Mental Health Literacy Clinical Trial
Official title:
Entertainment Education for Depression in Latinx Adults: Testing Mediators and Moderators of a Culture-Centric Narrative Intervention to Promote Help-Seeking Behavior
Although rates of depression are similar in Latinx populations compared to non-Latinx whites (NLW), there are significant disparities in service utilization. Mental health literacy - one's knowledge and attitudes about mental health and treatment-seeking - is a significant predictor of help-seeking behavior and likely contributes to mental health disparities among Latinx. Understanding ways to improve mental health literacy in Latinx populations is important to reducing these disparities. Health literacy interventions that are engaging, dramatic, and culturally-relevant, such as fotonovelas (graphic novels designed to change health-related knowledge and attitudes), show promise in changing mental health literacy in Latinx populations. However, little is known about how these interventions work and for whom they are most effective. Furthermore, although there is some evidence that fotonovelas can change mental health attitudes and intent to seek treatment, their impact on help-seeking behavior is less understood. The purpose of this study is to examine 1) if narrative and cultural elements of a fotonovela for Latinx with depression (i.e., transportation, identification, and social proliferation) are important mediators in changing mental health attitudes and help-seeking behaviors and 2) if factors such as rurality, acculturation, depression severity and logistic barriers to treatment moderate these relationships.
Latinx adults with depression are a particularly vulnerable population; although Latinx
exhibit similar rates of depression to other racial/ethnic groups, they are less likely to
seek treatment, are more likely to drop out of treatment, and thus experience greater
chronicity of depression. This health disparity is likely due to a complex network of
factors, but mental health literacy is one important contributing factor. Latinx are more
likely to exhibit lower mental health literacy (including misconceptions, stigma, knowledge
of treatment, etc.), which contributes to lower rates of treatment-seeking. Understanding how
to engage Latinx in depression treatment by overcoming health literacy barriers is important
in reducing health disparities.
Entertainment-education interventions are those that use popular media to engage consumers
and deliver health messages. These interventions hypothesized to be useful in targeting
populations with health disparities in encouraging changes in health-related behavior through
dramatic and culturally-relevant narrative elements. However, no study has tested these
theorized mechanisms in helping to explain changes in health literacy and subsequent health
behavior.
This study will test the impact of a graphic novel about depression specifically for Latinx
adults with depressive symptoms on theorized mediators, including transportation (feeling
emotionally engaged in the narrative), identification (cultural relevance of characters,
their language, and their appearance), and social proliferation (sharing of health
information and mutual reinforcement of health behaviors). Furthermore, this study will test
if these mediators help explain changes in mental health literacy and subsequent health
behavior. Lastly, this study will test moderators of changes in mental health literacy and
behavior to determine for whom the fotonovela has the largest impact.
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