The study described here was designed to determine treatment preferences among Latinas to identify treatment options that meet their needs and increase their engagement. Focus group interviews were conducted with 22 prenatal and postpartum Latinas at risk for depression. The group interviews were conducted in Spanish and English using a standardized interview protocol. Focus group transcripts were analyzed to identify themes regarding perinatal depression coping strategies, preferred approaches to treating perinatal depression, and recommendations for engaging perinatal Latinas in treatment. The results suggest that Latinas’ treatment preferences consist of a pathway (i.e., hierarchical) approach that begins with the use of one’s own resources, followed by the use of formal support systems (e.g., home-visiting nurse), and supplemented with the use of behavioral therapy. Antidepressant use was judged to be acceptable only in severe cases or after delivery. The data indicate that to increase health-seeking behaviors among perinatal Latinas, practitioners should first build trust.
AhmedA.StewartD. E.TengL.WahoushO.GagnonA. J. (2008). Experiences of immigrant new mothers with symptoms of depression. Archives of Women’s Mental Health, 11, 295–303. doi:10.1007/s00737-008-0025-6
2.
AlvidrezJ.AzocarF. (1999). Distressed women’s clinic patients: Preferences for mental health treatments and perceived obstacles. General Hospital Psychiatry, 21, 340–347.
3.
AndersonC. M.RobinsC. S.GreenoC. G.CahalaneH.CopelandV. C.AndrewsR. M. (2006). Why lower income mothers do not engage with the formal mental health care system: Perceived barriers to care. Qualitative Health Research, 16, 926–943. doi:10.1177/1049732306289224
4.
BeckA. T.SteerR. A.BrownG. K. (1996). Beck Depression Inventory manual (2nd ed.). San Antonio, TX: Psychological Corporation.
5.
BelleD.DoucetJ. (2003). Poverty, inequality, and discrimination as sources of depression among US women. Psychology of Women Quarterly, 27, 101–113.
6.
CardemilE. V.KimS.PinedoT. M.MillerI. W. (2005). Developing a culturally appropriate depression prevention program: The family coping skills program. Cultural Diversity & Ethnic Minority Psychology, 11, 99–112. doi:10.1037/1099-9809.11.2.99
7.
ChaudronL. H.KitzmanH. J.PeiferK. L.MorrowS.PerezL. M.NewmanM. C. (2005). Self-recognition of and provider response to maternal depressive symptoms in low-income Hispanic women. Journal of Women’s Health, 14, 331–338. doi:10.1089/jwh.2005.14.331
8.
CooperL. A.GonzalezJ. J.GalloJ. J.RostK. M.MeredithL. S.RubensteinL. V.. . .FordD. E. (2003). The acceptability of treatment for depression among African-American, Hispanic, and White primary care patients. Medical Care, 41, 479–489.
9.
DavilaM.McFallS. L.ChengD. (2009). Acculturation and depressive symptoms among pregnant and postpartum Latinas. Maternal & Child Health Journal, 13, 318–325. doi:10.1007/s10995-008-0385-6
10.
DennisC. L. (2005). Psychosocial and psychological interventions for prevention of postnatal depression: Systematic review. British Medical Journal, 331, 15–18. doi:10.1136/bmj.331.7507.15
11.
FolkmanS.LazarusR. S.Dunkel-SchetterC.DeLongisA.GruenR. J. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality & Social Psychology, 50, 992–1003. doi:10.1037/0022-3514.50.5.992
12.
GaynesB. N.GavinN.Meltzer-BrodyS.LohrK.SwinsonT.GartlehnerG.. . .MillerW. C. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Summary, Evidence Report/Technology Assessment No. 119. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from http://archive.ahrq.gov/clinic/epcsums/peridepsum.pdf
13.
GivensJ. L.HoustonT. K.Van VoorheesB. W.FordD. E.CooperL. A. (2007). Ethnicity and preferences for depression treatment. General Hospital Psychiatry, 29, 182–191. doi:10.1016/j.genhosppsych.2006.11.002
14.
GraceS. L.EvindarA.StewartD. E. (2003). The effect of postpartum depression on child cognitive development and behavior: A review and critical analysis of the literature. Archives of Women’s Mental Health, 6, 263–274. doi:10.1007/s00737-003-0024-6
15.
GuarnacciaP. J.MarinezI. (2002). Comprehensive in-depth literature review and analysis of Hispanic mental health issues. New Jersey Mental Health Institute, Inc. Retrieved from www.njmhi.org/litreviewpdf.pdf
16.
HowellE. A.MoraP. A.HorowitzC. R.LeventhalH. (2005). Racial and ethnic differences in factors associated with early postpartum depressive symptoms. Obstetrics & Gynecology, 105, 1442–1450. doi:10.1097/01.AOG.0000164050.34126.37
17.
KaraszA.WatkinsL. (2006). Conceptual models of treatment in depressed Hispanic patients. Annals of Family Medicine, 4, 527–533. doi:10.1370/afm.579
18.
KeimK. S.SwansonM. A.CannS. E.SalinasA. (1999). Focus group methodology: Adapting the process for low-income adults and children of Hispanic and Caucasian ethnicity. Family & Consumer Sciences Research Journal, 27, 451–465. doi:10.1177/1077727X99274005
19.
