Several months into the COVID-19 pandemic, Migrant Clinicians Network’s Alma Galván MCH, MCN’s Senior Program Manager, approached Kaethe Weingarten, PhD, Director of the Witness to Witness (W2W) program, to talk about the virus, its disproportionate effects on Latinx communities, and the short- and long-term mental health consequences on community health workers (CHWs), those trying to bolster the health of those ravaged communities, as the virus raged on.

"I immediately saw that Alma was right: that the material W2W was using in the webinars could be developed for peer support groups to better support those on the frontlines,” Dr. Weingarten said. With Deliana Garcia, MA, MCN’s Director of International Projects and Emerging Issues, Dr. Weingarten and Galván rapidly and intensively developed a psychosocial support pilot project, through a partnership with the Ventanilla de Salud (VdS). With offices in each state’s Mexican Consulate, VdS aims to increase access to health care and health literacy for Mexican nationals and other Latinxs across the country. MCN, a longtime partner with the VdS, recruited 23 CHWs from different consulates to join in on the short pilot program, which was to be conducted virtually and entirely in Spanish over the course of three sessions. Dr. Weingarten and a W2W volunteer Sol D'Urso developed the curriculum and then D'Urso and Galván adapted it into Spanish.  D'Urso led the training of four volunteer facilitators, all of whom were Latinx immigrant CHWs themselves, into the W2W approach to psychosocial support in general and the curriculum in particular.  

The curriculum aimed to help CHWs develop strategies to cope with three key topics, one covered per session: stress, grief, and resilience. The three sessions took place in June 2020. Over the 90-minute sessions, participants gained skills and resources to manage stress and grief and foster resilience in themselves, and most critically, to then utilize those tools to bolster community mental health by improving self-efficacy in talking to immigrants about managing stress, grief, and resilience. “It is very important, this application of the learning they obtained so they can assist other immigrants,” emphasized Galván. "This pilot project shows that if we do short interventions and short trainings with those who are working with essential workers, they can help normalize the feelings of stress and anxiety that so many people are currently having – and reduce the stigma around mental health needs.  We think that as a consequence of that, agricultural workers and others they work with will feel more understood, and more able to say, ‘I need help,’ and maybe reach out for help.”

Additionally, and critically, the sessions created a space, albeit short-term, for participants to be in community together. “We know that peer support and a sense that we are not alone is a key factor in sustaining resilience during challenging times.  The participants immediately recognized each other as comrades and bonded with each other and the facilitators,” said Weingarten. In August 2020, Danna Carter, PhD, LMFT reviewed collected pre- and post-series data to determine the efficacy of the sessions. She analyzed demographics, participants’ questionnaires on self-efficacy and personal stress levels that were completed upon registration and after the series concluded, plus additional data and qualitative feedback gathered after each session. Her analysis found significant outcomes in each of the following five domains: (1) levels of stress and well-being; (2) relationship alliance; (3) self-efficacy and interesting findings in two domains 4) session feedback; and (5) process evaluation. (See text box for an excerpt from the executive summary on each of the five domains.)

“These results are very encouraging about the value of combining knowledge acquisition, skill development and peer support during times of high stress.  Participants not only felt better themselves but felt better prepared to do their jobs.  We are excited about extending our methodology to other settings,” said Dr. Carter.

There were limitations to the data. All but one of the participants, facilitators, and MCN staff support were female, which may have skewed the development of a sense of community over just the short three-week time frame. At present, the results reflect participant outcomes directly after the end of the project; the pilot project developers plan to evaluate how long the positive results of the sessions will hold.  “Still, we are encouraged that CHWs are able to benefit from short-term virtual communities of support, a modality that will be with us for months to come,” said Dr. Weingarten.

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