The novel coronavirus (COVID-19) pandemic has created an unprecedented global health challenge. There is risk that the outbreak will create a “second pandemic” of mental health crises in health systems and communities. Thus, a comprehensive public health response to the pandemic must include (a) attention to the psychological aspects of hospitalization for patients, families, and staff affected by COVID-19; (b) planning for emergency and acute psychiatric patient care if hospitals become overwhelmed with COVID-19 patients; and (c) innovations for providing mental health care in communities while social distancing is required and health system resources are strained. Nurses and nurse leaders must anticipate these mental health challenges, assist with preparedness in health systems and communities, and advocate for a coordinated response to promote mental wellness and resilience.

PURPOSE We undertook a study to describe factors related to depression and posttraumatic stress disorder (PTSD) among pregnant Latinas who were or were not exposed to intimate partner violence. METHODSWe interviewed 210 pregnant Latinas attending prenatal clinics located in Los Angeles, California. Latinas who did and did not have histories of intimate partner violence were recruited. We then assessed the women for strengths, adverse social behavioral circumstances, posttraumatic stress disorder (PTSD), and depression. RESULTSSignifi cantly more women exposed to intimate partner violence scored at or above the cutoff point for depression than women who were not (41% vs 18.6%; P <.001). Signifi cantly more women exposed to intimate partner violence scored at or above the cutoff point for PTSD than women who were not (16% vs 7.6%; P <.001). Lack of mastery, which measures feelings of being in control of forces that affect life (odds ratio [OR], 0.72; 95% confi dence interval [CI], 0.62-0.84), a history of trauma not associated with intimate partner violence (OR, 1.33; 95% CI, 1.08-1.63), and exposure to intimate partner violence (OR, 2.43; 95% CI, 1.16-5.11) were associated with depression after adjusting for age, language of interview, and site effects. Stress (OR, 1.72; 95% CI, 1.34-2.2) and a history of trauma (OR, 1.45; 95% CI, 1.03-2.04) were independently associated with PTSD, whereas higher income was associated with decreased risk of PTSD (OR, 0.10; 95% CI, 0.02-0.63), after adjusting for age, language of interview, and site effects.CONCLUSIONS Intimate partner violence was signifi cantly associated with depression and PTSD but was associated with depression only after controlling for other factors in the multivariate model. The risk for depression declined with greater mastery but increased with a history of trauma or exposure to intimate partner violence. Stress, a history of trauma not associated with intimate partner violence, and lower income were all independently associated with increased risk for PTSD. INTRODUCTIONA pproximately 1.5 million women in the United States experience intimate partner violence every year. [1][2][3][4][5][6][7][8][9][10][11][12][13] The prevalence among pregnant women is estimated at 5.2%.14 Thus, intimate partner violence is at least as common as gestational diabetes (2% to 3%) and approaches rates of preeclampsia (5.7% to 14.3%). 15 Moreover, 23% to 52% of women who experienced abuse during pregnancy were battered in the year before conception. 5,16,17 Women abused during pregnancy have 3 times the odds of attempted or completed homicide, 18 are more likely to have unplanned pregnancies and seek pregnancy care after 20 weeks, and are at greater risk for adverse birth outcomes 19 and maternal complications. [20][21][22][23] Intimate partner violence is also associated with such adverse health behaviors as smoking [24][25][26] and problem drinking. 26,27 The prevalence of intimate partner violence among Latinas in the United States during pregnancy and the perin...

As an immigrant population becomes more prominent in an established culture, research strategies for examining intragroup differences are needed to understand their health care risks and strengths. However, acculturation also must be taken into account. Our objective in this secondary analysis was to identify the most useful acculturation parameter for examining depressive symptoms in relation to strengths and resources among women of Mexican descent living in the United States during the vulnerable perinatal period and to examine other intragroup differences among the women by childbearing status (pregnant or postpartum). Our secondary analysis was done with a subsample of 129 women from a larger cross-sectional study of 315 women of Mexican descent who were recruited from three urban community health centers and an associated bilingual school in the United States. Exposure to the United States in childhood, a poor sense of mastery, and dissatisfaction with life were more related to depressive symptom experience than childbearing status or more traditional demographic variables such as age, income, or education.

This study assessed the course of perinatal depression amongst 210 Latinas who were and were not affected by intimate partner violence (IPV) and identified associated psychosocial factors. Peak depression prevalence occurred prenatally among 45.7% of IPV-exposed and 24.6% of non-IPV-exposed Latinas. At each assessment, depression was significantly higher for IPV-exposed compared to non-IPV-exposed mothers. Mastery and social support were associated with lower depression, while history of IPV, perceived stress and avoidant coping behaviors were associated with higher depression. Findings support recommendations for routine depression and IPV screening of Latinas in perinatal clinical settings.

Although intrinsic strength factors have rarely been included in research related to depression in women of Mexican descent, they were more directly related to lack of depressive symptoms than traditional demographic risk factors.

