University of Washington, School of Public Health, Department of Health Systems and Population Health, USA.
University of Washington School of Public Health, Department of Global Health, USA.
Soc Sci Med. 2023 Mar;321:115776. doi: 10.1016/j.socscimed.2023.115776. Epub 2023 Feb 16.
Latina immigrants are at increased risk of depression and anxiety and limited access to mental health care. This study evaluated the effectiveness of Amigas Latinas Motivando el Alma (ALMA), a community-based intervention to reduce stress and promote mental health among Latina immigrants.
ALMA was evaluated using a delayed intervention comparison group study design. Latina immigrants (N = 226) were recruited from community organizations in King County, Washington from 2018 to 2021. Although originally developed to be delivered in-person, due to the COVID-19 pandemic the intervention was adapted mid-study to be delivered online. Participants completed surveys to assess changes in depression and anxiety post-intervention and at a two-month follow-up. We estimated generalized estimating equation models to assess differences in outcomes across groups, including stratified models for those receiving the intervention in-person or online.
In adjusted models, participants in the intervention group had lower levels of depressive symptoms than the comparison group post-intervention (β = -1.82, p = 0.01) and at two-month follow-up (β = -1.52, p = 0.01). Anxiety scores decreased for both groups, and there were no significant differences post-intervention or at follow-up. In stratified models, participants in the online intervention group had lower levels of depressive (β = -2.50, p = 0.007) and anxiety (β = -1.86, p = 0.02) symptoms than those in the comparison group, but there were no significant differences among those that received the intervention in-person.
Community-based interventions can be effective in preventing and reducing depressive symptoms among Latina immigrant women, even when delivered online. Further research should evaluate the ALMA intervention among larger more diverse Latina immigrant populations.
拉丁裔移民患抑郁症和焦虑症的风险增加,且获得精神保健的机会有限。本研究评估了基于社区的 Amigas Latinas Motivando el Alma(ALMA)干预措施的有效性,该干预措施旨在减轻拉丁裔移民的压力并促进其心理健康。
采用延迟干预对照组研究设计来评估 ALMA。2018 年至 2021 年,从华盛顿州金县的社区组织招募拉丁裔移民(N=226)参与研究。虽然最初是为面对面交付而开发的,但由于 COVID-19 大流行,该干预措施在研究过程中进行了调整,改为在线交付。参与者完成了调查,以评估干预后和两个月随访时的抑郁和焦虑变化。我们估计了广义估计方程模型,以评估组间结果的差异,包括针对在线或面对面接受干预的人群的分层模型。
在调整后的模型中,干预组参与者的抑郁症状水平低于对照组,干预后(β=-1.82,p=0.01)和两个月随访时(β=-1.52,p=0.01)。两组的焦虑评分均降低,且干预后和随访时均无显著差异。在分层模型中,在线干预组参与者的抑郁(β=-2.50,p=0.007)和焦虑(β=-1.86,p=0.02)症状水平低于对照组,但面对面接受干预的人群中则没有显著差异。
即使是在线交付,基于社区的干预措施也可以有效预防和减轻拉丁裔移民女性的抑郁症状。应进一步研究在更大、更多样化的拉丁裔移民群体中评估 ALMA 干预措施的效果。