Mentes Positivas en Acción: A Randomized Feasibility Study of a Promotor-Delivered Cognitive Behavioral Stress Management Program for Low-Income Spanish-Speaking Latinos

Abstract

Purpose: Although psychological distress is common among Latinos in the United States, they underutilize mental health services. We describe a community-based program to manage stress and reduce depressive symptoms among low-income Spanish-speaking Latinos. Methods: Mentes Positivas en Acción (MPA) (Positive Minds in Action) is an 8-week group program, delivered by trained promotores in community settings and evaluated through a randomized feasibility study. Participants were randomly assigned to an immediate MPA treatment group or a delayed-intervention control group. Outcomes assessed at baseline and 8 weeks included stress (Perceived Stress Scale [PSS]) and depressive symptoms (PHQ-9); higher scores indicate worse health. Repeated-measures analysis of variance examined group×time interaction effects for group differences in change from baseline to 8 weeks. The control group offered the program after the 8-week assessment, completed an additional assessment at the end of the program (16 weeks); t-tests assessed within-group changes. Results: Most participants were female, born in Mexico, and spoke only Spanish. Group×time interaction effects were significant for both outcomes. Mean PSS scores improved in the treatment group but not the control group (-0.80 vs. +0.10; p<0.014). Mean PHQ-9 scores improved more in the treatment group than the control group (-5.7 vs. -0.3; p<0.011). Within-group analyses of the control group found significant improvements in stress (-0.8; p<0.000) and depressive symptoms (-3.9; p<0.002). Conclusions: This study provides preliminary evidence of the effectiveness of a community-based promotor-delivered program to manage stress and reduce depressive symptoms among vulnerable underserved Latinos in the United States.