KouyoumdjianH.ZamboangaB. L.HansenD. J. (2003). Barriers to community mental health services for Latinos: Treatment considerations. Clinical Psychology, 10, 394–422. doi:10.1093/clipsy/bpg041
20.
KuoW. H.WilsonT. E.HolmanS.Fuentes-AfflickE.O’SullivanM. J.MinkoffH. (2004). Depressive symptoms in the immediate postpartum period among Hispanic women in three U.S. cities. Journal of Immigrant Health, 6, 145–153. doi:10.1023/B:JOIH.0000045252.10412.fa
21.
LagomasinoI. T.Dwight-JohnsonM.MirandaJ.ZhangL.LiaoD.DuanN.WellsK. B. (2005). Disparities in depression treatment for Latinos and site of care. Psychiatric Services, 56, 1517–1523. doi:10.1176/appi.ps.56.12.1517
22.
LaraM. A.LeH. N.LetechipiaG.HochhausenL. (2009). Prenatal depression in Latinas in the U.S. and Mexico. Maternal & Child Health Journal, 13, 567–576. doi:10.1007/s10995-008-0379-4
23.
Lara-CinisomoS.Burke BeckjordE.KeyserD. J. (2010). Mothers’ perspectives on enhancing consumer engagement in behavioral health treatment for maternal depression. In KronenfeldJ. J. (Ed.), Research in the sociology of health care: Vol. 28. The impact of demographics on health and health care: Race, ethnicity and other social factors (pp. 249–268). Bingley, United Kingdom: Emerald Group.
24.
Lewis-FernándezR.DasA. K.AlfonsoC.WeissmanM. M.OlfsonM. (2005). Depression in US Hispanics: Diagnostic and management considerations in family practice. Journal of the American Board of Family Practice, 18, 282–296. doi:10.3122/jabfm.18.4.282
25.
LinP.CampbellD. G.ChaneyE. F.LiuC. F.HeagertyP.FelkerB. L.HedrickS. C. (2005). The influence of patient preference on depression treatment in primary care. Annals of Behavioral Medicine, 30, 164–173. doi:10.1207/s15324796abm3002_9
MilesM. B.HubermanA. M. (1984). Qualitative data analysis: A source book of new methods. Beverly Hills, CA: Sage.
28.
MorganD. L. (1993). Successful focus groups: Advancing the state of the art. Newbury Park, CA: Sage.
29.
Munet-VilaróF.FolkmanS.GregorichS. (1999). Depressive symptomatology in three Latino groups. Western Journal of Nursing Research, 21, 209–224. doi:10.1177/01939459922043848
30.
NadeemE.LangeJ. M.MirandaJ. (2008). Mental health care preferences among low-income and minority women. Archives of Women’s Mental Health, 11, 93–102. doi:10.1007/s00737-008-0002-0
31.
PatelS. R.WisnerK. L. (2011). Decision making for depression treatment during pregnancy and the postpartum period. Depression & Anxiety, 28, 589–595. doi:10.1002/da.20844
32.
PreloranH. M.BrownerC. H.LieberE. (2001). Strategies for motivating Latino couples’ participation in qualitative health research and their effects on sample construction. American Journal of Public Health, 91, 1832–1841. doi:10.2105/AJPH.91.11.1832
33.
RadloffL. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Journal of Applied Psychological Measures, 1, 385–401. doi:10.1177/014662167700100306
34.
SleathB.WestS.TudorG.PerreiraK.KingV.MorrisseyJ. (2005). Ethnicity and depression treatment preferences of pregnant women. Journal of Psychosomatic Obstetrics & Gynaecology, 26, 135–140. doi:10.1080/01443610400023130
35.
TempleB.YoungA. (2004). Qualitative research and translation dilemmas. Qualitative Research, 4, 161–178. doi:10.1177/1468794104044430
36.
VegaW. A.KolodyB.Aguilar-GaxiolaS. (2001). Help seeking for mental health problems among Mexican Americans. Journal of Immigrant Health, 3, 133–140. doi:10.1023/A:1011385004913
37.
WassermanM.BenderD.LeeS. D. (2007). Use of preventive maternal and child health services by Latina women: A review of published intervention studies. Medical Care Research & Review, 64, 4–45. doi:10.1177/1077558706296238
38.
WisnerK. L.SitD. K. Y.HanusaB. H.Moses-KolkoE. L.BogenD. L.HunkerD. F.. . .BodnarL. M. (2009). Major depression and antidepressant treatment: Impact on pregnancy and neonatal outcomes. American Journal of Psychiatry, 166, 557–566. doi:10.1176/appi.ajp.2008.08081170
39.
YonkersK. A.RaminS. M.RushA. J.NavarreteC. A.CarmodyT.MarchD.. . .LevenoK. J. (2001). Onset and persistence of post-partum depression in an inner-city maternal health clinic system. American Journal of Psychiatry, 158, 1856–1863. doi:10.1176/appi.ajp.158.11.1856
40.
ZayasL. H.JankowskiK. R. B.McKeeD. M. (2003). Prenatal and postpartum depression among low-income Dominican and Puerto Rican women. Hispanic Journal of Behavioral Sciences, 25, 370–385. doi:10.1177/0739986303256914
