Objectives
We developed and evaluated new media‐related health information acquisition measures for U.S.‐based Latino populations.
Methods
In 2021, a sample of U.S.‐based Latino adults (N = 1574) ...self‐completed a 20‐min survey of health information acquisition measures across three language/cultural dimensions: Spanish media, Latino‐tailored media in English, and general media in English. Socio‐demographics were also ascertained. Means and standard deviations for the health acquisition measures were adjusted for age and sex and reported across nativity status.
Results
The sample was diverse across age, gender, race, ethnicity, socioeconomic status, migration, and language competency. Internal consistency reliability of developed scales was excellent overall and within age, gender, race, ethnicity, and socioeconomic subgroups (Cronbach's alphas = 0.86–0.94). English media scales had higher means overall indicating higher prolonged quantity (i.e., dosage) than Spanish media scales. In contrast, standard deviations for Spanish media scales were higher overall indicating broader reach at lower doses than English media scales.
Conclusions
Findings suggest English‐language media is popular among Latino populations overall. However, Spanish‐language media retains broad reach through both passive and active exposure. Our findings demonstrate the value of including more nuanced measurement of health information acquisition such as the scales developed in this study to improve health promotion among Latino populations.
Since 1950, public communication about the neurobiological-psychosocial basis of mental illness from the diathesis-stress model has promoted reception to treatment yet violent/dangerous stereotypes ...have increased during this period. Moreover, public mental health communication efforts have predominantly diffused in English-language media, excluding Spanish/Latinx media and its consumers from these efforts. To inform future mental health communication strategies, this study leverages high versus low diffusion of public mental health communication across English and Spanish/Latinx media to examine public mental health communication effects on stigma and treatment beliefs via neurobiological-psychosocial beliefs.
A quota sample of 2058 U.S.-based Latinx residents ages 13–86 with diverse language/cultural media preferences was recruited to self-complete a survey about mental health information acquisition in 2021. Assessments ascertained frequency of Spanish/Latinx and English media use and mental health content scanning and seeking (α = 0.86–0.94); and items from the General Social Survey about mental illness neurobiological-psychosocial causal beliefs (α = 0.72)—genetics, brain chemistry, environment, stress; treatment beliefs—mental illness improves with treatment or on its own; and stigma beliefs—violent/dangerous and bad character stereotypes and unwillingness to socialize with a person with mental illness. Structural equation models estimated total, direct, and indirect effects of Spanish/Latinx and English media exposures on treatment and stigma beliefs via neurobiological-psychosocial beliefs, net individual/family factors.
Spanish/Latinx media reduced, while English media increased, neurobiological-psychosocial beliefs (p < 0.01). Neurobiological-psychosocial beliefs, in turn, increased treatment and stigma beliefs (p < 0.01), simultaneously. Indirect pathways were also significant (p < 0.05). Proportion mediated on treatment beliefs was one-third for Spanish/Latinx and two-thirds for English media. Proportion mediated on stigma beliefs for all media exposures averaged ≥1.
While consumers of Spanish/Latinx media report lower neurobiological-psychosocial knowledge that impedes treatment beliefs, consumers of English media report greater neurobiological-psychosocial and treatment knowledge and, consequently, more stigma. Innovation in public mental health communication is needed to counter stigma and health inequity.
•Mental health communication is inequitable across English- and Spanish/Latinx-media.•Spanish/Latinx-media reduces, while English-media increases, neurobiological-psychosocial causal beliefs.•Neurobiological-psychosocial causal beliefs increase treatment and stigma beliefs, simultaneously.•Public mental health communication requires innovation to combat stigma and inequity.
This study identifies mental health, tobacco prevention, alcohol/beer, food/beverage, pharmaceutical, and other health-related advertisements across Spanish- and English-language TV networks owned by ...the same parent media company in the U.S. as commercial determinants of health disparities for Latino populations and/or viewers of Spanish-language TV.
A 3-week composite sample of Telemundo and National Broadcasting Company prime-time TV owned by the same parent media company was randomly drawn from March 31, 2021 to June 12, 2021 in Houston, Texas. A total of 1,593 health-related advertisements were yielded for systematic content analysis. Analyses included intercoder reliability, descriptive and bivariate analysis, and rate ratio and rate difference calculations.
Telemundo had significantly more health-adverse and fewer health-beneficial advertisements than National Broadcasting Company. Telemundo broadcasted about 11 more alcohol (95% CI=9.1, 12.5) and 5 more unhealthy/noncore food/beverages (95% CI=2.0, 7.2) advertisements per hour of TV advertisement programming than the National Broadcasting Company. Telemundo also broadcasted about 1 fewer mental health/tobacco prevention (95% CI= -0.9, -0.2), 3 fewer healthy/core food/beverages (95% CI= -1.5, -4.3), and 4 fewer pharmaceutical (95% CI= -2.4, -5.7) advertisements per hour of advertisement programming than the National Broadcasting Company.
