Immigrant Wellbeing Project Study Protocol: Addressing the Socio-Structural Determinants of Latinx Immigrant Mental Health.

The goal of the (IWP) study is to test a transdisciplinary ecological approach to reducing Latinx immigrants' mental health disparities by adapting and integrating a multilevel community-based advocacy, learning, and social support intervention into existing efforts at four community partner organizations that focus on mental health, education, legal issues, and community mobilization for Spanish-speaking immigrants. This protocol paper describes a study designed to advance the science of multilevel interventions and health equity through the conceptualization of the IWP intervention model as one component of complex processes and interventions that aim to create sustainable change at multiple levels. After completing in-depth qualitative interviews with 24 Latinx immigrants to elucidate their mental health needs, stressors, political/economic/social context, and local solutions, and a process of community engagement and intervention adaptation, a mixed methods strategy with data collected from 60 participants at four timepoints over 12 months will be used to test the impact of the 6-month intervention on reducing psychological distress, increasing protective factors, and achieving system-level changes in policies and practices that impact Latinx immigrants' well-being. Mechanisms of change will be explored by testing mediating relationships between protective factors and distress. Qualitative data will explore feasibility, acceptability, and participants' experiences; document multilevel changes and the context of implementation; and inform interpretation of quantitative data. Data on quality of community partnerships and their relationship to multilevel outcomes will also be examined. This paper describes the theoretical foundation, research design, qualitative and quantitative analysis plans, and innovations of the study.