Table 3.

Qualitative results for pre- post- evaluation of a mental health promotion intervention for Mexican immigrants.

Theme	Description	Sample quote
Social support networks
Pre- evaluation	Participants described having networks such as family members (partners, parents, siblings) and identified priests as a secondary source of social support. Many mentioned that their networks are small, limited to family, almost none mentioned having large friend networks. They mentioned that they spend time together with family on a daily basis but seldom with friends. Strategies to broaden their social networks were incorporated into the sessions.	“Mmm… I have few friends, don't have too many, in general twice a month, something like that, we do something with family, someone invites me to their home, or I invite them to mine.” (Health assistant, US permanent resident, 36 years, pre-interview)
Post-evaluation	Participants were better able to conceptualize their social support networks, for example people with whom they feel supported in case of a difficult situation or emergency. Almost all participants said that they felt supported by their nuclear family living in Mexico or in the US, such as spouse, children, siblings, and brothers or sisters in law. They also in general identified larger social support networks that included friends, community organizations, coworkers, and mental health professionals or spiritual counselors (including priests). They also related that they were spending time with their nuclear family every day, either in person with those living in the US or via video calls or text messaging with those living in Mexico. They also mentioned that the increased interactions with extended family or friends were through video calls or messages due to the COVID-19 pandemic.	“With my close family, meaning my parents, sisters, with…After the sessions where we talked about how we should broaden the circle of persons who we can trust I have tried to become closer with people I know to try to broaden it.” (Bank assistant, DACA recipient, 25 years, post-interview)
Adaptability
Pre-evaluation	For some participants, adapting to the US was easy because they desired to live in this country or because they migrated when they were very young, or because of what they identified as their individual capacity to adapt quickly to new environments. Others expressed that it was difficult due to the radical change of environment, traditions, and language; however, they were eventually able to achieve it.	“It does affect you to be in another country because imagine that you from one day to another had a job, family, friends and you leave it and well adapting to the language, the traditions, I did not know people, it was very difficult for me at the beginning to get used to it and to help my children at school, it can be quite frustrating.” (Housewife, US Citizen, 54 years, pre-interview)
Post-evaluation	Participants expressed that they felt adapted and willing to adapt to new situations.	“I feel adapted, but I would also like to go back to my country, things are what they are, if it is not possible that is what it is and that is it, right?” (Supervisor, DACA recipient, 36 years, post- interview)
Positive mental health habits
Pre-evaluation	Practices which participants used were using music or relaxation videos, drinking tea, or using relaxing oils, excercising, or putting their trust in a superior being. A few participants said that they did not take any actions to care for their mental health.	“Well, I don't know, I like when I have time to listen to relaxing music, to help me relax the mind and all that. But, well, is the only thing that I do, try to take teas to not be stressed, or something like that. But really, well I do not think I take care of my mental health. And well, like I said I try not to.. not to pay too much attention to stuff and that has really helped me.” (Supervisor, DACA recipient, 36 years, pre- interview)
Post-evaluation	Participants described that now they understood better the importance of taking care of their mental health; also, that they were practicing the techniques that they learned more frequently, such as diaphragmatic breathing, full breathing, relaxing activities, stop thinking about work worries when they are not working, and regulating their emotions of fear and anxiety, not putting pressure on themselves, excercising, sleeping at least 8 hours per day, eating healthy, engaging in hobbies, taking the sun, and positive thinking. A couple of participants mentioned difficulties with healthy eating and not engaging in any activity.	“I have done many of the exercises that we covered in the workshops like the full breathing or that one that… How do you call it? Diaphragmatic I think, that one where you fill and empty the stomach, I have tried to let go of my thoughts and I go on walks to take care of my mind.” (Legal assistant, US citizen, 37 years, post-interview)
Emotion regulation
Pre-evaluation	The main emotions identified were anger, fear and sadness. Participants in general mentioned that they tried to avoid feeling or confronting these emotions but identified them as being constantly present in their daily lives.	“Mmmm… when I get angry, I am often in my temperament very easy to anger and yell a lot, I get pretty exalted.” (Health assistant, permanent resident, 36 years, pre-interview) “The hardest is being without papers, because well my mom can come to visit us, to say that I miss my mom, well no, thanks God she can come to see us, the hardest is that being without papers, that is what worries one, what is going to happen with you. I live with that fear.” (Housewife, undocumented, 39 years, pre interview)
