UC Berkeley

Recent studies find a high risk of depression among immigrant Latinas known to increase during the acculturation process. Several barriers, such as stigma and low health literacy, frequently separate Latinas from treatment. In response this study aimed to replicate the effectiveness of Entertainment-Education (E-E), in the form of a Spanish language fotonovela, in increasing depression literacy among immigrant Latinas at risk for depression. This study specifically sought to assess if exposure to the fotonovela, delivered in a multifaceted approach to health education used by promotoras, improved depression knowledge, the self-efficacy to identify the need for treatment, and the intent to seek treatment while reducing stigma towards depression treatment. Additional exploratory research assessed the participants' response to the fotonovela. Through a mixed methods approach comprised of quantitative data (employing a pretest-posttest randomized control group experimental design) and qualitative data (composed of structured follow- up interviews) 142 immigrant Latinas in a large urban setting were included in this study. Results indicate statistically significant posttest differences in depression knowledge, self-efficacy to identify the need for treatment, and antidepressant stigma between control and experimental group participants. Results also suggest a positive response to the fotonovela reflected in the participants' identification and engagement with the story and its characters. Follow-up interviews detect most participants discussed the content of the fotonovela with friends whom they identified as depressed. Findings suggest use of cost effective E-E health literacy tools, in combination with the multifaceted approach to health education used by promotoras, may increase mental health knowledge and intention to share knowledge among underserved populations. Further mixed methods research is recommended in the continued assessment of mental health literacy among Latinos and development of culturally competent mental health literacy tools.