Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Megan V. Smith

Second Advisor

Trace Kershaw

Abstract

Abstract

Objective: This thesis evaluates the acceptability and feasibility of training community mental health workers in mental health in community settings. The specific aims of this study are:

(1) to determine whether community health worker trainings in mental health delivered in the community by non-researchers can be evaluated using a structured research protocol and

(2) to assess whether the community mental health worker training improves the knowledge, behaviors, and attitudes of the people who complete the training.

Background: Mental health task-sharing interventions targeting mothers in the United States have minimal research regarding efficacy and feasibility. This thesis describes the development and evaluation of a Community Mental Health Ambassador (CMHA) training to help improve mental health outcomes among mothers in New Haven, CT.

Methods: Data were derived from 5 CMHA training sessions with a total of 51 participants. Training participants completed pre- and post- training measures of communication skills and confidence in self-efficacy and perceived control in addition to a core competency assessment and satisfaction evaluation. Sensitivity analyses were conducted to determine differences between baseline and post-training scores by group characteristic. Data were stratified by education (high school or college/vocational tech) and role (parent/caretaker or provider). Bivariate analyses examined relationships between education and role with ability scores.

Results: High levels of satisfaction were reported among training participants. Participants agreed that the training sessions appropriately addressed the core competencies of the CMHA training. A trend was observed in the confidence score in ability to handle responsibilities (p=0.063). Improvement by one-point in median scores from pre-training to post-training was seen in the self-efficacy categories of ability to give advice or assistance on health issues (2.0, 3.0, p=0.6133) and ability to give advice or assistance on community issues (2.0, 3.0, p=0.5938). The sensitivity analysis revealed a significant effect of role on verbal communication ability (p=0.02).

Conclusions: The CMHA training as implemented by the MOMs Partnership is an effective and feasible means of training people in the community about maternal mental health issues. While more training sessions need to be conducted to increase sample size and power, the results of this thesis show promising potential to help increase access to community mental health resources for mothers.

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This is an Open Access Thesis.

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