Process Evaluation of a Parish-Based Intervention to Reduce Mental Health-Related Stigma

Latino populations in the United States have high levels of unmet mental health (MH) needs and MH-related stigma. Collaborative, community-based programming with predominately Latino churches is a promising approach for reducing MH stigma and unmet MH need in Latino communities. Project AMEN implemented MH workshops, homilies and text messages with Latino Catholic parishes to test this approach. We examined reach, satisfaction, effectiveness and fidelity for the overall intervention and individual activities. We collected baseline and one-year post-intervention data from n = 579 people at seven parishes in southern California. Variables included participation in and satisfaction with activities, MH stigma, sociodemographic characteristics, faith-related characteristics, MH needs, and fidelity measures for workshops. We used bivariate and multivariate modeling to describe intervention reach, satisfaction and effectiveness and to identify differences across subgroups. We describe fidelity for the MH workshop. Overall, 71% of the sample participated in at least one intervention activity. Participants were on average 48 years old, female, married, had less than high school education, and attended the parish for more than five years; 24% reported MH needs. Reach and satisfaction were greater for married individuals and those with strong connections to the parish. Individuals with MH problems had more barriers to participation. Activities most often participated in were text messages (42%), the introductory MH workshop (20%) and MH homily (20%). We observed high workshop fidelity. The number of AMEN activities predicted reduction in four types of MH stigma. AMEN showed promising results with respect to reach, satisfaction and effectiveness at reducing MH stigmaf.