Mental Health; Treatment Engagement; E-E Video


Medicine and Health Sciences


Purpose/Background: Approximately 30% of Latinos experience some form of psychiatric illness in their lifetime. Despite the high prevalence rate of mood disorders among Latinos and the availability of empirically supported treatments that target anxiety and depression, Latinos underutilize behavioral health services. Perceived stigma associated with the pursuit of behavioral health services disproportionately restricts mental health care in Latinos. The research team created an Entertainment- Education (E-E) telenovela-style video (in Spanish), which acted as the experimental intervention in the proposed project. The experimental intervention is based on the E-E model which incorporates health and educational messages in an entertaining, story-telling narrative using characters who have characteristics, beliefs, attitudes, and behaviors that are similar to those of the targeted audience to maximize social validity. The video chronicles the story of Ana who while having pan y café (sweet bread and coffee) with two family members, shares her challenges with depression and her successful outcome with therapy. The video utilizes the genre of the telenovela which creates an entertaining environment where the audience is captivated by the content and absorbs the messages portrayed.

Materials & Methods: Study Site. Community Health Alliance (CHA) is a Federally Qualified Health Center that provides integrated medical services. CHA annually sees 33,000 patients over the course of 92,000 visits a year. Of the thousands of visits made by patients each year, 58% of the patients seen at CHA identify as being Latino and Spanish-speaking. The study was be conducted at the main clinic, which is located in a Latino neighborhood.

Participants: Participants consisted of Spanish-speaking, Latino adults who endorsed symptoms of depression on the Patient Health Questionnaire-9. Participants were randomly assigned to treatment as usual (TAU) or the intervention condition. Treatment as usual included a brochure on depression and referral information to a behavioral health clinic. In the intervention condition participants received TAU + the E-E video. In both conditions the participants completed a basic demographic form and both before and after TAU or the intervention condition participants completed the Depression Stigma Scale (DSS); the Depression Literacy Scale (D-Lit); and the Attitudes Towards Seeking Professional Help (ATSPH) questionnaire.

Results: Data collection is currently underway. A preliminary review of the data indicates that the Latinos in our sample have low levels of mental health literacy, high levels of stigma, and moderate attittudes towards seeking professional help. The E-E video appears to reduce stigma, increase mental health literacy, and improve attitudes towards seeking professional help. We plan to utilize Hotelling's T 2 test to to examine differences in scores on the DSS, D-lT, and ATSPH for the TAU vs. TAU + the E-E video condition.

Discussion/Conclusion: Given the high rates of mood disorders among Latinos, the availability of empirically supported treatments for mood disorders, the low treatment-seeking rates of Latinos who have a mood disorder, and the evidence that indicates that stigma and mental health literacy mediate the relationship between ethnicity and behavioral health service use, it is necessary to develop interventions aimed at reducing stigma and increasing mental health literacy. Such interventions have the potential to improve attitudes towards help-seeking and ultimately improve treatment seeking rates among Latinos. The results from this study suggest that utilizing a culturally-specific intervention (a telenovela-style video) targeted at reducing stigma and increasing mental health literacy may be an effective way of reducing the behavioral health service use disparity between Latinos and non-Latino Whites. This is a low-cost and easily disseminable intervention and as such holds promise for behavioral health service use disparity between Latinos and non-Latino Whites. Future researchers should examine similar interventions with other ethnic groups.