The proposed study is written in response to the heightened need for research designed to help reduce mental health disparities. The investigation focuses on one of the fastest growing but understudied and underserved ethnic minority groups: Korean American elders. Building upon our previous findings that Korean American older adults have high levels of mental health problems yet underutilize mental health services, the proposed study conceptualizes low mental health literacy as a major reason for service underutilization and a central focus of intervention efforts. The overall goals are to better understand the levels of mental health literacy manifest in the target population and to develop/test an educational intervention. The proposed study includes three phases: (1) data collection with a mixed methodology including a survey and focus groups;(2) development of an educational intervention program, and (3) pilot testing and evaluation. Survey data drawing on structured questionnaires will be used to assess the level of mental health literacy and to determine facilitators and barriers of mental health literacy. In order to provide a more in-depth assessment of mental health literacy, data from focus groups will also be used. The latter discussions will be conducted with Korean American older adults, their family members, health care professionals, and religious leaders. Various mental health issues and ways to promote community mental health and service utilization will serve as focal points for diverse perspectives. Findings from the survey data and focus groups will guide the development of a culturally appropriate and acceptable educational intervention program. An educational brochure in Korean will be written with the twin goals of increasing mental health literacy and making positive changes in attitudes toward mental disorders and service utilization. We will also adopt a peer-led education strategy where lay peer leaders are trained to deliver an educational session. The session includes not only the brochure but also peer-education and group discussion. The peer-based approach allows greater sensitivity to the unique characteristics of ethnic minority communities, where informal leaders play a significant role. During the third and final phase, an experiment with three randomized conditions (control, general brochure, and peer-led education) will be conducted to explore the effectiveness of the educational brochure and peer-led education strategy. We hypothesize that 1) those in the treatment groups (general brochure and peer-led education) would show increased knowledge of depression and positive changes in attitudes toward mental illness and service use compared to those in the control group, and 2) peer-led education would be more effective than the brochure-only approach. Pilot testing and evaluation will serve as an important means to assess effect size of intervention and feasibility of the program for implementation in a subsequent project. We also hope to use our findings to develop a protocol for application to other ethnic minority groups. Public Health Relevance: Building upon previous findings that Korean American older adults have high levels of mental health problems yet underutilize mental health services, the proposed study conceptualizes low mental health literacy as a major reason for service underutilization and a central focus of intervention efforts. The overall goals of the study are (1) to better understand the levels of mental health literacy manifest in the target population and (2) to develop/test an educational intervention.
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