Comparative effectiveness of an activation intervention for Latino parents raising children with mental health needs

Research Objective: This study examines the comparative effectiveness of an activation intervention for Latino mothers raising children with mental health needs. Activation is a promising strategy to reduce disparities because it supports the development of attitudes and skills that position the client to change their behavior and build self-efficacy.  We will describe the impact of the intervention on patient-centered outcome measures, standard measures and measures suggested by our Latino participant advisors.

Study Design: A randomized controlled trial was conducted of a 4-week, 1 hour/week psycho-educational intervention to teach activation skills, compared to a support group control, in a Spanish-language mental health clinic that serves children and families (n=180).  The protocol was developed with the help of Spanish-language clinic staff and a focus group comprised of Latina mothers with 'lived experience" in the mental health system. As the study progressed, we established a Latino mentor parent group to advise with on-going design and implementation decisions.  Mothers who participated in the study were surveyed at baseline, one and 3 months. Difference-in-difference models using fixed effects regression were estimated to assess changes in mothers’ self-reported activation and the quality of their school interactions.

Principal Findings: Patient activation, school activation and the quality of school involvement scores were high at baseline. Mean levels of all measures increased from baseline to 1 and 3-month assessments (p<0.001) and are highly correlated at month 3 (p<0.01). Parent-reported increase in activation skills with mental health service providers and school personnel was greater among the intervention compared to the control group at the 1-month assessment (p<0.05). Preliminary data suggest that the increase in school activation was also greater among the intervention compared to the control group at the 3-month assessment (p<0.01). 

Conclusions: A psycho-educational intervention was successful in raising Latino mothers’ report of activation with their child’s mental health providers, school personnel, and the quality of their interactions with their child’s school. Sustainable support for this group intervention and promising avenues for dissemination, such as schools, will be important to explore.