School of Public Health of Mexico, National Institute of Public Health, Cuernavaca, Mexico.
Oaxaca Health Services, Oaxaca, Mexico.
Front Public Health. 2022 Apr 15;10:877465. doi: 10.3389/fpubh.2022.877465. eCollection 2022.
Mexican immigrants in the United States face mental health challenges, disparities, and limited access to healthcare; however, mental health promotion efforts specifically targeting this population have been insufficient. The objective of this study was to develop and test a mental health promotion intervention based on protective mental health factors and coping strategies for Mexican immigrants recruited through a free, consulate-based program in Atlanta.
Working with the Ventanilla de Salud program, we conducted a longitudinal study in three phases: formative research and design, pre-intervention assessment and post-implementation evaluation. The intervention was designed based on the health promotion model and interviews with stakeholders. Qualitative information was collected by semi-structured interviews with participants before and after the intervention. Quantitative outcomes were knowledge about protective factors and coping mechanisms, and psychosocial distress. Differences were assessed using the Wilcoxon non-parametrical test. Intent-to-treat analysis was conducted with all participants who signed the informed consent (carrying last observation forward), and a complete case analysis was conducted with those who attended at least 70% of the sessions and completed the post- implementation evaluation.
Twenty-five participants were enrolled in the intervention. Mean age was 38 years, and the majority were women. Only nine participants attended at least 70% of the sessions and completed the final evaluation. Men, those who did not complete high school, and workers in service or construction jobs were more likely to drop out. Knowledge about protective factors [pre- vs. post-intervention median (inter-quartile range) = 111 (100, 120) vs. 115 (100, 124)] and coping mechanisms [96 (85, 104) vs. 99 (90, 110)], as well as psychosocial distress [3 (2, 3) vs. 2 (2, 3)] improved after the intervention in both intent-to treat and complete case analyses ( < 0.05). Qualitative results also support improvements in targeted protective factors.
The intervention was successful in improving psychological distress among Mexican immigrants. These results support the implementation of evidence-based mental health promotion interventions among Mexican immigrants via free and familiar programs. A limitation was the high attrition; future studies should explore approaches to improve retention in this population.
在美国的墨西哥移民面临心理健康挑战、差异和有限的医疗保健机会;然而,专门针对这一人群的心理健康促进工作一直不足。本研究的目的是为通过亚特兰大的一个免费领事馆项目招募的墨西哥移民制定和测试一项基于保护心理健康因素和应对策略的心理健康促进干预措施。
与 Ventanilla de Salud 项目合作,我们进行了一项纵向研究,分为三个阶段:形成性研究和设计、干预前评估和实施后评估。该干预措施是基于健康促进模型和对利益相关者的访谈设计的。在干预前后,通过半结构化访谈收集参与者的定性信息。使用非参数 Wilcoxon 检验评估差异。对签署知情同意书的所有参与者进行意向治疗分析(携带最后观察向前),对参加至少 70%的课程并完成实施后评估的参与者进行完全案例分析。
共有 25 名参与者参加了干预。平均年龄为 38 岁,大多数为女性。只有 9 名参与者参加了至少 70%的课程并完成了最终评估。男性、未完成高中学业的人以及从事服务或建筑工作的人更有可能中途退出。干预前后,保护因素的知识[干预前与干预后中位数(四分位距)= 111(100,120)与 115(100,124)]和应对机制[96(85,104)与 99(90,110)]以及心理社会困扰[3(2,3)与 2(2,3)]均有所改善在意向治疗和完全案例分析中(<0.05)。定性结果也支持针对保护因素的改善。
该干预措施成功地改善了墨西哥移民的心理困扰。这些结果支持在墨西哥移民中实施基于证据的心理健康促进干预措施,通过免费和熟悉的项目。一个限制是高脱落率;未来的研究应探索改善这一人群保留率的方法。