title: ASHA: Using Participatory Methods to Develop an Asset-building Mental Health Intervention for Bangladeshi Immigrant Women.
abstract: BACKGROUND
  Common mental disorder (CMD) is highly prevalent among low-income immigrant women, yet few receive effective treatment. This underutilization is partly owing to a lack of conceptual synchrony between biopsychiatric theories underlying conventional mental treatments and explanatory models in community settings. The Action to Improve Self-esteem and Health through Asset building (ASHA) program is a depression intervention designed by and for South Asian women immigrants. ASHA helps women to build psychological, social, and financial assets.
  
  
  OBJECTIVE
  This paper describes the development and a preliminary pilot evaluation of the ASHA intervention.
  
  
  METHODS
  Researchers, clinicians, activists, and women from the Bronx Bangladeshi community collaboratively designed a depression intervention that would synchronize with local concepts of distress. In addition to providing mental health treatment, ASHA addresses social isolation and financial dependence. ASHA was evaluated in a pilot study described in this paper. Participants were assigned to intervention or delayed intervention (control) groups. Data collection at baseline and time 2 (6 months) included the Patient Health Questionnaire-9 (PHQ-9) and an indigenous measure of psychological and somatic distress.
  
  
  RESULTS
  Eighty percent of intervention participants completed the 6-month program. After treatment, mean PHQ-9 scores in the intervention group decreased from 9.90 to 4.26 (p &lt; .001). Participants saved an average of $10 per week. To date, participants have applied their skills and savings toward such activities as starting small businesses and enrolling in community college.
  
  
  CONCLUSIONS
  ASHA was effective in improving depression and increasing financial independence. Using a culturally synchronous approach to psychological treatment may be effective in ameliorating distress in immigrant populations.
authors.forename: Alison
authors.initials: A
authors.lastname: Karasz
authors.forename: Sumithra
authors.initials: S
authors.lastname: Raghavan
authors.forename: Viraj
authors.initials: V
authors.lastname: Patel
authors.forename: Moumita
authors.initials: M
authors.lastname: Zaman
authors.forename: Laila
authors.initials: L
authors.lastname: Akhter
authors.forename: Mahbhooba
authors.initials: M
authors.lastname: Kabita
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000208:ethnology; D055812:Community-Based Participatory Research / Q000379:methods*; D003159:Community-Institutional Relations; D003863:Depression / Q000523:psychology* / Q000628:therapy*; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D006266:Health Education / Q000458:organization & administration; D006801:Humans; D007398:Interpersonal Relations; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010865:Pilot Projects; D012649:Self Concept