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.

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.

Impact of Integrating Community-Based Participatory Research Into a Baccalaureate Nursing Curriculum.

BACKGROUND: Community-based participatory research (CBPR) is rapidly gaining respect within the health care community as a means to promote public health and address health disparities. It has also recently been named as one of the competencies needed by public health professionals to be effective. METHOD: This article describes an educational innovation where CBPR is integrated into a baccalaureate nursing curriculum as a strategy to create meaningful learning experiences for nursing students while benefitting the health of the community. RESULTS: The impact of this approach was analyzed over a period of 12 years. The positive outcomes for the community, students, and faculty are described, along with the unique challenges. CONCLUSION: Integrating CBPR into a nursing curriculum is an innovation that is worthy of further assessment.

Conducting Research With Community Groups.

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. Although several barriers to conducting research with community groups exist, community-based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This article presents case studies that demonstrate how CBPR principles guided the development of (a) a healthy body weight program for urban, underserved African American women; (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women; and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research-intensive academic environments.

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.

Using community-based participatory research to explore social determinants of women's mental health and barriers to help-seeking in three urban, ethnically diverse, impoverished, and underserved communities.

Depression and anxiety are significant mental health issues that affect urban, ethnically diverse, impoverished women disproportionately. This study sought to identify social determinants of mental health and barriers to help-seeking for this population. Using community based participatory research and focus groups, sixty-one Black, Hispanic, and White women identified economic, family, cultural, and neighborhood issues as perceived determinants of their depression/anxiety. They identified practical, psychosocial, and cultural barriers to their help-seeking behavior. These results can promote women's health by fostering an understanding of social factors as perceived determinants of depression/anxiety and shaping practice and policy initiatives that foster positive aggregate outcomes.

Desired mental health resources for urban, ethnically diverse, impoverished women struggling with anxiety and depression.

Depression and anxiety are mental health issues that disproportionately affect women-particularly when access to culturally sensitive care is limited. The purpose of this study was to identify mental health concerns in three urban, ethnically diverse, underserved, and impoverished neighborhoods using the ideological perspective of community-based participatory research. In the context of long-term partnerships between a department of nursing and these neighborhoods, we recruited 61 women aged 18 to 69 years and collected data via homogeneous focus groups comprised of Black, Hispanic, and White women, respectively. We conducted five of the focus groups in English and one in Spanish. The women perceived anxiety and depression as significant concerns for themselves, their families, and their communities. They used unique community resources to manage mental health issues and desired new resources, including support groups and education.

Clinging to any bit of joy: urban, ethnically diverse, impoverished women's descriptions of anxiety and depression.

Depression and anxiety are mental health issues that disproportionately affect women. This study sought to capture perceptions of anxiety and depression in 3 urban, ethnically diverse, underserved, and impoverished neighborhoods. Using community-based participatory research, in the context of long-term partnerships between a department of nursing and these neighborhoods, the researchers recruited 61 women aged 18 to 69 years. Data were collected via 6 homogeneous focus groups composed of Black, Hispanic, and White women, respectively. The women identified themes pertaining to the manifestations and effects of anxiety and depression as well as unique coping strategies.