Reducing Unhealthy Alcohol Use in Older Hispanic Day Laborers

描述（由申请人提供）：需要采取干预措施，以减少美国低收入、边缘就业人员的不健康饮酒，其中许多人是少数民族。在这一人群中，西班牙裔是增长最快的少数群体，西班牙裔男性比其他少数群体更有可能陷入严重的间歇性饮酒。此外，西班牙裔人比其他种族/族裔群体更有可能死于肝脏疾病和事故；与饮酒有关的疾病。我们的目标是中年和老年西班牙裔男性进行干预，以减少不健康的酒精使用，因为他们由于年龄的增长和可能归因于或因酒精而恶化的合并症，酒精相关伤害的风险更高。将现有的行为疗法整合到西班牙裔移民人群中，并由社区健康促进者（promotoras）在他们的社区提供治疗，可以提高治疗参与和保留的可能性，并减少不健康的酒精使用。加州南部人民教育研究所（IDEPSCA）是一个以社区为基础的非营利性教育组织，它有一个工人健康方案，以解决大洛杉矶地区大多数移民日工和家庭工人的健康需求。该组织还运营着6个就业中心，日工可以来这里找工作。我们建议与IDEPSCA合作，整合两种基于证据的行为疗法：动机增强疗法和基于优势的案例管理，并试点测试采用这种综合方法的干预措施，以减少在IDEPSCA组织的就业中心寻找工作的中老年男性，西班牙裔日工的不健康饮酒。干预将由IDEPSCA的志愿者推广人员提供。拟议工作的总体目标是将两种疗法结合起来，并开始测试一种方法，以最大限度地提高治疗的参与度和保留率，并减少低收入、边缘就业人口中老年西班牙裔男性的不健康饮酒。我们的假设是，与那些接受简短反馈的人相比，接受综合干预的人会改善结果。本研究的长期目标是通过社区健康促进者提供的有效、相关且相对简短的干预措施，改善对社会弱势西班牙裔男性不健康饮酒的识别和治疗。该项目的一个重要目标是开发一种干预方法，从IDEPSCA的角度来看，这种方法最终是可持续的。

DESCRIPTION (provided by applicant): Interventions are needed to reduce unhealthy alcohol use among low-income, marginally employed persons in the US, many of whom are minority populations. Among this population, Hispanics are the most rapidly growing minority group and Hispanic males are more likely than other minority groups to engage in heavy episodic drinking. Further, Hispanics are more likely than other racial/ethnic groups to die from liver disease and accidents; conditions associated with alcohol use. We are targeting midlife and older Hispanic men for interventions to reduce unhealthy alcohol use as they are higher risk for alcohol-related harm due to their advancing age and comorbidities that may be attributable to or worsened by alcohol. Integrating existing behavioral therapies for use in immigrant Hispanic populations and providing the therapies in their communities by community health promoters (promotoras) may improve the likelihood of treatment engagement and retention and reduce unhealthy alcohol use. The Instituto de Educacisn Popular del Sur de California (IDEPSCA) is a non-profit community-based educational organization that has a Workers Health Program to address the health needs of mostly immigrant day laborers and household workers in the greater Los Angeles area. The organization also operates 6 job centers where day laborers can come to find work. We propose to collaborate with IDEPSCA to integrate two evidence-based behavioral therapies: Motivational Enhancement Therapy and Strengths- Based Case Management and pilot test an intervention employing this integrated approach to reduce unhealthy drinking among middle-aged and older male, Hispanic day laborers who seek work at the job centers organized by IDEPSCA. The intervention will be delivered by promotoras who volunteer with IDEPSCA. The overall goal of the proposed work is to integrate the two therapies and begin to test an approach to maximize treatment engagement and retention and to reduce unhealthy drinking among a low income, marginally employed population of middle-aged and older Hispanic men. Our hypothesis is that the integrated intervention will improve outcomes of those who receive it compared to those who receive brief feedback. The long-term goal of this research is to improve identification and treatment of unhealthy alcohol use among socially disadvantaged Hispanic men by developing an effective, relevant, and relatively brief intervention that may be provided by community health promoters. An important aim of this project is to develop an intervention approach that is ultimately sustainable from IDEPSCA's standpoint. PUBLIC HEALTH RELEVANCE: Interventions are needed to reduce unhealthy alcohol use among low-income, marginally employed persons in the US, many of whom are Hispanic and who have comorbidities and symptoms that may be worsened by alcohol use. Integrating evidence-based behavioral therapies, and training community health promoters (promotoras) to deliver them to immigrant Hispanic populations in their communities may increase the likelihood of success in engaging and retaining them in treatment and in reducing alcohol use. The overall goal of the proposed work is to partner with the Instituto de Educacisn Popular del Sur de California (IDEPSCA), a non-profit community-based educational organization that has a Workers Health Program, to address the health needs of mostly immigrant day laborers to integrate two evidence-based behavioral therapies: Motivational Enhancement Therapy and Strengths-Based Case Management, and begin to test a relevant and sustainable intervention to reduce unhealthy drinking among a low income, marginally employed population of middle-aged and older Hispanic men.