Women are 70% more likely to experience depression and 60% more likely to experience an anxiety disorder during their lifetime than men (NIMH, 2012). In 2005-2010, the prevalence of depression among adults was five times higher for those below the poverty level compared with those above the poverty level (CDC, 2011). African-Americans are 20% more likely to report psychological distress than Non-Hispanic Whites (OMH, 2012a). In 2008, US Hispanics received mental health treatment nearly three times less often than non-Hispanic Whites (OMH, 2012b) did. A study of depressed, underserved, African-American women found that these women experienced a mismatch between what they perceived they needed and what therapists thought they needed which left them feeling disrespected and misunderstood (Poleshuck, Cerrito, Leshoure, Finocan-Kaag & Kearney, 2013). Simon and Ludman (2010) reported that non-adherence and treatment dropout rates, leading to frequent and significant under treatment of depressive symptoms, were high among persons of color and low-income individuals. Thus, the confluence of gender, poverty, and ethnicity may create significant vulnerability to depression and anxiety as well as treatment inequities.
Given these facts, the Women Supporting Women research project was created. Using the ideological perspective of community based participatory research and in the context of long-term partnerships between our department of nursing and several underserved neighborhoods, we initially conducted focus groups. Via these focus groups, we learned that the women desired support as well as education about anxiety and depression.
Using Dorthea Orem’s theory of self-care as the conceptual model, the purpose of the current study is to pilot the suggested supportive/educative groups. Facilitated by a community health worker (CHW), taught by undergraduate nursing students, and supervised by a faculty member, the research team offers a supportive/educative group in each of our four partner neighborhoods. The pilot intervention entails six meetings of 90 minutes each and includes reconnecting, education, and support components. Before and after measures of the women’s anxiety and depression symptomatology, the adequacy of the women’s knowledge for self-care, and their satisfaction with the groups is collected. To date, approximately 50 women have participated in the pilot study. This study is foundational for designing appropriate interventions for urban, ethnically diverse, and impoverished women struggling with anxiety and depression.
Principal Investigator: Mary Molewyk Doornbos – Professor of Nursing
Research Team: Gail Zandee – Assistant Professor of Nursing; Megan DeMaagd-Rodriguez – Student Research Assistant; Joleen DeGroot – Student Research Assistant
Funding Sources: Calvin College Research Fellowship (CRF) 2012-13 and 2013-14; Perrigo Company Foundation
Centers for Disease Control (CDC) (2011). Health, United States, 2011.
National Institute of Mental Health (NIMH) (2012). Statistics.
Office of Minority Health (OMH). (2012a). Mental health and African-Americans. Retrieved from http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=9&ID=6474
Office of Minority Health (OMH). (2012b). Mental health and Hispanics. Retrieved from http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=9&ID=6477
Poleshuck, E.L., Cerrito, B., Leshoure, N., Finocan-Kaag, G. & Kearney, M.H. (2013). Underserved women in a women’s health clinic describe their experiences of depressive symptoms and why they have low uptake of psychotherapy. Community Mental Health Journal, 49, 50-60.
Simon, G.E. & Ludman, E.J. (2010). Preditors of early dropout from psychotherapy for depression in community practice. Psychiatric Services, 61, 684-689.