Overall greater health-adverse and fewer health-beneficial advertisements are broadcasted on Spanish-language than on English-language TV. Unchecked corporate marketing strategies may serve as a commercial determinant of health disparities for Latino populations by Spanish-language TV.
This systematic literature review provides evidence concerning the association of school race/ethnic composition in mental health outcomes among adolescents (ages 11–17 years). A range of mental ...health outcomes were assessed (e.g., internalizing behaviors, psychotic symptoms) in order to broadly capture the relationship between school context on mental health and psychological wellbeing. Methods: A search across six databases from 1990 to 2018 resulted in 13 articles from three countries (United States, United Kingdom, and the Netherlands) that met inclusion criteria following a two step review of titles/abstracts and full-text. Results: The existing research on school race/ethnic composition and mental health point to two distinct measures of school composition: density—the proportion of one race/ethnic group enrolled in a school, and diversity—an index capturing the range and size of all race/ethnic groups enrolled in a school. Overall, higher same race/ethnic peer density was associated with better mental health for all adolescents. In contrast, there was no overall strong evidence of mental health advantage in schools with increased diversity. Conclusions: Theoretical and methodological considerations for future research towards strengthening causal inference, and implications for policies and practices concerning the mental health of adolescent-aged students are discussed.
•Policy analysis of school race/ethnic composition rarely focuses on mental health.•A systematic review assessed the role of school race/ethnic composition on mental health.•Greater density of same race/ethnic peers led to better mental health for all youth.•No overall mental health advantage in schools with increased diversity was found.•Implications for policy, intervention, and future research are discussed.
Differences in mental illness (MI) stigma among adolescents were examined cross-sectionally across race, ethnicity, and gender to identify target populations and cultural considerations for future ...antistigma efforts. An ethnically and socioeconomically diverse sample of sixth graders (N = 667; mean age = 11.5) self-completed assessments of their MI-related knowledge, positive attitudes, and behaviors toward peers with MI and adolescent vignettes described as experiencing bipolar (Julia) and social anxiety (David) symptoms. Self-reported race, ethnicity, and gender were combined to generate 6 intersectional composite variables: Latino boys, Latina girls, non-Latina/o (NL) Black boys, NL-Black girls, NL-White boys, and NL-White girls-referent. Linear regression models adjusting for personal and family factors examined differences in stigma using separate and composite race, ethnicity, and gender variables. In main effects models, boys and Latina/o adolescents reported greater stigma for some outcomes than girls and NL-White adolescents, respectively. However, intersectional analyses revealed unique patterns. NL-Black boys reported less knowledge/positive attitudes than NL-Black and White girls. NL-Black and Latino boys reported greater avoidance/discomfort than NL-White girls. Moreover, NL-Black girls and boys and Latina/o girls and boys wanted more social separation from peers with mental illness than NL-White girls; NL-Black boys also reported more separation than NL-White boys, NL-Black girls, and Latina girls. Finally, NL-Black boys and Latina girls wanted more distance from David than NL-White and Black girls. Vital for informing future antistigma interventions, this study generates new knowledge about how differences in views about MI exist across racial and ethnic identity, and how gender intersects with these perceptions.
Public Policy Relevance Statement
Even as the need for mental health care among youth is rising, mental illness stigma can significantly impede access to that care. Our research with middle-school aged students shows that the intersections of race, ethnicity, and gender affect how young adolescents perceive mental illness in others. By identifying differences in mental illness stigma, including mental health literacy and desired separation from persons with mental illness, in diverse student populations, we can better understand the mechanisms of stigma within each of those groups and better inform future antistigma interventions that address disparities in mental illness stigma.
ABSTRACT
BACKGROUND
Addressing school violence is an important public health goal. To assess the role of school mental health curricula in violence prevention, we evaluated effects of an anti‐stigma ...curriculum on violence victimization/perpetration.
METHODS
An ethnically/socioeconomically diverse sample of 751 sixth‐graders (mean age 11.5 years) across 14 schools in Texas were block‐randomized by school (2011‐2012) to receive singly or in combination: (1) a mental illness anti‐stigma curriculum; (2) contact with 2 young adults with mental illness; or (3) merged control (printed materials/no intervention). Pre‐ and post‐test assessments were self‐completed during health education classes; prior to randomization, 484 (64.5%) agreed to 2‐year, home‐based longitudinal assessments. Statistical models tested short‐ and long‐term effects on physical, verbal, and relational/social violence victimization/perpetration.
RESULTS
At 1‐month post‐test, students who received the curriculum versus control made fewer verbal threats (p < .05). Those with high‐level mental health symptoms in the curriculum group versus control used less violence overall and received fewer verbal threats from peers short‐term (p < .05). Curriculum effects of reducing violence perpetration sustained long‐term among adolescents with high‐symptoms (p < .01). The comparator contact intervention was ineffective short‐ and long‐term.
CONCLUSIONS
Implementing efficacious mental health curricula can serve as a multi‐pronged strategy with anti‐bulling efforts to prevent violence and improve mental health.
