attachment to their infants. Teh Promotoras who regularly conduct home visits for postpartum Latinas will be trained in administering a screening instrument for detection of minor depression, the PrimeMD. Four Promotoras will then be trained and supervised in delivering a standardized 12-session cognitive behavioral therapy intervention developed to prevent depression in pregnant women and new mothers. 100 postpartum Mexican American immigrant women recently discharged from the hospital following childbirth, will be identified as having minor depression and will be consented to participate in the study. The participants will be randomized to either the intervention group or a control condition. The main outcome variable will be maternal depression symptoms as measured by a structured interview for the Hamilton Rating Scale. Data will also be collected on appropriateness of parenting, attachment, and developmental outcome measures to estimate effect sizes and sample size needed (through power calculations) for a full-scale trial of the preventive intervention.
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