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 Depression and Anxiety: Contributing Factors and Barriers to Intervention.

BACKGROUND: Urban, ethnically/racially diverse, impoverished men are predisposed to experience unaddressed depression and anxiety. The overlap of these factors creates significant mental health inequity. AIMS: This study sought to capture men's impressions of the factors that contributed to their experience of depression and anxiety as well as barriers that they experienced in pursuing intervention. METHODS: Using community-based participatory research, in the context of long-term partnerships between a department of nursing and three urban, racially/ethnically diverse, and impoverished neighborhoods, the researchers recruited 50 men ages 23-83 years. Data were collected via six homogeneous, Zoom-based focus groups composed of Black, Hispanic, and White men, respectively. RESULTS: The men identified multiple themes pertaining to modifiable and non-modifiable contributing factors that played a role in their development of depression and anxiety as well as barriers related to stigma, resource issues, and a lack of knowledge of mental illness that they faced when seeking intervention. CONCLUSIONS: Understanding men's perspectives on the contributing factors and barriers to mental health intervention can provide an evidence base with which to address mental health inequity via tailored care, policy, and research agendas.

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 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.

Attending to Communication and Patterns of Interaction: Culturally Sensitive Mental Health Care for Groups of Urban, Ethnically Diverse, Impoverished, and Underserved Women.

BACKGROUND: The United States is ethnically diverse. This diversity presents challenges to nurses, who, without empirical evidence to design culturally congruent interventions, may contribute to mental health care disparities. OBJECTIVE: Using Leininger's theory of culture care diversity and universality, this study documented communication and interaction patterns of ethnically diverse, urban, impoverished, and underserved women. DESIGN: Using a community-based participatory research framework, 61 Black, Hispanic, and White women participated in focus groups around their experiences with anxiety/depression. Researchers recorded verbal communication, nonverbal behavior, and patterns of interaction. RESULTS: The women's communication and interaction patterns gave evidence of three themes that were evident across all focus groups and five subthemes that emerged along ethnic lines. CONCLUSIONS: The results suggest cultural universalities and cultural uniquenesses relative to the communication and interaction patterns of urban, ethnically diverse, impoverished, and underserved women that may assist in the design of culturally sensitive mental health care.