CBPR Pilot Intervention: Understanding Social Health Determinants of Mental Health in Rural Latinos
Keywords:Community-based participatory research, rural Latinos, psychosocial determinants, mental health
The purpose of this study is to identify challenges and facilitators for interventions on determinants of mental health in the literature and to analyze themes and coping strategies of psychosocial health determinants described by rural Latinos in a church-based intervention. This study was a review of literature and secondary data analysis of an arm of a larger Community-Based Participatory Research (CBPR) on the mental well-being of rural Latinos in North Florida - a CBPR pilot intervention. It was developed to respond to and prevent social stressors by creating a space where rural Latinos can help one another by sharing their experiences; empowering people to address health determinants that affect their well-being. All data from the pilot intervention was thematically analyzed using NVivo11. Psychosocial determinants of mental health identified in the CBPR intervention were: social environment factors (discrimination, family conflict, social isolation, undocumented status) and health services (uninsured & poor health literacy). Positive coping strategies described by rural Latinos were: avoiding conflictive relationships, alternative medicine, exercise, family & peer support, health education, community social support, instillation of hope, learn English, spirituality and religiosity. Negative coping strategies described were: categorical thinking, isolation, substance abuse.
Alegria, M., Polo, A., Gao, S., Santana, L., Rothstein, D., Jimenez, A., . . . Normand, S. L. (2008). Evaluation of a patient activation and empowerment intervention in mental health care. Med Care, 46(3), 247-256. doi:10.1097/MLR.0b013e318158af52
Baernholdt, M., Yan, G., Hinton, I., Rose, K., & Mattos, M. (2012). Quality of Life in Rural and Urban Adults 65 Years and Older: Findings From the National Health and Nutrition Examination Survey. The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association, 28(4), 339–347. http://doi.org/10.1111/j.1748-0361.2011.00403.x
Barrio, C., & Yamada, A. M. (2010). Culturally Based Intervention Development: The Case of Latino Families Dealing With Schizophrenia. Res Soc Work Pract, 20(5), 483-492. doi:10.1177/1049731510361613
Brennan, R. L. K., Baker, E. A., & Metzler, M. (2008). Promoting health equity: A resource to help communities address social determinants of health. Atlanta, GA: Centers for Disease Control and Prevention.
Chong, J., & Moreno, F. (2012). Feasibility and acceptability of clinic-based telepsychiatry for low-income Hispanic primary care patients. Telemed J E Health, 18(4), 297-304. doi:10.1089/tmj.2011.0126
Collado, A., Castillo, S. D., Maero, F., Lejuez, C. W., & Macpherson, L. (2014). Pilot of the brief behavioral activation treatment for depression in latinos with limited english proficiency: preliminary evaluation of efficacy and acceptability. Behav Ther, 45(1), 102-115. doi:10.1016/j.beth.2013.10.001
Cristancho, S., Peters, K. E., & Garces, D. M. (2016). Comunidades de la Latinos y Latinas, salud mental y necesidades de servicio en las zonas rurales los EE.UU. Interamerican Journal of Psychology, 50(1), 149-160.
Dwight-Johnson, M., Aisenberg, E., Golinelli, D., Hong, S., O'Brien, M., & Ludman, E. (2011). Telephone-based cognitive-behavioral therapy for Latino patients living in rural areas: a randomized pilot study. Psychiatr Serv, 62(8), 936-942. doi:10.1176/ps.62.8.pss6208_0936
Green, M. A., Perez, G., Ornelas, I. J., Tran, A. N., Blumenthal, C., Lyn, M., & Corbie-Smith, G. (2012). Amigas Latinas Motivando el ALMA (ALMA): Development and Pilot Implementation of a Stress Reduction Promotora Intervention. Calif J Health Promot, 10, 52-64.
HealthyPeople.gov (no date). Healthy People 2020. Washington, DC: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.
