Abstract
Lack of knowledge and negative attitudes towards mental health is linked to low utilization of services among Latinxs. Entertainment-education videos have been effective at increasing literacy and reducing stigma across different health domains but Latinxs have not been a focus of research. We developed an E-E video aimed at reducing stigma and increasing mental health literacy. Focus groups (N = 28) and expert consultants (N = 2) were used to aid in the development of the video. After the video was developed, we conducted a randomized control trial (RCT) in which Latina participants (N = 111) were assigned to view the video or receive an informational brochure. Results indicated that participants in the video intervention condition experienced statistically significant increases in mental health literacy as compared to the participants in the flyer condition and that both the video and the flyer contributed to shifts in stigma.
Similar content being viewed by others
References
Agency for Healthcare Research and Quality (AHRQ). (2016). Nonpharmacological versus pharmacological treatments for adult patients with major depressive disorder. Retrieved from https://effectivehealthcare.ahrq.gov/topics/major-depressive-disorder/research-protocol/
Alegria, M., Mulvaney-Day, N., Torres, M., Polo, A., Cao, Z., & Canino, G. (2007). Prevalence of psychiatric disorders across Latinos subgroups in the United States. American Journal of Public Health, 97, 68–75.
Anastasia, E. A., & Bridges, A. J. (2015). Understanding service utilization disparities and depression in Latinos: The role of Fatalismo. Journal of Immigrant and Minority Health, 17, 1758–1764. https://doi.org/10.1007/s10903-015-0196-y
Asnaani, A., Richey, J. A., Dimaite, R., Hinton, D. E., & Hofmann, S. G. (2010). A cross-ethnic comparison of lifetime prevalence rates of anxiety disorders. The Journal of Nervous and Mental Disease, 198(8), 551–555. https://doi.org/10.1097/NMD.0b013e3181ea169f
Atkin, C. K., & Freimuth, V. S. (2001). Formative evaluation research in campaign design. In R. E. Rice & C. K. Atkin (Eds.), Public communications campaign. Sage.
Baezconde-Garbanati, L. A., Chatterjee, J. S., Frank, L. B., Murphy, S. T., Moran, M. B., Werth, L. N., … O’Brien, D. (2014). Tamale lesson: A case study of a narrative health communication intervention. Journal of Communication in Healthcare, 7(2), 82–92.https://doi.org/10.1179/1753807614Y.0000000055
Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52, 1–26. https://doi.org/10.1146/annurev.psych.52.1.1
Benuto, L. T., Gonzalez, F., Reinosa Segovia, F., & Duckworth, M. (2019). Mental health literacy, stigma, & behavioral health service use: The case of Latinx and non-Latinx whites. Journal of Racial and Ethnic Health Disparities, 6(6), 1122–1130. https://doi.org/10.1007/s40615-019-00614-8
Benuto, L. T., Casas, J., Gonzalez, F., & Newlands, R. (2020). The behavioral model of health: Education, behavioral health factors, and stigma as predictors of help-seeking attitudes. Community Mental Health Journal. https://doi.org/10.1007/s10597-020-00601-y
Benuto, L.T., Zimmerman, M., Casas, J., Gonzalez, F., & Newlands, R. (2021). ¡No me duele cuando me deprimo! An examination of ethnic differences in depression symptoms among Latinx and non-Latinx Primary Care Patients. Journal of Immigrant and Minority Health. https://doi.org/10.1007/s10903-021-01238-z
Booker, N. A., Miller, A. N., & Ngure, P. (2016). Heavy sexual content versus safer sex content: A content analysis of the entertainment education drama shuga. Journal Health and Communications, 31, 1437–1446. https://doi.org/10.1080/10410236.2015.1077691
Borrayo, E. A. (2004). Where’s Maria? A video to increase awareness about breast cancer and mammography screening among low-literacy Latinas. Preventive Medicine, 39, 99–110. https://doi.org/10.1016/j.ypmed.2004.03.024
Borrayo, E. A., Rosales, M., & Gonzalez, P. (2016). Entertainment-education narrative versus nonnarrative interventions to educate and motivate Latinas to engage in mammography screening. Health Education Behavior, 44(3), 394–402. https://doi.org/10.1177/1090198116665624
Brame, C.J. (2015). Effective educational videos. Retrieved September 1, 2017 from http://cft.vanderbilt.edu/guides-sub-pages/effective-educational-videos/
Bridges, A. J., Andrews, A. R., 3rd., & Deen, T. L. (2012). Mental health needs and service utilization by Hispanic immigrants residing in mid-southern United States. Journal of Transcultural Nursing, 23(4), 359–368. https://doi.org/10.1177/1043659612451259
Bridges, A. J., Andrews, A. R., Villalobos, B. T., Pastrana, F. A., Cavell, T. A., & Gomez, D. (2014). Does integrated behavioral health care reduce mental health disparities for Latinos? Initial Findings. Journal of Latina/o Psychology, 2(1), 37–53. https://doi.org/10.1037/lat0000009
Cabassa, L. J., Ezell, J. M., & Lewis-Fernandez, R. (2010). Lifestyle interventions for adults with serious mental illness: A systematic literature review. Psychiatric Services, 61(8), 774–782. https://doi.org/10.1176/ps.2010.61.8.774
Cabassa, L. J., Oh, H., Humensky, J. L., Molina, G. B., Unger, J. B., & Baron, M. (2016). Comparing the impact on Latinxs of a depression brochure and an entertainment-education depression fotonovela. Psychiatric Services, 66(3), 313–316. https://doi.org/10.1176/appi.ps.201400146
Cardemil, E.V., Nelson, T., Keefe, K. (2015). Racial and Ethnic Disparities in depression treatment. Current Opinion in Psychology, 4, 37–42. https://doi.org/10.1016/j.copsyc.2015.01.021.
