Online Program

337360
Understanding the Context and Meaning of Depression and Anxiety for Women in Rural Guanajuato, Mexico: Recommendations for a Mental Health Support Group Intervention


Monday, November 2, 2015

Liza Engstrom, MPH, Department of Health Behavior,, University of North Carolina Gillings School of Global Public Health, Carrboro, NC
Cristina Sansone, MPH Candidate, Department of Health Behavior,, University of North Carolina Gillings School of Global Public Health, , Chapel Hill, NC
Sandra Clark, MD, MPH, - Family Medicine Department, University of North Carolina, Chapel Hill

Background/Purpose: Proyecto Puentes de Salud has a documented rate of  50% prevalence of depression among women in rural Mexico. Few  women seek help for reasons including a scarcity of local resources, stigma associated with depression, and the costs of obtaining therapy. Our intervention program, entitled “Mujeres en Solidaridad Apoyandose” (MESA), trained “promotoras” (lay health workers) from rural communities outside the city of San Miguel de Allende, Guanajuato, Mexico. These promotoras led small group sessions for women in their communities. The training curriculum focused on peer support, coping techniques, and mental health education.

Methods:  Researchers conducted a pre-post mixed methods evaluation using the DASS-21 (Depression, Anxiety, and Stress Scale) questionnaire to measure depression, anxiety, and stress, and in-depth qualitative interviews to better understand contextual factors. The progress of the support groups were monitored for six weeks post-training and placement of promotores,

Findings: Participants demonstrated significant decreases in levels of depression (p=0.0011), anxiety (p=0.0003), and stress symptoms (p=0.0004), as well as increased levels of social support. Further analysis of qualitative evaluation research will be presented.  

Implications: Support groups for women in rural Mexico may alleviate symptoms of depression and anxiety. Public health organizations such as the DIF (Desarrollo Integral de Familia) throughout Mexico should consider implementing programs like MESA that train promotoras to facilitate these groups. The MESA curriculum may offer effective components that can be adapted for future mental health interventions that seek to address depression, anxiety, and stress.

Learning Areas:

Administer health education strategies, interventions and programs
Chronic disease management and prevention
Public health or related public policy
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Demonstrate how the MESA intervention significantly improved mental health of women in rural Mexico. Explain a successful replication of results in a new area (MESA had previously been implemented in a neighboring city in Mexico, Juventino Rosas). Explain the context and findings surrounding high depression and anxiety rates among women living in rural Mexico

Keyword(s): Chronic Disease Management and Care, Community-Based Partnership & Collaboration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: II am a MPH student and have completed research with this community under supervision of my mentor.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.