Hiott, A. E., Grzywacz, J., Davis, S., Quandt, S., & Arcury, T. (2008). Migrant farmworker stress: Mental health implications. Journal of Rural Health, 24(1), 32–39. doi: 1748-0361.2008.00134.x
Institute of Medicine . Unequal treatment: Confronting racial and ethnic disparities in healthcare. National Academies Press; Washington, DC: 2003.
Kaltman, S., Pauk, J., & Alter, C. L. (2011). Meeting the Mental Health Needs of Low-Income Immigrants in Primary Care: A Community Adaptation of an Evidence-Based Model. Am J Orthopsychiatry, 81(4), 543-551. doi:10.1111/j.1939-0025.2011.01125.x
Kanter, J. W., Santiago-Rivera, A. L., Rusch, L. C., Busch, A. M., & West, P. (2010). Initial outcomes of a culturally adapted behavioral activation for Latinas diagnosed with depression at a community clinic. Behav Modif, 34(2), 120-144. doi:10.1177/0145445509359682
Kelly, U. A., & Pich, K. (2014). Community-based PTSD treatment for ethnically diverse women who experienced intimate partner violence: a feasibility study. Issues Ment Health Nurs, 35(12), 906-913. doi:10.3109/01612840.2014.931496
Lichter, D. T. (2012). Immigration and the New Racial Diversity in Rural America. Rural Sociology, 77(1), 3–35. http://doi.org/10.1111/j.1549-0831.2012.00070.x
Michael, Y. L., Farquhar, S. A., Wiggins, N., & Green, M. K. (2008). Findings from a community-based participatory prevention research intervention designed to increase social capital in Latino and African American communities. J Immigr Minor Health, 10(3), 281-289. doi:10.1007/s10903-007-9078-2
Ryan GW, Bernard RH. Techniques to identify themes. Field Methods. 2003; 15(85):85–109. DOI: 10.1177/1525822X02239569
Ryan, J. G., Buford, U., Arias, E., Alfonsin-Vittoria, I., Fedders, M., Jennings, T., & Grubb, W. (2014). Participation in and impact of a depression care management program targeting low-income minority patients in an urban community-based clinic. Clin Ther, 36(5), 778-790. doi:10.1016/j.clinthera.2014.03.007
Stacciarini, J., Smith, R., Garvan, C. W., Weins, B., & Cottler, L. B. (2014). Rural Latinos’ Mental Wellbeing: A Mixed-methods Pilot study of Family, Environment and Social Isolation Factors. Community Mental Health. doi:10.1007/s10597-014-9774-z
Tondora, J., O'Connell, M., Miller, R., Dinzeo, T., Bellamy, C., Andres-Hyman, R., & Davidson, L. (2010). A clinical trial of peer-based culturally responsive person-centered care for psychosis for African Americans and Latinos. Clin Trials, 7(4), 368-379. doi:10.1177/1740774510369847
Uebelacker, L. A., Marootian, B. A., Tigue, P., Haggarty, R., Primack, J. M., & Miller, I. W. (2011). Telephone depression care management for Latino Medicaid health plan members: a pilot randomized controlled trial. J Nerv Ment Dis, 199(9), 678-683. doi:10.1097/NMD.0b013e318229d100
United States Department of Health and Human Services . Mental Health: Culture, race, and ethnicity: A supplement to mental health: A report of the Surgeon General. US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; Rockville, MD: 2001.
Wells, K. B., Jones, L., Chung, B., Dixon, E. L., Tang, L., Gilmore, J., . . . Miranda, J. (2013). Community-partnered cluster-randomized comparative effectiveness trial of community engagement and planning or resources for services to address depression disparities. J Gen Intern Med, 28(10), 1268-1278. doi:10.1007/s11606-013-2484-3
World Health Organization & Calouste Gulbenkain Foundation. (2014). Social determinants of mental health. World Health Organization, Geneva.
Some journals stipulate that submitted articles cannot be under consideration for publication or published in another journal. The student-author and mentor have the option of determining which journal the paper will be submitted to first. UF JUR accepts papers that have been published in other journals or might be published in the future. It is the responsibility of the student-author and mentor to determine whether another journal will accept a paper that has been published in UF JUR.