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

解决拉丁裔性少数群体的饮酒健康差异：针对交叉形式歧视的文化一致性动机干预措施

• 批准号: 10662852
• 负责人: David G. Zelaya
• 金额: $ 19.35万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10662852
• 关键词: Address; Adult; Age; Alcohol abuse; Alcohol consumption; Alcohols; Arizona; Award; Behavior; Behavior Therapy; Behavioral Model; Client satisfaction; Clinic; Communities; Data; Development; Discrimination; Equipment and supply inventories; Evaluation; Feedback; Frequencies; Future; Goals; Grant; Heavy Drinking; Heterosexuals; Hour; Individual; Intervention; Interview; Latinx; Latinx population; Lesbian Gay Bisexual Transgender Queer; Link; Manuals; Measures; Mental Health; Modeling; Modification; National Institute on Alcohol Abuse and Alcoholism; New England; Outcome; Participant; Phase; Population; Population Heterogeneity; Process; Protocols documentation; Provider; Public Health; Randomized, Controlled Trials; Research; Research Methodology; Research Personnel; Research Project Grants; Risk; Sampling; Science; Series; Source; Special Population; Strategic Planning; Stress; Surveys; Testing; Time; Training; Translating; Treatment Protocols; United States National Institutes of Health; Woman; acceptability and feasibility; addiction; alcohol misuse; alcohol related problem; alcohol use disorder; behavioral health intervention; binge drinking; cisgender; community engaged research; community intervention; community partnership; coping; drinking; drinking behavior; evidence base; experience; feasibility testing; geographic difference; health disparity; health disparity populations; innovation; intersectionality; marginalization; member; men; minority stress; motivational enhancement therapy; motivational intervention; novel; perceived discrimination; pilot test; primary outcome; psychological distress; queer; racism; randomized, clinical trials; resilience; response; secondary outcome; sexual minority; sexual minority community; sexual minority group; sexual minority health disparity; sexual risk behavior; skills; stressor; substance use; telehealth; therapy development; trial comparing; trial design

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.

项目摘要 拉丁人的性少数群体生活在两个NIH确定的健康差异群体的交汇处， 加重饮酒行为和与酒精有关的问题的风险增加了 他们经历的歧视的交叉形式 - 种族主义和异性恋。目前没有 滥用行为健康干预措施，以解决独特的需求和身份交集 拉丁人性少数群体。有一个应许的干预措施，具有文化适应的动机访谈 （CAMI），这表明在拉丁裔个体中降低酒精滥用的效率。具体来说，卡米是一个 针对适应性压力的拉丁裔个体的量身定制干预措施，并在 它减少了滥用酒精。但是，卡米仅解决歧视的单数形式，不使用 交叉性和LGBTQ会影响观点以解决多种形式的歧视。因此，卡米 将使用LGBTQ情感模型的干预适应模型进行调整，并以少数派压力告知 开发一种处理歧视交叉形式的干预措施，以靶向滥用酒精 拉丁人的性少数群体称为拉丁酷儿改编的动机访谈（Laqami）。 Laqami会 通过远程医疗交付，它将提供英语和西班牙语以及传统的励志采访 将用作控制条件。该研究将在新英格兰（NE）和 西南（亚利桑那州西南部）考虑了拉丁文性的多样性，以解释地理差异 少数民族。该研究将分为三个阶段：深入的拉丁人性访谈 NE和SW（n = 10; AIM 1）的少数族裔（n = 20）和诊所利益相关者捕获交叉形式的 歧视和与酒精滥用的联系，并收到有关手册改编的反馈；第二个 阶段将是开放的系列，它将专注于检查干预的可行性和可接受性及其 将用16个拉丁人的性少数族裔（NE; NE; n = 8的SW的n = 8）进行测试，并将纳入反馈 进入治疗方案（AIM 2）；第三阶段将是一个飞行员随机对照试验（RCT），60 拉丁人的性少数群体，有30名来自NE的参与者和来自SW的30名参与者（15个接受了新的参与者 干预和15个从每个区域接收MI；目标3）。当前研究的目标与 NIAAA确定了特殊人群和战略计划。此外，当前的K23将建立在 申请人在健康分配，少数群体压力和定量技能方面的专业知识，它将为申请人提供 通过文化适应的高级培训，社区参与研究，概念化和执行 RCT，定性和混合方法研究。 K23培训期将为申请人提供 需要受到保护的时间和培训，成为主要的健康差异研究人员，专注于多样性和 成瘾科学。