Effectiveness of a Community Health Worker-Delivered Depression Intervention for Uninsured Latine Immigrants

Access to evidence-based mental health care remains limited for Latine immigrants. We tested the effectiveness of an evidence-based intervention, Strong Minds, delivered by community-health workers (CHWs) for improving depression symptoms. We used a single-arm pretest-posttest design to evaluate the effectiveness of Strong Minds in a sample of uninsured, Spanish-speaking, Latine immigrant adults recruited between October 7, 2020, and December 6, 2024. The intervention, adapted from cognitive behavioral therapy, includes 10 individual sessions. We performed a longitudinal analysis using linear mixed-effects models to estimate the trajectories of depression symptoms across five time points: baseline and sessions 1, 3, 6, and 9. Effectiveness was determined by changes in depression symptoms (PROMIS Depression 8a), and as a secondary outcome, changes in anxiety symptoms (PROMIS Anxiety 7a). We also analyzed potential selection bias by evaluating differences in baseline scores between participants who completed and discontinued participation. Of the 129 participants enrolled in the intervention (mean age, 39 years), 73 (56.6%) completed it (defined as attending at least 8 of 10 sessions). Completing the intervention was associated with improved symptoms of depression and anxiety. Participants with greater symptoms of depression at baseline were more likely than those with less severe symptoms to complete the intervention. These results add to the growing body of evidence in the United States that CHW-delivered mental health interventions are effective. Nonetheless, research is needed to rigorously demonstrate that CHW-delivered interventions are an equitable, clinically effective, sustainable, and scalable alternative to traditional models of mental health care.