Chang, C., & Biegel, D. E. (2017). Factors affecting mental health service utilization among Latino Americans with mental health issues. Journal of Mental Health. https://doi.org/10.1080/09638237.2017.1385742
Cohen, Y., Gafni, N., & Hanani, P. (2007). Translating and adapting a test, yet another source of variance; the standard error of translation. A paper submitted to the annual meeting of the IAEA Baku, Azerbaijan, September 2007. Retrieved from: https://www.researchgate.net/publication/236731046_Translating_and_Adapting_a_Test_yet_another_Source_of_Variance_the_Standard_Error_of_Translation
Fisher, E. H., & Turner, J. I. (1970). Orientations to seeking professional help: Development and research utility of an attitude scale. Journal of Consulting and Clinical Psychology, 35, 79–90. https://doi.org/10.1037/h0029636
Frank, R. G., Pindyck, T., Donahue, S. A., Pease, E. A., Foster, M. J., Felton, C. J., & Essock, S. M. (2006). Impact of a media campaign for disaster mental health counseling in post-September 11 New York. Psychiatric Services, 57(9), 1304–1308. https://doi.org/10.1176/ps.2006.57.9.1304
Fu, R., & Holmer, H.K. (2015). Change score or followup score? An empirical evaluation of the impact of choice of mean difference estimates. Agency for Healthcare Research and Quality (US). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK294288/
Gonzalez, F. R. (2015). Assessing psychological distress, experiential avoidance, and mental healthcare access among a Latino community sample (Unpublished Masters Thesis). University of Nevada.
Griffiths, K. M., Christensen, H., Jorm, A. F., Evans, K., & Groves, C. (2004). Effect of web-based depression literacy and cognitive behavioural therapy interventions on stigmatizing attitudes to depression. British Journal of Psychiatry, 185, 342–349. https://doi.org/10.1192/bjp.185.4.342
Griffiths, K. M., Batterham, P. J., Barney, L., & Parsons, A. (2011). The generalized anxiety stigma scale (GASS): Psychometric properties in a community sample. BMC Psychiatry, 11, 184–184. https://doi.org/10.1186/1471-244X-11-184
Hernandez, M. Y., & Organista, K. C. (2013). Entertainment–Education? A fotonovela? A new strategy to improve depression literacy and help-seeking behaviors in at-risk immigrant Latinas. American Journal of Community Psychology, 52, 224–235. https://doi.org/10.1176/ps.2010.61.8.774
Hernandez, R., Ruggiero, L., Prohaska, T. R., Chavez, N., Boughton, S. W., Peacock, N., Zhao, W., & Nouwen, A. (2016). A cross-sectional study of depressive symptoms and diabetes self-care in African Americans and Hispanics/Latinos with diabetes: The role of self-efficacy. Diabetes Education, 42, 452–461. https://doi.org/10.1177/0145721716654008
Hirai, K., Ishikawa, Y., Fukuyoshi, J., Yonekura, A., Harada, K., Shibuya, D., Yamamoto, S., … Saito, H. (2015). Tailored message interventions versus typical messages for increasing participation in colorectal cancer screening among a non-adherent population: A randomized controlled trial. BMC Public Health, 16, 431. https://doi.org/10.1186/s12889-016-3069-y
Interian, A., Ang, A., Gara, M. A., Link, B. G., Rodruiguez, M. A., & Vega, W. A. (2010). Stigma and depression treatment utilization among Latinos: Utility of four stigma measures. Psychiatry Services, 61(4), 373–379. https://doi.org/10.1176/appi.ps.61.4.373
Jibaja-Weiss, M.L., Volk, R.J., Granchi, T.S., Neff, N.E., Robinson, E.K., Spann, S.J., Aoki, N., … Beck, J.R. (2010). Entertainment education for breast cancer surgery decisions: A randomized trial among patients with low health literacy. Patient Education and Counseling, 84, 41–48. https://doi.org/10.1016/j.pec.2010.06.009
Jimenez, D. E., Bartels, S. J., Cardenas, V., Daliwal, S. S., & Alegria, M. A. (2012). Cultural beliefs and mental health treatment preferences of ethnically diverse older adult consumers in primary care. American Journal of Geriatric Psychiatry, 20(6), 533–542. https://doi.org/10.1097/JGP.0b013e318227f876
Khalil, G. E., & Rintamaki, L. S. (2014). A televised entertainment-education drama to promote positive discussion about organ donation. Health Education Research, 29, 284–296. https://doi.org/10.1093/her/cyt106
Love, G. D., Mouttapa, M., & Tanjasiri, S. P. (2009). Everybody’s talking: Using entertainment-education video to reduce barriers to discussion of cervical cancer screening among Thai women. Health Education Research, 24(5), 829–838. https://doi.org/10.1093/her/cyp019
Miles, M. B., Huberman, A. M., & Saldana, J. (2014). Qualitative data analysis: A methods sourcebook (3rd ed.). Sage.
