Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107832

Julia Muennich Cowell, PhD, RNC, FAAN¹, Diane B. McNaughton, PhD, RN², Sarah H. Ailey, PhD, RN¹, Louis Fogg, PhD³, and Deborah A. Gross, DNSc, RN, FAAN¹. (1) College of Nursing, Community and Mental Health Nursing, Rush University, 600 South Paulina, 1080 Armour Academic Center, Chicago, IL 60612, (312) 942-5836, julia_cowell@rush.edu, (2) Department of Community and Mental Health Nursing, Rush University College of Nursing, 600 S. Paulina Street, Suite 1080, Chicago, IL 60612, (3) Community and Mental Health Nursing, Rush University, 600 South Paulina, Chicago, IL 60612

Mexican American children and youth present the highest rates of depression and suicide ideation. At the advice of the Surgeon General to address the mental health crisis, researchers are describing mental health problems and testing interventions to address this crisis. The purpose of this paper is to report the initial outcomes of a randomized clinical trial testing a public health nursing mental health promotion intervention delivered mothers and after school classes to their fourth and fifth grade children. The intervention is delivered by public health nurses. The Rush Mexican American Problem Solving Model (Rush MAPS) guided the study. The model has three elements that focus on personal and background factors, interaction factors and outcome factors. Subjects (n = 302) were recruited from schools that were randomly assigned to treatment or control conditions. Assessments were made on home visits at baseline, 20 and 60 weeks after baseline. Intervention home visits (6-10) were delivered to mothers individually and linked classes were delivered to groups of up to five children. Outcome measures included mothers' reports of family functioning and mental health. Children's outcome measures included health conceptions, self esteem and mental health. Reliabilities for the measures are acceptable ranging from 0.62 to 0.94. Depression rates were significant for mothers and children in both groups with 34% of mothers and 31% of children referred for further screening. Of greater concern, 38% of children reported suicide ideation. Mental health scores improved for mothers and children in both groups. Improvements in family functioning were not statistically significant. Among children in the intervention, there were statistically significant improvements in health conceptions and self-esteem, compared to their peers in the control group. Children's personal characteristics related to self-esteem and health conceptions are the most powerful predictors of depression. Issues related to mental health measurement and outcomes will be discussed. Given the limitations, the preliminary evidence supports the effectiveness of the intervention.

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