A Randomized Clinical Trial Of Culturally Tailored MI

针对文化定制的 MI 的随机临床试验

• 批准号: 8438022
• 负责人: CHRISTINA S LEE
• 金额: $ 60.35万
• 依托单位: NORTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-12-15 至 2017-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8438022
• 关键词: Acculturation; Address; Adopted; Adverse effects; Affect; Alcohol consumption; Alcoholic beverage heavy drinker; Alcohols; Area; Behavior; Behavior Therapy; Caring; Cells; Cirrhosis; Clinical; Clinical Trials; Communities; Complex; Data; Dependence; Disadvantaged; Discrimination; Early Intervention; Ensure; Epidemiology; Equilibrium; Ethnic group; Evidence based treatment; Funding; Goals; Health Services Research; Health behavior; Heavy Drinking; Immigrant; Informed Consent; Injury; Intervention; K-Series Research Career Programs; Knowledge; Language; Latino; Legal; Life; Mainstreaming; Minority; Modeling; Modification; Participant; Pattern; Pilot Projects; Population; Poverty; Process; Public Health; Randomized; Randomized Clinical Trials; Recovery; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Resources; Risk; Role; Services; Severities; Sexually Transmitted Diseases; Social Network; Source; Stress; Testing; Time; Translating; Treatment Efficacy; Treatment outcome; United States; United States National Academy of Sciences; Vehicle crash; Violent injury; Woman; Workplace; addiction; alcohol abuse therapy; alcohol related problem; alcohol risk; alcohol use disorder; base; burden of illness; comparative efficacy; cultural values; density of AOD outlets; drinking; drinking behavior; experience; follow-up; gender preference; hazardous drinking; health disparity; improved; meetings; men; motivational enhancement therapy; motivational intervention; named group; prevent; programs; prospective; psychosocial; public health relevance; racial and ethnic; response; screening; screening and brief intervention; social; stressor; substance abuse treatment; treatment response; trial comparing

DESCRIPTION (provided by applicant): This application addresses the priority area Treatment for Health Disparities/Special Populations. Epidemiological and psychosocial research indicates that Latinos suffer greater adverse effects from hazardous drinking compared to other racial/ethnic groups, including higher rates of cirrhosis fatality and alcohol-involved motor vehicle crashes. Culturally-tailored empirically-based interventions are needed because Latinos suffer alcohol-related health disparities, are less likely to initiate and to remai in treatment, and are more likely to live in communities with high density of alcohol outlets. However, research on the field is challenged by the lack of studies comparing tailored to non-tailored treatments. We have pilot data from the PI's (New Investigator) K award (AA014905) demonstrating that culturally tailored motivational interviewing (CTMI) outperformed motivational interviewing (MI) that was not tailored to the needs of Latino heavy drinkers. This study will be the basis for the current proposed study, which is a larger scale version of the pilot. The key modification was to incorporate social stressors in the context of acculturation. Thus, in the proposed study, we will also explore acculturation stress as an influence on the relationship between acculturation and alcohol consumption behavior. The public health impact of this study will be to develop a program of early screening and brief intervention to reduce hazardous drinking among Latinos in communities that may lack such services. By providing early screening and intervention, we hope to minimize the burden of illness and social consequences that disproportionately affect Latino communities. Study Design: 357 Latino men and women who meet criteria for hazardous drinking (> 5/occasion for men, >4/occasion for women) will be recruited from the community. Following informed consent, they will complete a baseline assessment in either Spanish or English, and will then be randomized to receive either un-tailored motivational intervention (MI) or a culturally-tailored motivational intervention (CTMI). Participant randomization will be balanced by language preference, gender, alcohol severity, acculturation stress, and negative consequences, to ensure there is equivalent representation in each cell. Participants will be contacted by research assistants unaware of treatment assignment at 2, 6, and 12 months follow-up. Primary Aim 1: It is hypothesized that those randomized to receive the tailored treatment will report fewer alcohol- related negative consequences and fewer heavy drinking days at follow-up vs. those randomized to receive the un-tailored treatment. Primary Aim 2: Explore acculturation stress as a moderator of alcohol treatment outcomes. Long term goals: Develop a model of care that is easily disseminated in the community, and to generate theoretically-informed hypotheses to better understand how acculturation stress and processes confer risk for increased drinking among Latinos. We expect that this project will contribute needed knowledge about the role of acculturation stress in alcohol drinking behavior and treatment response.

描述（由申请人提供）：本申请涉及健康差异/特殊人群的优先领域治疗。流行病学和心理社会研究表明，与其他种族/族裔群体相比，拉丁美洲人因危险饮酒而遭受的不利影响更大，包括肝硬化死亡率和酒精引起的机动车辆碰撞率更高。需要文化定制的基于酒精的干预措施，因为拉丁美洲人遭受与酒精相关的健康差异，不太可能开始和继续治疗，并且更有可能生活在酒精出口密度高的社区。然而，该领域的研究受到缺乏研究的挑战，比较定制和非定制治疗。我们从PI（新研究者）K奖（AA 014905）的试点数据表明，文化定制的动机面试（CTMI）优于动机面试（MI），这是不是针对拉丁美洲酗酒者的需求。这项研究将是目前拟议的研究的基础，这是一个更大规模的试点版本。关键的修改是在文化适应的背景下纳入社会压力。因此，在本研究中，我们也将探讨文化适应压力对文化适应与饮酒行为之间关系的影响。这项研究的公共卫生影响将是制定一项早期筛查和短暂干预计划，以减少可能缺乏此类服务的社区中拉丁美洲人的危险饮酒。通过提供早期筛查和干预，我们希望最大限度地减少对拉丁裔社区造成不成比例影响的疾病负担和社会后果。研究设计：将从社区招募357名符合危险饮酒标准（男性> 5次/次，女性>4次/次）的拉丁美洲男性和女性。在知情同意后，他们将用西班牙语或英语完成基线评估，然后随机接受非定制的动机干预（MI）或文化定制的动机干预（CTMI）。受试者随机化将根据语言偏好、性别、酒精严重程度、文化适应压力和负面后果进行平衡，以确保每个单元格中的代表性相等。研究助理将在2、6和12个月随访时联系不知道治疗分配的受试者。主要目标1：据推测，与随机接受非定制治疗的患者相比，随机接受定制治疗的患者在随访时报告的酒精相关不良后果较少，重度饮酒天数较少。主要目的2：探讨文化适应压力作为酒精治疗结果的调节剂。长期目标：制定一个护理模式，很容易在社区传播，并产生理论上知情的假设，以更好地了解如何涵化压力和过程赋予风险增加拉丁美洲人之间的饮酒。我们期望这个项目将有助于文化适应压力在饮酒行为和治疗反应中的作用。