Entertainment-Education? A Fotonovela?: A New Strategy to Increase the Self-Efficacy to Seek Mental Health Treatment among Immigrant Latinas

Among Latinos, women indicate a greater risk for depression than men and its prevalence increases as Latinas acculturate. Several barriers, such as stigma and low health literacy, separate Latinas from treatment. A fotonovela titled Secret Feelings, a form of entertainment-education, may be one strategy for effectively increasing mental health knowledge and the likelihood to seek depression treatment among immigrant Latinas at risk for depression and low health literacy. Immigrant Latinas in a large urban setting, not enrolled in treatment, were selected to participate in a study utilizing an experimental pretest- posttest control group design. Changes in levels of depression knowledge, stigma, and self-efficacy to seek treatment were compared between women (n = 75) exposed to the fotonovela and women (n = 65) exposed to treatment as usual. Independent samples t-tests results indicate significant posttest differences in depression knowledge (t = -7.0017, p < .000) and antidepressant stigma (t = 3.1306, p < .0023) between control and experimental group participants. Fisher's exact test results imply a more significant improvement in self-efficacy to identify symptoms of depression (p < .000) and to locate depression treatment (p < .000) among members of the experimental group, compared to control group participants. Results also indicate acceptable Cronbach's alphas for scales used to capture the response to the fotonovela, including the identification with story/characters subscale (.94) and the engagement with story/characters subscale (.88). Findings support health policies calling for implementation of culturally competent literacy tools in community settings to better educate immigrants about the importance of mental health treatment.