Amigas Latinas Motivando el Alma (ALMA): A Randomized Control Trial of an Intervention to Reduce Mental Health Disparities in Mexican Immigrant Women

Amigas Latinas Motivando el Alma (ALMA)：减少墨西哥移民妇女心理健康差异干预措施的随机对照试验

• 批准号: 9420377
• 负责人: India Jane Ornelas
• 金额: $ 56.62万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-24 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9420377
• 关键词: Address; Anxiety; Area; Climate; Cognitive; Communities; Control Groups; Controlled Study; County; Discrimination; Economics; Educational Background; Ensure; Exposure to; Face; Faculty; Family; Focus Groups; Friends; Growth; Health; Health Insurance; Health Priorities; Healthcare; Hispanics; Immigrant; Immigration; Individual; Intervention; Intervention Studies; Intervention Trial; Interview; Language; Latina; Latino; Linguistics; Link; Measures; Mediating; Mediator of activation protein; Medicine; Mental Depression; Mental Health; Mental Health Services; Methods; Mexican; Mexico; Outcome; Participant; Pilot Projects; Politics; Population; Poverty; Prevention program; Procedures; Process; Protocols documentation; Provider; Psychology; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Research Design; Research Personnel; Resources; Risk; Series; Social Work; Social isolation; Social support; Stress and Coping; Surveys; Testing; Time; Treatment Efficacy; Underserved Population; United States; United States National Institutes of Health; Universities; Violence; Washington; Woman; anxiety symptoms; base; clinically significant; community based participatory research; community setting; comparative efficacy; control trial; coping; depressive symptoms; effective intervention; efficacy testing; evidence base; experience; family support; health care disparity; health care service utilization; health disparity; high risk; innovation; interest; member; migration; post intervention; prevent; programs; research and development; satisfaction; social; social stigma; stress symptom; stressor; therapy development; treatment program

Project Summary 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.

项目概要 最近的研究表明，美国 30% 的拉丁裔女性患有临床上严重的疾病 抑郁和焦虑症状，并且这些比率随着在美国呆的时间的增加而增加。 由于许多社会和经济问题，移民特别容易抑郁和焦虑。 他们面临的压力源，包括：高度贫困、教育水平低、家庭义务、语言 障碍和社会孤立的拉丁裔移民也不太可能患有抑郁症和焦虑症。 由于缺乏健康保险，在文化和语言上很少获得和利用优质的精神卫生保健 有能力的提供者，以及与寻求基于社区的干预措施相关的耻辱。 增加应对策略并提供社会支持可以帮助减少心理健康差异 墨西哥移民妇女。拟议的研究旨在解决国家卫生研究院的优先事项： 在随机等候名单中测试 Amigas Latinas Motivando el Alma (ALMA) 干预的效果 ALMA 是一项为期 8 周的小组项目，旨在向女性传授新的应对策略和方法。 加强他们的社会联系和社会支持，以预防和减少他们的抑郁和焦虑。 拟议的研究旨在完善 ALMA 干预和研究程序，以确保它们与文化相关， 使用从焦点小组和对墨西哥移民妇女的认知访谈中获得的信息，目标 2 是。 确定 ALMA 干预措施对减少抑郁和焦虑症状的功效 我们将从社区服务组织中招募女性。 拉丁裔移民参与该计划，该计划将在社区环境中提供，我们将对其进行评估。 通过观察和深入了解招募、保留、忠诚度和参与者满意度的流程结果 我们将通过比较参与者的变化来评估干预措施的有效性。 干预组和候补对照组中女性在四个时间点的抑郁和焦虑症状 （干预前、干预后、3 个月、6 个月）目标 3 是评估干预措施的潜在影响。 对个人（耻辱、压力、应对策略）和人际（社会支持、社会关系）的干预 因素，以及干预的影响是否由这些因素介导。 心理学、医学、社会工作和公共卫生以及社区研究人员 该研究使用严格的方法来测试一项创新计划，该计划旨在为墨西哥移民提供服务。 整合文化相关和基于证据的策略来解决重大心理健康问题 高风险和服务不足人群中的差异将有助于为未来的研究和实践提供信息。 鉴于拉丁裔人口的增长，确定减少拉丁裔之间心理健康差异的干预措施 墨西哥移民妇女可以对公共卫生产生重大影响。