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: 8776241
• 负责人: CHRISTINA S LEE
• 金额: $ 58.39万
• 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 2015-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8776241
• 关键词: Acculturation; Address; Adopted; Adverse effects; Affect; Alcohol consumption; Alcoholic beverage heavy drinker; Alcohols; Area; Behavior; 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; 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; behavioral outcome; behavioral response; burden of illness; comparative efficacy; cultural values; density of AOD outlets; drinking; drinking behavior; experience; follow-up; gender preference; hazardous drinking; health disparity; improved; individualized medicine; meetings; men; motivational enhancement therapy; motivational intervention; named group; prevent; programs; prospective; psychosocial; 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）：本申请介绍了健康差异/特殊人群的优先区域治疗。流行病学和心理社会研究表明，与其他种族/族裔群体相比，拉丁美洲人对危险饮酒的不利影响更大，包括急躁病死的率更高和涉及酒精的汽车车辆崩溃。由于拉丁裔遭受与酒精相关的健康差异，启动和接受REMAI的治疗的可能性较小，并且更有可能居住在酒精饮料密度高的社区中，因此需要以经验为基础的干预措施。但是，缺乏与非限制治疗量身定制的研究有关的挑战。我们拥有PI（新调查员）K奖（AA014905）的飞行员数据，证明，文化量身定制的动机访谈（CTMI）优于激励性访谈（MI），这些访谈（MI）并不是针对拉丁裔重型饮酒者的需求量身定制的。这项研究将是当前拟议的研究的基础，该研究是飞行员的大规模版本。关键的修改是在适应性的背景下纳入社会压力源。因此，在拟议的研究中，我们还将探索适应应力，以此作为对文化和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简短干预计划，以减少拉丁美洲人在可能缺乏此类服务的社区中的危险饮酒。通过提供早期筛查和干预，我们希望最大程度地减少对拉丁裔社区不成比例的疾病和社会后果的负担。研究设计：将从社区招募357个符合危险饮酒标准的拉丁裔男女（男性> 5/场合，> 4/场合）。遵循知情同意，他们将以西班牙语或英语完成基线评估，然后随后将其随机接受，以接受未限制的动机干预措施（MI）或经过文化定制的动机干预措施（CTMI）。参与者的随机分组将通过语言偏好，性别，酒精严重程度，适应应力和负面后果来平衡，以确保每个细胞中都有同等的表示。研究助理将在2、6和12个月的随访中与参与者联系。主要目的1：假设那些随机接受量身定制的治疗的人报告会报告与酒精相关的负面后果较少，随访时与随机接受未量化治疗的人相比，饮酒日较少。主要目的2：探索文化应激作为酒精治疗结果的主持人。长期目标：开发一种很容易在社区中传播的护理模型，并产生理论上知名的假设，以更好地了解适应性压力和过程如何赋予拉丁美洲人增加饮酒的风险。我们预计该项目将有助于了解适应应力在饮酒行为和治疗反应中的作用所需的知识。