Women supporting women: Supportive/educative groups for ethnically diverse, urban, impoverished women dealing with depression and anxiety

Capturing men's perspectives on prevalence, existing resources, and solutions to depression and anxiety using community-based participatory research and focus groups

OBJECTIVE

Men are predisposed to suffer from unaddressed depression and anxiety. The purpose of this study was to capture the perceptions of men in three urban, racially/ethnically diverse, under-resourced, and impoverished neighborhoods around this health issue. The results were used to design a resident-driven solution to this health disparity.

DESIGN

Design This study utilized a focus group method within the ideological perspective of community-based participatory research (CBPR).

SAMPLE

Sample The researchers recruited 50 Black, Hispanic, and White men aged 23-83 years to participate in this study during the summer of 2021.

MEASUREMENTS

Measurements Data were collected via six homogeneous, Zoom-based focus groups. Five of the focus groups were offered in English and the sixth in Spanish.

RESULTS

The men identified themes and subthemes pertaining to the perception of widespread depression and anxiety in their neighborhoods, existing typical and atypical community resources, and suggested solutions to this health disparity. These results were translated into a solution involving the training of five male, lay mental health ambassadors.

CONCLUSIONS

Policies and solutions to issues of mental health disparity must be informed by the communities that they intend to serve. CBPR is a robust vehicle for empowering communities to address the healthcare issues facing them.

Men's mental health - Conceptualization, effects, and coping

Men are predisposed to suffer with unaddressed depression and anxiety. This study sought to empower men, in three urban, racially/ethnically diverse, underserved, and impoverished neighborhoods, for mental health self-care by capturing their perceptions of depression and anxiety. Using community-based participatory research, in the context of long-term partnerships between a department of nursing and these neighborhoods, the researchers recruited 50 men aged 23-83 years. Data were collected via six homogeneous, zoom-based focus groups composed of Black, Hispanic, and White men, respectively. The men identified themes pertaining to the conceptualization and devastating effects of depression and anxiety as well as coping strategies employed to mitigate the symptoms.

Women Supporting Women: The Use of Art With Anxious/Depressed, Urban, Impoverished, Ethnically Diverse Women

BACKGROUND: Depression and anxiety disproportionately affect urban, ethnically diverse, impoverished women-particularly when access to culturally sensitive care is limited. Using community-based participatory research in the context of long-term, academic/community partnerships, women supporting women, a supportive/educative group intervention piloting an art project, was offered. AIMS: The purpose of this study was to examine the impact of an artist book-making project on diverse women struggling with anxiety and depression. METHODS: A descriptive qualitative approach was used within this mixed-method study. Thirty-one participants, aged 18 to 86 years, were asked: (1) How does this book tell your story? (2) How did creating this book impact you personally? (3) How would you describe the experience of creating your book alongside women from our group? (4) How did this project help you with anxiety and depression? (5) What did you do with the book that you made? The framework method for analysis of qualitative data in multidisciplinary health research was used. RESULTS: Four themes, with corresponding subthemes, were identified: (1) personal story entailed expression of past, present, and future journey and mediums to depict the story; (2) method of coping included relaxation, diversion, and self-care; (3) creative impact encompassed affirmation of identity, empowerment, healing, pride in work, and a vehicle to connect; and (4) creating in community incorporated inspiration, sharing, and solidarity. CONCLUSIONS: These results suggest that an art project provides a culturally sensitive, clinically relevant, and cost-effective self-care intervention for vulnerable women struggling with anxiety and depression.

Factors affecting quality of life in low-income overweight and obese women: The mediating effects of health-promoting behaviors

BACKGROUND

It is necessary to comprehensively consider the personal and environmental factors of women who experience overweight or obesity and low-income households (WOOL) to improve their quality of life (QoL).

AIMS

The aim of this study was to test a hypothetical path model to estimate the effects of self-efficacy, psychological distress, social support, and health-promoting behaviors (HPB) on QoL and verify the mediating effects of HPB among WOOL.

METHODS

A total of 151 women with a monthly household income less than 50% of the national median income at eight welfare centers in South Korea participated in this study. Data were collected from January to December 2019 and analyzed using SPSS 25.0 and Amos 23.0.

RESULTS

The fit indices of the model were adequate (χ²  = 0.197, p = .657; normed χ²  = 0.197, GFI = 0.999, CFI = 1.000, NFI = 0.999, TLI = 1.000, RMSEA = 0.000, and SRMR = 0.005). Self-efficacy had significant indirect and total effects on QoL (β = 0.064, p = .004, 95% CI [0.015, 0.139]; β = 0.064, p = .004, 95% CI [0.015, 0.139]). HPB completely mediated the path of self-efficacy to QoL. Social support had significant total, direct, indirect, and total effects on QoL (β = 0.326, p = .001, 95% CI [0.010, 0.025]; β = 0.047, p = .015, 95% CI [0.008, 0.120]; β = 0.373, p = .001, 95% CI [0.015, 0.369]). HPB partially mediated the path of social support to QoL. Psychological distress had significant direct effects on QoL (β = -0.307, p = .001, 95% CI [-0.022, -0.007]). Self-efficacy, psychological distress, social support, and HPB explained 42.3% of the total variance in QoL.

