#BlackGirlsTalk: A Pilot Program to Raise Awareness about Depression among African-American Women in Baltimore, MD Open Access

Gitukui, Stephanie (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/1g05fc72f?locale=en


Major depression is one of the most common mental disorders in the U.S and the second most common cause of disability-adjusted life years (DALYs) lost from ages 15-44. It causes severe symptoms that affect how one feels and thinks, interfering with their ability to carry out daily activities such as sleeping, eating, working or studying. Some symptoms of depression include persistent sadness or emptiness, feelings of hopelessness or worthlessness, loss of interest in hobbies, decreased energy or fatigue, difficulty concentrating, and difficulty sleeping. It is projected that by 2030, depression will be among the top three leading causes of burden of disease. African Americans make up approximately 13% of the U.S. population, yet they account for 18.6% of those affected by mental illness. On the 2016 Behavioral Risk Factor Surveillance System Survey, 34.7% of African American adults reported poor mental health status. Despite these findings, African-Americans are least likely to receive treatment for depression and other mental illnesses. African-American women, in particular, are among the most undertreated groups for depression in the country. They are at a higher risk for developing mental illness and have a higher prevalence of depression than men. Through a tailored, public health education campaign, the #BlackGirlsTalk program seeks to address some of the individual and systemic-level barriers to help-seeking among this population. These barriers, which will be further described later in this application, include stigma, cultural beliefs and attitudes, stereotypes, preferred coping strategies, and lack of awareness/knowledge. Education campaigns targeting the African American community should address common depression- and treatment-related beliefs using culturally appropriate images and language. Additionally, funding from this grant will be used to enhance the mobile application, “The Safe Place”, which is a mental health tool designed to educate and raise awareness about mental illness in the African American community. We will build a database into the application that will allow users to locate African American therapists in Maryland, increasing awareness about culturally appropriate psychotherapy services that are available. 

Table of Contents

Table of Contents

Chapter I: Introduction                                                                                                          1

Introduction                                                                                                                         1

Problem Statement                                                                                                            2

Program Description and Purpose                                                                                       3

Program Objectives                                                                                                            4

Theoretical Framework                                                                                                      5

Significance Statement                                                                                                       8

Definition of Key Terms                                                                                                      9

Chapter II: Literature Review                                                                                              11

Historical Barriers and the Legacy of Distrust                                                                       11

History of Medical Experimentation on African Americans                                                 12

History of Racism and Racial Bias in Mental Health                                                            13

Individual-Level Barriers                                                                                                     15        

Stigma                                                                                                                             15

Cultural Beliefs and Attitudes                                                                                           16

The “Strong Black Woman” Stereotype (SBW)                                                                   16

Preferred Coping Strategies (Faith, Spirituality, and Community)                                        17

Lack of Knowledge or Awareness                                                                                      18

Economic Barriers                                                                                                               18

Systemic Barriers                                                                                                                19

Insufficient Number of African American Providers                                                            19

Cultural Competence and Clinical Bias                                                                               20

Use of Culturally Inappropriate Assessments                                                                     21

Chapter III: Methodology                                                                                                    22

Review of Relevant Funding Agencies                                                                                 22

Summary of Grant Announcement                                                                                     24

Grant Review Criteria and Process                                                                                      25

Description of Grant Proposal                                                                                             25

Daniel (Dan) C. Rutz, MPH                                                                                                25

Iris E. Smith, MPH, PhD                                                                                                    26

Chantea Williams, PhD                                                                                                     26

Mahlet Endale, PhD.                                                                                                        27

Tene T. Lewis, PhD                                                                                                           27

Chapter IV: Reviewer Comments                                                                                        28

Reviewer 1 Comments                                                                                                        28

Reviewer 2 Comments                                                                                                        31

Reviewer 3 Comments                                                                                                        35

Reviewer 4 Comments                                                                                                        37

Reviewer 5 Comments                                                                                                        40

Chapter V: Final Grant Proposal                                                                                          42

References                                                                                                                            76

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