The purpose of this study is to test the reliability and validity of a Spanish translation of the Resilience Scale (RS), which was originally created in English by Wagnild and Young (1993). A team of bilingual, bicultural translators participated in the translation process to enhance the linguistic accuracy and cultural appropriateness of the Spanish translation. As part of the convenience sample of 315 women of Mexican descent who participated in the larger study, data from 147 women who preferred to read and write in Spanish were used in this analysis. The English version of the RS consists of a 17-item "Personal Competence" subscale and an 8-item "Acceptance of Self and Life" subscale for a total of 25 items. However, two items had low item-total loadings and were removed to form a modified 23-item RS. The exploratory principal components factor analysis, varimax rotation, and subsequent goodness of fit indices were ambivalent on whether a one or two-factor solution was appropriate, but the chi-square difference test clearly demonstrated that the two-factor solution of the Spanish version was more useful in explaining variance than a one-factor solution. Internal consistency reliability was estimated with Cronbach's alpha (alpha = 0.93) which was acceptable for the 23-item RS as well as its subscales. Construct validity was demonstrated by a significant positive correlation between resilience and life satisfaction (r = 0.36; p < 0.001), and a significant negative correlation between resilience and depressive symptoms (r = -0.29; p < 0.01). This analysis ultimately supports the appropriateness of the modified 23-item Spanish translation of the RS and its subscales in a sample of urban, low-income women of Mexican descent in the U.S.

Aim To describe immigrant Latinas’ perspectives of a lifestyle behavior intervention, focusing on their interactions with and perceptions of the promotoras who delivered the program in the United States. Background Immigrant Latinas in the United States have high obesity rates, which contribute to increased risk for cardiovascular disease and other chronic diseases. Interventions using the promotora model appear to be effective in reducing cardiovascular disease risk by improving dietary habits, physical activity, and selected clinical variables among Latinas. However, there has been very limited inquiry into what it is about these interventions and promotoras that facilitates behavior change, from the perspective of participants. Design Grounded theory methodology guided the data collection and analysis. Methods This qualitative study was completed in 2012 in California, after the end of a lifestyle behavior intervention. Four focus groups and seven one-on-one interviews were conducted with a total of 18 immigrant Latina intervention participants. Results Women described promotoras as helping them change by motivating them through three interconnected elements: tools, support, and knowledge. Latinas viewed their ability to make lifestyle changes as connected with their emotional and psychological health, and saw promotoras as counselors who provided emotional and social support. In this respect, the intervention was emotionally therapeutic for this sample of Latinas, although this was not the original intention of the program. Conclusion Promotoras provided the backbone of the intervention and were crucial in motivating Latinas to implement lifestyle changes. Future lifestyle behavior interventions should include a strong component of mental and emotional well-being.

BackgroundLatinos report higher rates of depression and anxiety than US whites but are less likely to receive care. Transmedia storytelling interventions accessible on the Internet via smartphones, tablets, and computers hold promise for reducing reluctance to explore or get help for symptoms because they are private, convenient, and can reach large numbers of people, including Latinas with mental health needs.ObjectiveThe purpose of this study was to examine the feasibility, acceptability, and preliminary efficacy of a mental health transmedia intervention for Latinas with elevated symptoms of depression, anxiety, or both.MethodsA total of 28 symptomatic English-speaking Latina women aged 21 to 48 years participated in a 6-week study using a within-group design. All aspects of the study were completed via telephone or Internet. Participants used their personal devices to engage the Web-based transmedia intervention (in English) that included story-based videos, a data-informed psychotherapeutic video, an interactive video sequence, and a blog written from the point of view of one of the characters with links to mental health resources. Perceived confidence to get help and perceived importance for seeking immediate help were both measured using single-item questions. Participants completed surveys at baseline (via telephone) and 1 and 6 weeks after media engagement that measured various factors, including depression (Patient Health Questionnaire; PHQ-9 and PHQ-8) and anxiety (Generalized Anxiety Disorder scale; GAD-7). A telephone interview was conducted within 72 hours of media engagement. Action taken or intentions to get help (single-item question) and talking about the videos with others (single-item question) were measured 1 and 6 weeks after media engagement. Repeated measures analysis of variance was used to assess change in depression (PHQ-8) and anxiety (GAD-7) before transmedia engagement and 1 and 6 weeks after. Spearman correlations evaluated the association of confidence and importance of getting help with action taken, anxiety, and depression.ResultsAll 28 Latinas (English speakers) who engaged with the transmedia remained in the 6-week study. Within 1 week of transmedia engagement, 39% of women took action to get help, and 82% discussed the media with others. Symptoms of depression (F2,54=9.0, P<.001) and anxiety (F2,54=18.7, P<.001) significantly reduced across time. Higher levels of confidence were significantly associated with actions taken at 1 (P=.005) and 6 weeks (P=.04), and higher levels of importance were significantly associated with actions taken at 1 (P=.009) and 6 weeks (P=.003). Higher levels of confidence were associated with lower levels of depression (P=.04) and anxiety (P=.01) at 6 weeks.ConclusionsPreliminary findings indicate a culturally tailored mental health transmedia intervention is a feasible approach that holds promise for engaging large numbers of symptomatic English-speaking Latina women to begin the process of seeking help, as well as decreasing symptoms of anxiety and...