Qualitative Exploration of an Effective Depression Literacy Fotonovela with at Risk Latina Immigrants

While depression is prevalent among immigrant Latinas, mental health literacy is low. Culturally tailored health narratives can improve mental health literacy and are now increasingly featured in Spanish language fotonovelas (i.e., booklets in a comic book format with posed photographs and dialogue bubbles). The purpose of this qualitative study is to explore why a depression literacy fotonovela proved effective with Latina immigrants at risk for depression in a quantitative randomized control study. This study is the qualitative companion of the previously published quantitative piece of a mixed methods study, the latter revealing posttest improvements in depression knowledge, self-efficacy to identify the need for treatment, and decreased stigma towards mental health care (Hernandez and Organista in Am J Community Psychol 2013. doi: 10.1007/s10464-013-9587-1). Twenty-five immigrant Latinas participated in structured interviews, in the current qualitative study, 3 weeks after participating in the quantitative study. Results suggest depression literacy improved because participants evidenced high recall of the storyline and characters, which they also found appealing (e.g., liked peer and professional support offered to depressed main character). Further, identification with the main character was reflected in participants recalling similar circumstances impacting their mental health. Despite some improvement, stigma related to depression and its treatment remained for some women. Future research for the improvement of health literacy tools is discussed.