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

项目总结

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.