This study aimed to examine racial and ethnic variations in national trends, past-year prevalence, determinants of major depressive episode (MDE), MDE-related role impairment and mental health (MH) ...services utilization in U.S. adolescents.
Data was extracted from the National Survey on Drug Use and Health (NSDUH) from 2010 to 2018. A total of 137,671 nationally representative adolescents aged 12–17 were included in the study. Weighted temporal trends in the past-year prevalence of MDE, and MDE with severe role impairment were estimated both overall and by race and ethnicity. Weighted multivariate logistic regressions were conducted to assess racial/ethnic differences in determinants of MDE, MDE-related severe role impairment, and MH services utilization after adjusting for sociodemographic characteristics, family structure, substance use, activity participation, and problem-solving group engagement.
The prevalence of MDE and MDE with severe role impairment among U.S. adolescents has steadily increased, while MDE-related health services utilization remained low from 2010 to 2018. Racial and ethnic minority adolescents were more likely to experience an MDE, but less likely to use MH services compared to their White counterparts. Participating in school, family, community, or faith-based activities was significantly associated with lower MDE incidence. Problem-solving group engagement was associated with MH services utilization (all p-values < 0.05).
High prevalence of depression and low MH service utilization among U.S. adolescents remains a public health issue. Moreover, racial/ethnic disparities persist in MH and service utilization outcomes. Future research must investigate the burden and predictors of mental illness, and the factors influencing MH services utilization in diverse adolescent populations.
•The prevalence of past-year MDE increased from 2010 to 2018, but services utilization remained low in U.S. adolescents.•Racial/ethnic disparities exist in MDE, severe role impairment, and health services utilization in U.S. adolescents.•Participation in social activities is associated with lower MDE risk.•Problem-solving group engagement increased the likelihood of MDE-related mental health service utilization.
This study aimed to identify disparate health-related marketing across English- and Spanish-language television networks in New York City, ultimately to inform policy that can counteract ...disproportionate health-related marketing that provides harmful content to and withholds beneficial information from Latinx populations.
A 2-week composite sample of primetime English-language (National Broadcasting Company and Columbia Broadcasting System) and Spanish-language (Telemundo and Univision) television networks from YouTube television was randomly drawn from September 7, 2022 to September 27, 2022 in New York City. A total of 9,314 health-related television advertisements were identified for systematic media content analysis and coded into categories: alcohol, core or noncore foods/beverages, mental health/tobacco prevention, health insurance, medical centers, and pharmaceuticals. Analyses conducted in 2022–2024 included intercoder reliability and descriptive and rate difference estimates using total advertisement broadcasting time in the full sample and subsamples by language networks on YouTube television.
Spanish television networks broadcast greater health-adverse advertisements per hour for alcohol (rate difference=4.91; 95% CI=3.96, 5.85) and noncore foods/beverages (rate difference=13.43; 95% CI=11.52, 15.34) and fewer health-beneficial advertisements per hour for mental health/tobacco prevention (rate difference= −0.99; 95% CI= −1.45, −0.54), health insurance (rate difference= −1.00; 95% CI= −1.44, −0.57), medical centers (rate difference= −0.55; 95% CI= −1.23, 0.12), and pharmaceuticals (rate difference= −5.72; 95% CI= −7.32, −4.11) than New York City primetime English television networks.
Multilevel policy innovation and implementation are required to mitigate primetime television marketing strategies that contribute to health inequities.
Parents are one of several key gatekeepers to mental health (MH) services for adolescents with MH problems. Parental MH stigma is a significant barrier to treatment, yet little is known about how ...stigma may bias parental recognition of mental illness in youth.
This study examines how stigma influences a critical and early stage of the help-seeking process—the recognition of MH problems in preadolescents by their parents.
Parents from a school-based anti-stigma intervention study were analyzed. Logistic regressions examined the association of stigma with parental recognition of MH problems in their preadolescent child (10–12 years old) and that of two preadolescent vignette characters described as having bipolar disorder and social anxiety disorder.
The more parents desired their preadolescent child to avoid interaction with individuals with a mental illness—that is, to be more socially distant—the less likely these parents believed their child had a MH problem, controlling for parent-reported MH symptoms and other covariates. This pattern was prominent among parents who reported high symptoms in their child. Social distance had no bearing on whether parents recognized the vignette characters as having a problem. Avoidance of individuals with a mental illness and knowledge/positive MH attitudes were not associated with problem recognition.
Stigmatizing attitudes of parents may be detrimental when trying to understand the psychopathology of their own preadolescent children but not preadolescents outside their family. Stigma may present itself as a barrier to problem recognition because it may impose a significant personal cost on the family, thereby affecting the help-seeking process earlier than considered by previous work.
•Stigma's role on parent mental health problem recognition in youth is unknown.•Social distance obstructs parental problem recognition in their own child.•Stigma is not associated with problem recognition in adolescent vignette characters.•Stigma may affect help seeking early as parents assess their child's mental health.
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