Alpha Omega Alpha Honor Medical Society

2011 Research Abstract

MESA: A Promotora-Based Women's Mental Health and Social Support Intervention in Rural Mexico

Investigator: Kathryn McKenney, University of North Carolina at Chapel Hill School of Medicine

Co-investigators: Jason Bischof, Lilli Mann, Heather Edelblute, Jacob Stein, Sandra Clark, Christine Kistler

Mentor: Sandra Clark, MD, University of North Carolina at Chapel Hill School of Medicine

The purpose of this study is to examine the effectiveness of Mujeres en Solidaridad Apoyandose (MESA), an expanded mental health and social support intervention aimed at improving the mental health of women in rural Mexican communities affected by emigration.

During previous trips to the target community, medical students from UNC identified a need for mental health interventions in rural Mexican women using the PHQ-9 depression rating scale in the summer of 2007; over 60% of the women surveyed were eligible to receive a diagnosis of depression (n=343).

Support group leaders (promotoras) and participants were recruited with the help of local community leaders. Promotoras were screened for depression. Those with satisfactory CES-D scores then received 15 hours of training in the MESA model during one week. The promotoras each led five support group sessions over five weeks according to the MESA curriculum, followed by structured monthly sessions. Pre- and post-intervention demographic information, CES-D scores, and Social Support Scale scores were collected from participants before and after the set of five weekly sessions. Pre- and post-intervention data were collected from 40 of the 60 participants who completed a majority of the intervention sessions. Participants were categorized as mildly, moderately, or severely depressed by baseline CES-D score. CES-D scores decreased among women with moderate and severe depressive symptoms. Social Support Tool scores increased in all three groups. Considerable variation existed in both CES-D and Social Support Tool scores between promotora groups.

There are various limitations to the study model, which include the lack of a control group and intervention time. However, results from this limited intervention suggest that women with moderate and severe depressive symptoms benefited from the MESA intervention with increased social support and decreased depressive symptoms. Further study with larger numbers of participants is necessary to clarify the effect.

Updated on January 10, 2012.

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