Culturally Adapted Motivational Interviewing Hispanics

描述(由申请者提供)：此申请是对以患者为导向的研究职业指导奖(K23)的请求，以发展为一名独立的临床试验研究人员，专门从事酒精治疗研究在服务不足的群体中的实施和评估。在之前的一次拨款中，我发现临床医生对少数族裔饮酒者的反应较少同情，并认为白人男性饮酒者对自己的酒精消费控制较少。偏见、得不到治疗和语言障碍是造成卫生保健差距的原因之一。这些因素解释了拉美裔美国人从饮酒到危险饮酒的加速过程，与非拉美裔相比，他们经历了不成比例的更高的酒精问题。这项拟议的研究希望通过开发一种文化适应的励志访谈来解决这些障碍，供讲英语的临床医生在处理西班牙裔患者时使用。 这项应用的主要研究目的是开发和评估文化适应的动机访谈(CAMI)，并将这种干预的效果与标准动机访谈(SMI)进行比较。CAMI的重点将是：1)将关于饮酒的文化规范和态度纳入干预，以及2)以文化敏感的方式提供干预的方法。CAMI的开发将遵循阶段指导方针。这项研究的意义将是增加对以下问题的理解：将文化因素整合到现有的心理社会治疗中是否会提高治疗效果，以及培训说英语的临床医生以文化敏感的方式提供干预是否会改善临床过程和结果。 培训目标是：1)扩大影响东北部拉美裔酒精使用的因素的概念性知识，2)增加激励访谈的交付和评估方面的专业知识，3)提高临床试验方法和统计方面的技能，4)学术生产力，以及5)接受研究伦理方面的培训，包括与社区研究进行有关的伦理问题。培训目标将通过1)布朗大学酒精和成瘾研究中心，2)指导，3)专注于课程和临床经验，以及4)拟议的研究项目提供的资源来实现。

DESCRIPTION (provided by applicant): This application is a request for a Mentored Patient-Oriented Research Career Award (K23) to develop as an independent clinical trials researcher specializing in the implementation and evaluation of alcohol treatment research with underserved groups. In a prior grant, I found that clinicians responded to minority drinkers with less pity and rated white male drinkers to have less control over their alcohol consumption. Bias, lack of access to treatment, and the language barrier, contribute to health care disparities. These factors explain the accelerated course from drinking to hazardous drinking for Hispanics, who experience a disproportionately higher rate of alcohol problems compared with non-Hispanics. The proposed research study hopes to address these barriers by developing a culturally adapted motivational interview for use by English-speaking clinicians working with Hispanic patients. Primary research aims of this application are to develop and evaluate a culturally adapted motivational interview (CAMI), and to compare the efficacy of this intervention with standard motivational interview (SMI). CAMI foci will be on: 1) the integration of cultural norms and attitudes about drinking into the intervention, and 2) methods to deliver the intervention in a culturally sensitive manner. CAMI development will follow stage guidelines. The significance of this research will be to increase understanding on whether integrating cultural factors into an existing psychosocial treatment enhances treatment efficacy, and whether training English-speaking clinicians to deliver an intervention in a culturally sensitive manner enhances clinical process and outcome. Training goals are to: 1) broaden conceptual knowledge of the factors that influence Hispanic alcohol use in the Northeast, 2) increase expertise in the delivery and evaluation of motivational interviewing, 3) enhance skills in clinical trials methodology and statistics, 4) scholarly productivity, and 5) receive training in research ethics, including ethical issues regarding the conduct of community research. Training goals will be achieved through resources available at 1) the Center for Alcohol and Addiction Studies, Brown University, 2) mentorship, 3) focused coursework and clinical experiences, and 4) the proposed research project.