LINKING EVIDENCE TO ACTION

Integrated nursing interventions that consider self-efficacy, psychological distress, social stress, and HPB can be useful for improving the QoL of WOOL.

Companionship as a method to reduce anxiety in pregnant women hospitalized during their third trimester

OBJECTIVE

The aim of this study was to study the association between pregnancy-related anxiety in women, screened during the third trimester, and companionship during their hospitalization.

METHOD

A case-control study was conducted in which 80 pregnant women over the age of 18 years, at 28 weeks and beyond, and without any diagnosed physical and/or health conditions took part. They were divided into 20 cases and 60 controls. Anxiety was measured using State-Trait Anxiety Inventory (STAI) and specific variables were recorded. A descriptive bivariate analysis was performed to compare the chosen variables by means of the chi-squared, Kruskal-Wallis H and Mann-Whitney U tests.

RESULTS

Companionship was associated with a reduction in state and trait anxiety ( p = 0.038 in both dimensions) during hospitalization. Women of the Roma (Gitano) ethnicity developed the most anxiety ( p = 0.019) and primiparous women were at four times greater risk.

CONCLUSION

The absence of support from a person of trust during hospitalization, together with ethnicity and primiparity, contributed to increased symptoms of anxiety in pregnant women hospitalized during their third trimester. Therefore, involvement by their close social circle is essential for the prevention and/or reduction of anxiety in this population.

A scoping review of the use of co-design methods with culturally and linguistically diverse communities to improve or adapt mental health services

Mental health services are increasingly encouraged to use co-design methodologies to engage individuals and families affected by mental health problems in service design and improvement. This scoping review aimed to identify research that used co-design methods with Culturally and Linguistically Diverse (CALD) communities in mental health services, and to identify methodological considerations for working with this population. In October 2019, we searched five electronic databases (CINAHL, PsycINFO, EMBASE, MEDLINE, Web of Science) to identify papers published in which people from CALD backgrounds were engaged in the co-design of a mental health service or program. Searches were limited to peer-reviewed articles published in English in the last 25 years (1993-2019). The search identified nine articles that matched the inclusion criteria. Using a scoping review methodology, the first author charted the data using extraction fields and then used qualitative synthesis methods to identify themes. Data were grouped into themes relevant to the research question. The two key themes relate first, to improving the experience for CALD communities when engaging in co-design research and second, to the development of co-design methods themselves. These findings support the need for further research into the transferability of co-design tools with CALD communities, particularly if co-design is to become a best practice method for service design and improvement. This scoping review identified methodological and practical consideration for researchers looking to use co-design with CALD communities for mental health service design, re-design or quality improvement initiatives. Further research is required to explore experiences of co-design methods, including documented protocols such as experience-based co-design, with CALD communities. This review indicates that explanatory models of mental health, community and co-design impact partnerships with CALD communities, and need to be understood to optimise the quality of these relationships when using co-design methods.

Factors impacting attrition of vulnerable women from a longitudinal mental health intervention study

OBJECTIVE

This study explored factors associated with attrition of vulnerable women from a community-based, longitudinal mental health intervention study.

DESIGN

The study employed a quasi-experimental, nonequivalent comparison group pretest-posttest design. The intervention consisted of six, 90-min meetings featuring education and support.

SAMPLE

One hundred and eighteen women aged 18-88 years enrolled from four urban neighborhoods.

MEASUREMENTS

The team used the Generalized Anxiety Disorder-7, the Primary Health Questionnaire-9, a self-care knowledge for anxiety and depression instrument, and demographics to measure variables.

INTERVENTION

Sessions occurred at trusted neighborhood sites. The team provided transportation, child care, and reminder calls or texts. Community health workers actively encouraged participants to continue in the study. The researchers did not offer financial incentives. Completion of the intervention involved attending four of six sessions.

RESULTS

The study had a 39% attrition rate. Results, using a Chi-square test for independence, indicated significant associations between attrition, neighborhood/homelessness, and family income. Additionally, there were significant associations between attrition, a past diagnosis of anxiety, and a lack of concurrent therapy for anxiety/depression.

CONCLUSIONS

This study identified social determinants and mental health factors linked to the attrition of urban, ethnically diverse, and impoverished women from longitudinal intervention studies.