Working… Menu

Testing Mediators and Moderators of a Fotonovela for Depression to Promote Help-seeking Behavior

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT04319458
Recruitment Status : Active, not recruiting
First Posted : March 24, 2020
Last Update Posted : March 25, 2020
Information provided by (Responsible Party):
Louise Dixon De Silva, University of California, Los Angeles

Brief Summary:
Although rates of depression are similar in Latinx populations compared to non-Latinx whites (NLW), there are significant disparities in service utilization. Mental health literacy - one's knowledge and attitudes about mental health and treatment-seeking - is a significant predictor of help-seeking behavior and likely contributes to mental health disparities among Latinx. Understanding ways to improve mental health literacy in Latinx populations is important to reducing these disparities. Health literacy interventions that are engaging, dramatic, and culturally-relevant, such as fotonovelas (graphic novels designed to change health-related knowledge and attitudes), show promise in changing mental health literacy in Latinx populations. However, little is known about how these interventions work and for whom they are most effective. Furthermore, although there is some evidence that fotonovelas can change mental health attitudes and intent to seek treatment, their impact on help-seeking behavior is less understood. The purpose of this study is to examine 1) if narrative and cultural elements of a fotonovela for Latinx with depression (i.e., transportation, identification, and social proliferation) are important mediators in changing mental health attitudes and help-seeking behaviors and 2) if factors such as rurality, acculturation, depression severity and logistic barriers to treatment moderate these relationships.

Condition or disease Intervention/treatment Phase
Mental Health Literacy Behavioral: Fotonovela Behavioral: Control Not Applicable

Detailed Description:

Latinx adults with depression are a particularly vulnerable population; although Latinx exhibit similar rates of depression to other racial/ethnic groups, they are less likely to seek treatment, are more likely to drop out of treatment, and thus experience greater chronicity of depression. This health disparity is likely due to a complex network of factors, but mental health literacy is one important contributing factor. Latinx are more likely to exhibit lower mental health literacy (including misconceptions, stigma, knowledge of treatment, etc.), which contributes to lower rates of treatment-seeking. Understanding how to engage Latinx in depression treatment by overcoming health literacy barriers is important in reducing health disparities.

Entertainment-education interventions are those that use popular media to engage consumers and deliver health messages. These interventions hypothesized to be useful in targeting populations with health disparities in encouraging changes in health-related behavior through dramatic and culturally-relevant narrative elements. However, no study has tested these theorized mechanisms in helping to explain changes in health literacy and subsequent health behavior.

This study will test the impact of a graphic novel about depression specifically for Latinx adults with depressive symptoms on theorized mediators, including transportation (feeling emotionally engaged in the narrative), identification (cultural relevance of characters, their language, and their appearance), and social proliferation (sharing of health information and mutual reinforcement of health behaviors). Furthermore, this study will test if these mediators help explain changes in mental health literacy and subsequent health behavior. Lastly, this study will test moderators of changes in mental health literacy and behavior to determine for whom the fotonovela has the largest impact.

Layout table for study information
Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 182 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary Purpose: Other
Official Title: Entertainment Education for Depression in Latinx Adults: Testing Mediators and Moderators of a Culture-Centric Narrative Intervention to Promote Help-Seeking Behavior
Actual Study Start Date : March 1, 2019
Estimated Primary Completion Date : August 30, 2020
Estimated Study Completion Date : August 30, 2020

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Fotonovela
Fotonovela mental health literacy intervention: Secret Feelings/Sentimientos Secretos
Behavioral: Fotonovela
Secret Feelings/Sentimientos Secretos

Active Comparator: Control
Control mental health literacy intervention: NIH publication - Depression: What You Need to Know
Behavioral: Control
NIH Brochure: Depression: What You Need to Know

Primary Outcome Measures :
  1. Help-Seeking Behavior [ Time Frame: 3 months ]
    The measure of help-seeking behavior is a checklist of behaviors that has been modified from the Service Assessment for Children and Adolescents. The measure assesses different sources of treatment, including psychiatrist, psychologist, social worker, spiritual advisors, ER visits, and traditional healers. Participants are asked if in the past 3 months, they have sought services from any of these professionals. Each item is binary (i.e., Yes or No). The total score will be calculated by summing the number of "yes" answers (i.e., the number of services used).

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • 18 years or older
  • fluent in English or Spanish
  • mild, moderate, or severe levels of depression
  • identify as Latinx or Hispanic

Exclusion Criteria:

  • receipt of psychotherapy or pharmacotherapy for mental health problems in the last 6 months
  • unable to read in English or Spanish

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04319458

Layout table for location information
United States, California
University of California Los Angeles
Los Angeles, California, United States, 90095
Sponsors and Collaborators
University of California, Los Angeles
Layout table for additonal information
Responsible Party: Louise Dixon De Silva, Principal Investigator, University of California, Los Angeles Identifier: NCT04319458    
Other Study ID Numbers: 19-000112
First Posted: March 24, 2020    Key Record Dates
Last Update Posted: March 25, 2020
Last Verified: March 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Layout table for additional information
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
Layout table for MeSH terms
Behavioral Symptoms