Addressing Alcohol Use Health Disparities in Latinx Sexual Minorities: A Culturally Congruent Motivational Intervention Targeting Intersectional Forms of Discrimination

项目摘要 拉丁裔性少数群体，谁是生活在两个国家卫生研究院确定的健康差距群体的交叉点，是在 酗酒行为和酒精相关问题的风险增加， 他们所经历的交叉形式的歧视-种族主义和异性恋歧视。目前没有 酒精滥用行为健康干预，解决独特的需求和身份的交叉点， 拉丁裔性少数群体。有一种很有希望的干预方法，文化适应动机面试 （CAMI），已显示出减少拉丁裔个体内酒精滥用的功效。具体来说，CAMI是一个 为拉丁裔个体量身定制的干预措施，以适应文化压力为目标， 减少酒精滥用。然而，非洲移徙部长会议只处理单一形式的歧视， 交叉性和LGBTQ肯定的观点，以解决多种形式的歧视。因此，CAMI 将采用LGBTQ积极干预适应模型进行调整，以少数民族压力为依据， 制定一项干预措施，解决交叉形式的歧视， 拉丁裔性少数群体被称为拉丁裔酷儿适应动机访谈（LaQAMI）。LaQami将是 通过远程医疗提供，它将以英语和西班牙语提供， 将被用作受控条件。本研究将在新英格兰（NE）和 西南部（亚利桑那州西南部）考虑到拉丁性别的多样性， 少数群体该研究将分三个阶段进行：深入定性访谈与拉丁性别 少数民族（n=20）和来自东北部和西南部的诊所利益相关者（n=10;目标1），以获取 歧视和酗酒之间的联系，并就手册的修改收到反馈意见;第二， 阶段将是开放系列，重点是审查干预措施的可行性和可接受性， 将对16名拉丁裔性少数群体进行测试（NE组n= 8; SW组n= 8），并将纳入反馈 第三阶段将是一项试验性随机对照试验（RCT），共有60名受试者。 拉丁裔性少数群体，30名来自东北部的参与者和30名来自西南部的参与者（15名接受新的 干预和15个接受MI从每个地区;目标3）。目前研究的目标与 NIAAA确定了特殊人群和战略计划。此外，目前的K23将建立在 申请人在健康差异，少数民族压力和定量技能方面的专业知识，它将为申请人提供 在文化适应，社区参与的研究，概念化和执行 随机对照试验、定性研究和混合研究。K23培训期间将为申请人提供 需要保护的时间和培训，成为一个领先的健康差异研究人员，专注于多样性， 成瘾科学

PROJECT SUMMARY Latinx sexual minorities, who are living at the intersection of two NIH identified health disparities groups, are at increased risk for binge drinking behavior and alcohol-related problems which has been linked to the intersectional forms of discrimination they experience – racism and heterosexism. Currently there are no alcohol misuse behavioral health interventions that address the unique need and intersection of identities for Latinx sexual minorities. There is one promising intervention, Culturally Adapted Motivational Interviewing (CAMI), that has shown efficacy in decreasing alcohol misuse within Latinx individuals. Specifically, CAMI is a tailored intervention for Latinx individuals which targets acculturative stress and has shown strong promise in its reduction of alcohol misuse. Yet, CAMI only address singular forms of discrimination and does not use an intersectionality and LGBTQ affirming perspective to address multiple forms of discrimination. Therefore, CAMI will be adapted using an LGBTQ affirmative model of intervention adaptation, informed by minority stress, to develop an intervention that addresses intersectional forms of discrimination to target alcohol misuse among Latinx sexual minorities called- Latinx Queer Adapted Motivational Interviewing (LaQAMI). LaQAMI will be delivered via telehealth, it will be available in English and in Spanish, and traditional motivational interviewing will be used as the controlled condition. The study will be conducted in New England (NE) and in the Southwest (SW in Arizona) to account for geographical differences given the diversity of Latinx sexual minorities. The study will be conducted in three phases: in-depth qualitative interviews with Latinx sexual minorities (n=20) and clinic stakeholders from NE and the SW (n=10; aim 1) to capture intersectional forms of discrimination and links to alcohol misuse and receive feedback on the adaptation of the manual; the second phase will be open series where it will focus on examining feasibility and acceptability of the intervention and it will be tested with 16 Latinx sexual minorities (n= 8 from NE; n= 8 from SW) and feedback will be incorporated into the treatment protocol (aim 2); the third phase will be a pilot randomized controlled trial (RCT) with 60 Latinx sexual minorities with 30 participants from NE and 30 participants from the SW (15 receiving the new intervention and 15 receiving MI from each region; aim 3). The goals of the current study are consistent with NIAAA’s identified special populations and strategic plan. Additionally, the current K23 will build on the applicant’s expertise in health disparities, minority stress, and quantitative skills and it will provide the applicant with advanced training in cultural adaptation, community-engaged research, conceptualizing and executing RCT’s, and qualitative and mixed methods research. The K23 training period will provide the applicant with the needed protected time and training to become a leading health disparities researcher focusing on diversity and addiction science.