Morgan, D. L. (1997). Qualitative Research Methods: Focus groups as qualitative research. SAGE Publications, Inc. https://doi.org/10.4135/9781412984287
National Academies of Sciences—Committee on the Science of Changing Behavioral Health Social Norms. (2016). Ending discrimination against people with mental and substance use disorders: The evidence for stigma change. National Academies Press. https://doi.org/10.17226/23442
Noe-Bustamante, L., Flores, A., & Shah, S. (2019). Facts on Hispanics of Mexican origin in the United States, 2017. Pew Research Center.
Petty, R. E., & Cacioppo, J. T. (1984). Source factors and the elaboration likelihood model of persuasion. Association for Consumer Research, 11, 668–672.
Ritterfeld, U., & Jin, S. (2006). Addressing media stigma for people experiencing mental illness using an entertainment-education strategy. Journal of Health Psychology, 11, 247–267. https://doi.org/10.1177/1359105306061185
Saldana, J. (2015). The coding manual for qualitative researchers. SAGE Publications.
Singhal, A., Cody, M. J., Rogers, E. M., & Sabido, M. (2012). Entertainment-education and social change: History, research, and practice. London: Lawrence Erlbaum Associates.
Volk, R. J., Jibaja-Weiss, M. L., Hawley, S. T., Kneuper, S., Spann, S. J., Miles, B. J., & Hyman, D. J. (2008). Entertainment education for prostate cancer screening: A randomized trial among primary care patients with low health literacy. Patient Education and Counseling, 73, 482–489. https://doi.org/10.1016/j.pec.2008.07.033
Wakefield, M.A., Loken, B., & Hornik, R.C. (2010). Use of mass media campaigns to change health behaviour. Lancet, 376(9748), 1261–1271. https://doi.org/10.1016/S0140-6736(10)60809-4.
Wassertheil-Smoller, S., Arredondo, E.M., Cai, J., Castaneda, S.F., Choca, J.P., Gallo, L.C., … Zee, P.C. (2014). Depression, anxiety, antidepressant use, and cardiovascular disease among Hispanic men and women of different national backgrounds: results from the Hispanic Community Health Study/Study of Latinos. Annals of Epidemiology, 24, 822–830. https://doi.org/10.1016/j.annepidem.2014.09.003
Winkler, P., Janoušková, M., Kožený, J., et al. (2017). Short video interventions to reduce mental health stigma: A multi-centre randomised controlled trial in nursing high schools. Social Psychiatry and Psychiatric Epidemiology: the International Journal for Research in Social and Genetic Epidemiology and Mental Health Services, 52(12), 1549–1557. https://doi.org/10.1007/s00127-017-1449-y
Zucker, S., Miska, M., Alaniz, L.G., & Guzman, L. (2005). Transadaptation: Publishing assessments in world languages. Retrieved from: https://images.pearsonassessments.com/images/tmrs/tmrs_rg/TransadaptionResPaper.pdf?WT.mc_id=TMRS_Transadaptation
Funding
The development of the video was funded by the Nevada Department of Children and Family Services through the Victims of Crime.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
We have no known conflict of interest to disclose.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Gonzalez, F., Benuto, L.T. ¡Yo no Estoy Loca! A Behavioral Health Telenovela Style Entertainment Education Video: Increasing Mental Health Literacy Among Latinas. Community Ment Health J 58, 850–861 (2022). https://doi.org/10.1007/s10597-021-00892-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-021-00892-9