Intervention Trial to Reduce Mental Health Disparities in Latina Immigrant Women
2022年4月29日 更新者：India Ornelas、University of Washington
ALMA: A Randomized Control Trial of an Intervention to Reduce Mental Health Disparities in Mexican Immigrant Women
Latina immigrant women are particularly vulnerable to depression and anxiety due to the social and economic stressors they face, including high levels of poverty, low levels of education, family obligations, exposure to violence, and limited access to community resources.
ALMA aims to prevent and reduce depression and anxiety among Latina immigrant women.
Women attend 8 weekly sessions in a group format to teach and encourage women to use coping strategies to reduce depression and anxiety.
The intervention aims to increase participants' social ties and the social support they receive from other Latina immigrant women.
The program also helps decrease the stigma associated with mental health and connects women to mental health services when needed.
研究概览
详细说明
The proposed study aims to test the efficacy of the Amigas Latinas Motivando el Alma (ALMA) intervention in a randomized control trial.
ALMA is an 8-week program offered in a group format to teach women new coping strategies and enhance their social ties and social support to prevent and reduce their depression and anxiety.
Aim 1 of the proposed study is to refine the ALMA intervention and study procedures, using information learned from focus groups and cognitive interviews with Mexican immigrant women.
Aim 2 is to determine the efficacy of the ALMA intervention to reduce depressive and anxiety symptoms using a randomized control study design.
We will recruit women from community-based organizations serving Latino immigrants to participate in the program, which will be offered in community settings.
We will assess process outcomes of recruitment, retention, fidelity, and participant satisfaction through observations and in-depth interviews with participants.
We will assess the efficacy of the intervention by comparing changes in women's depressive and anxiety symptoms in the intervention and attention control groups at four time points (pre-intervention, post-intervention, 6 months, 9 months).
Aim 3 is to assess the potential impact of the intervention on both individual (stigma, stress, coping strategies) and interpersonal (social support, social ties) factors, and whether the impact of the intervention is mediated by these factors.
The research team includes investigators in psychology, medicine, social work and public health, as well as community-based organizations serving Latina immigrants.
The study uses rigorous methods to test an innovative program that integrates both culturally relevant and evidenced-based strategies to address significant mental health disparities in a high-risk and underserved population.
Findings will help inform future research and practice.
Given the growth of the Latino population, identifying interventions that reduce mental health disparities among Mexican immigrant women can have a significant public health impact.
研究类型
介入性
注册 (实际的)
226
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
-
Washington
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Seattle、Washington、美国、98144
- Casa Latina
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Seattle、Washington、美国、98144
- El Centro de la Raza
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-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 及以上 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
女性
描述
Inclusion Criteria:
- To be eligible for study participation, participants must be at least 18 years of age, female, speak Spanish, must self-identify as Latina, and have been born outside of the United States.
Exclusion Criteria:
- Participant screened for high levels of depressive symptoms (as indicated by a score of 20 or higher on the PHQ-9) which indicates severe symptoms. Participants with scores above 20 were referred to the licensed mental health counselor on the study team. If these women are not already receiving mental health treatment, they will be referred to mental health providers offering low-cost services in Spanish. The counselor will discuss participation in the program with the potential participants and make the final determination about their ability to participate based on the care they are currently receiving and the severity of their symptoms.
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：预防
- 分配：非随机化
- 介入模型：并行分配
- 屏蔽：双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的：ALMA Intervention Group
Amigas Latinas Motivando el Alma (ALMA).
This group receives the intervention after baseline assessment.
|
In a series of 8 weekly sessions, the program uses a group format to teach and encourage women to use coping strategies to reduce depression and anxiety. Over the course of the eight ALMA sessions, 25 women are (1) engaged in activities to identify coping strategies they are currently using and encouraged to continue to use them; (2) introduced to new coping strategies (e.g. mindfulness techniques, increased social ties and social support); and, (3) provided resources for seeking additional help if needed. Due to COVID-19 pandemic, the intervention was changed to online synchronous delivery via Zoom over 6 weekly sessions. |
|
其他：ALMA Delayed Intervention Control Group
Amigas Latinas Motivando el Alma (ALMA).
This group receives the intervention five months after the baseline assessment (after the post-intervention, and 3 month assessments have been completed).
|
In a series of 8 weekly sessions, the program uses a group format to teach and encourage women to use coping strategies to reduce depression and anxiety. Over the course of the eight ALMA sessions, 25 women are (1) engaged in activities to identify coping strategies they are currently using and encouraged to continue to use them; (2) introduced to new coping strategies (e.g. mindfulness techniques, increased social ties and social support); and, (3) provided resources for seeking additional help if needed. Due to COVID-19 pandemic, the intervention was changed to online synchronous delivery via Zoom over 6 weekly sessions. |
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Depressive Symptoms
大体时间：Change measure (baseline, 4 months, 6 months, 9 months)
|
Frequency of depressive symptoms as measured by the Patient Health Questionnaire 9 in the last two weeks.
The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression.
Scores range from 0 to 27.
In general, a total of 10 or above is suggestive of the presence of depression.
Depression Severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe.
|
Change measure (baseline, 4 months, 6 months, 9 months)
|
|
Anxiety Symptoms
大体时间：Change measure (baseline, 4 months, 6 months, 9 months)
|
Frequency of anxiety symptoms as measured by the General Anxiety Disorders 7 in the last two weeks.
Generalized Anxiety Disorder 7 (GAD-7) is a self-reported questionnaire for screening and severity measuring of generalized anxiety disorder (GAD).
Scores range from 0 to 21. Scores ≥10.
Anxiety Severity: 1-4 minimal symptoms, 5-9 mild symptoms, 10-14 moderate symptoms, 15-21 severe symptoms
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Change measure (baseline, 4 months, 6 months, 9 months)
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
压力
大体时间：变化测量（基线、4 个月、6 个月、9 个月）
|
上个月感知压力的频率。
感知压力量表 (PSS) 是一种经典的压力评估工具。
PSS 的个人分数范围为 0 到 40，分数越高表示感知到的压力越大。
0-13 之间的分数将被视为低压力。
分数范围为 14-26 将被视为中度压力。
27-40 的分数将被视为高感知压力。
|
变化测量（基线、4 个月、6 个月、9 个月）
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Recruitment
大体时间：Baseline
|
Number of participants that are recruited to participate in the study
|
Baseline
|
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Retention
大体时间：First 9 months after enrollment
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Number of participant that complete study procedures, including intervention sessions and surveys.
Satisfactory retention is defined as 80% of participants complete survey and 75% attending at least half of the intervention sessions.
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First 9 months after enrollment
|
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Participant Satisfaction
大体时间：4 months, 9 months
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Survey items related to program logistics such as convenience for participants, perception of facilitators, connection with other participants, and perceived efficacy of the intervention.
Response options of 1 - 5, with 5 indicating highest satisfaction
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4 months, 9 months
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：India J Ornelas, PhD, MPH、University of Washington
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2018年3月7日
初级完成 (实际的)
2021年12月15日
研究完成 (实际的)
2022年1月1日
研究注册日期
首次提交
2018年5月11日
首先提交符合 QC 标准的
2018年5月22日
首次发布 (实际的)
2018年6月4日
研究记录更新
最后更新发布 (实际的)
2022年5月5日
上次提交的符合 QC 标准的更新
2022年4月29日
最后验证
2022年4月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.