		“I get sad and I go upstairs to my room to pray or something, or sometimes I even cry.” (Housewife, US citizen, 54 years, pre-interview)
Post-evaluation	Anger: they described dealing with anger in healthier ways such as thinking about the consequences before acting, breathing, and using motion release. A participant said that they are still working on dealing with their anger and that they still show it in an explosive way. Another said that they do not get angry. Fear: they described a decrease in the emotion of fear or dread, the most common response was that they had not felt it lately. A few participants did feel it especially related with the COVID pandemic or because of thoughts that something bad was going to happen. They used some of the emotion regulation techniques such as stopping negative thoughts and exchanging them for positive or facing their fears to control them. There was also a participant that identified that fear detonates other emotions such as anxiety or hopelessness. Sadness: related to sadness, participants said that when they felt it they had used one of the strategies learned in the workshops, such as seeking their social support network to talk about it, and this helped them, also they thought about something else or prayed as a way to control it. A minority said that they had not felt it and did not use any strategy.	“When I get angry, I have tried to stop yelling a lot, sometimes I remember and I continue to work on that.” (Health assistant, permanent resident, 36 years, post-interview) “I try with fear, as well as not letting it affect me so much thinking about a situation that I don't know if it will happen, trying not to be thinking and thinking that it hasn't arrived yet. If solutions can be found to solve the problem that is causing fear.” (Bank assistant, DACA recipient, 25 years, post-interview) “In the sadness, well, sometimes, well, I cry and it helps or I talk, talk to the person, my son or my husband and I explain that it was not right and after that one can express themself better, and well try to talk about it and sort it out.” (Housewife, US Citizen, 54 years, post- interview)
Capacity to manage stress when facing a problem
Pre-evaluation	Participants were not able to define what stress means, however they did acknowledge living situations and symptoms related to it.	“Mmmm… It is when someone has something to do things that is stress but when it is excessive that is distress and that is the one that hurts you.” (Housewife, 37 years, undocumented, pre interview)
Post-evaluation	Participants defined the concept of stress and some signs and symptoms such as headache, hair loss, neck pain, tiredness and psychological symptoms such as tension and mental fatigue. To manage their stress they described having used one or many of the techniques covered in the sessions, such as meditation, mindfulness, directed fantasy, full and diaphragmatic breathing, Jacobson progressive relaxation technique, technique to stop thinking, and exercise.	“Well I think that the same things that I have done have helped me, I do 30 breathings three times and that I only did once. I do breathing in the morning, laying down when I wake up, but turns out I fell asleep ha,ha,ha, then I did other exercises. What I still cannot do correctly is the breathing when you should think of nothing, thinking about nothing, I cannot, many things come to mind all the time and sometimes I think silly things. Well, that is how I am doing my breathing and something comes to mind and I say, well what am I doing, and then I concentrate again in the breathing and I think I cannot keep it for long, ha,ha.” (Housewife, undocumented, 56 years, post interview)
COVID-19
Pre-evaluation	The basal evaluation was conducted before the COVID-19 pandemic reached the United States. The theme did not appear during the pre-implementation evaluation. The COVID-19 pandemic was an unexpected event for the participants. Predominant emotions emerged in the participants who were planned to address during the educational sessions. However, not for the context of pandemic and confinement that the world was experiencing. Some participants were coping many days of confinement due to quarantine, exposure to the media, social networks with both trustworthy and false information that only instilled fear, others were developing essential jobs. All these experiences caused them to experience fear, anxiety, stress, and worry of contracting the disease or that it was contracted by a member of their family, children or husband.	“And with fear because I try to think positive, if I was afraid of the virus [coronavirus] for my girl, because if something happens to her or to me, I can't imagine leaving her alone, but I've taken care of myself, we do everything to clean and we don't go out.” (Legal assistant, US citizen, 37 years, post-interview)
Post-evaluation	The COVID-19 pandemic was an event that exposed to the participants to an unprecedented situation, triggering negative emotions. However, some participants stated using at that time some of the tools learned in the educational sessions to coping these negative emotions and they were useful.	“With much more confidence, with many more tools to reach out and cope the current situation of the coronavirus, because I believe all this came at the right time, because who would have known that all this was going to happen and at the same time that you were teaching us. The pandemic showed up and it has affected everyone, there is a lot of fear among people and all the things that are put on social media that are lies and many are true.” (Housewife, US Citizen, 54 years, post- interview)