A Reinforced Mindfulness-Based Intervention to Reduce Problematic Drinking among Latinx Emerging Adults: Feasibility and Acceptability

摘要 在美国所有年龄段的人群中，新兴成年人的饮酒率最高 约三分之一(32%)的人酗酒(女性/男性在两小时内饮酒4至5杯)。而Latinx 新兴成年人报告称，与非拉丁裔白人相比，他们的重度饮酒率较低。 拉丁裔饮酒者转变为物质使用障碍的风险更大，经历的情况也更严重 负面后果。相对于其他种族/民族群体，拉美裔新兴成年人从事 有问题的饮酒是(A)不太可能寻求治疗，(B)较少获得创新和 可获得的健康促进资源，加剧了健康不平等。越来越多的证据支持这一效用 以正念为基础的干预(MBIS)减少有问题的酒精使用并促进可持续的 健康的生活方式。然而，关于mbi解决酒精使用问题的研究仅限于(1)最低限度 种族/少数族裔代表性和(2)方案依从率和保留率较低。长期目标 这项研究的目的是减少拉美裔新兴成年饮酒者的酒精滥用 以自我调节过程为目标的基于正念的发展适应性干预计划。这个 这项研究的主要目的有两个。主要目标1-使用以社区为基础的参与性研究 (CBPR)以文化适应五个阶段为指导的行为健康干预方法，以确保 以正念为基础的减压的文化和发展适应性(MBSR-L) 拉美裔新兴成年人(18-25岁)，报告在前30天内有2次或更多的酗酒经历。 研究的这些形成阶段将包括专家咨询小组审查、关键线人访谈 (n=15)，焦点小组(n=30)和试点试验(n=10；8周，每周一小时的MBSR改编课程)。 将对形成性数据进行分析，以获得有关结构、持续时间、可接受性和文化方面的信息 干预方案的适当性和进一步细化。主要目标2-开展文化活动 适应性试验评价改良式MBSR-L干预方案在老年人中的可接受性和可行性 报告两次或两次以上酗酒事件的拉美裔未成年新兴成年人的社区样本(n=120) 在之前的30天内。参与者将被随机分配到MBSR-L条件下(每周8次，每次1小时 MBSR-L会话)或仅评估控制条件。次要目标2.1--审查 MBSR-L干预的效果。我们假设，相对于对照组中的参与者 在这种情况下，MBSR-L条件下的参与者将报告：(A)酗酒频率更大地减少 事件和每次饮酒次数，以及(B)更大的影响假定的机制 改变(例如，减少压力，加强自我调节，增强幸福感)。拟议的研究已经 通过为减少酒精滥用的翻译工作做出贡献，对公共卫生产生重大影响 以及拉丁裔初露头角的成年人之间的差异，否则他们不会寻求治疗。

Abstract Among all age cohorts in the United States, emerging adults have the highest prevalence of alcohol use and about one-third (32%) engage in binge drinking (4 to 5 drinks in two hours females/males). While Latinx emerging adults report lower rates of heavy alcohol use compared to their non-Latinx White counterparts, Latinx who do drink are at greater risk for transitioning to substance use disorders and experience more severe negative consequences. Relative to other racial/ethnic groups, Latinx emerging adults who engage in problematic drinking are (a) less likely to seek treatment, and (b) have less access to innovative and accessible health promoting resources, exacerbating health inequities. Increasing evidence supports the utility of mindfulness-based interventions (MBIs) for reducing problematic alcohol use and promoting a sustainable healthy lifestyle. However, research on MBIs to address alcohol use problems is limited by (1) minimal racial/ethnic minority representation and (2) low rates of program adherence and retention. The long-term goal of this research is to decrease alcohol misuse among Latinx emerging adult drinkers through a culturally and developmentally adapted mindfulness-based intervention program targeting self-regulatory processes. The primary aims of the study are twofold. Primary Aim 1 - Use Community-Based Participatory Research (CBPR) methods guided by the five stages of cultural adaptations of behavioral health interventions to ensure a culturally and developmentally appropriate adaptation of mindfulness-based stress reduction (MBSR-L) for Latinx emerging adults (18-25 years-old) who report 2 or more binge drinking episodes in the prior 30 days. These formative stages of the research will include an expert advisory panel review, key informant interviews (n=15), focus groups (n=30) and a pilot trial (n=10; 8-weeks with weekly hour-long adapted MBSR sessions). Formative data will be analyzed to obtain information on structure, duration, acceptability, and cultural appropriateness and further refinement of intervention protocols. Primary Aim 2 – Conduct a Cultural Adaptation Trial to evaluate the acceptability and feasibility of the adapted MBSR-L intervention among a community sample (n=120) of Latinx underage emerging adults who report 2 or more binge drinking episodes in the prior 30 days. Participants will be randomly assigned to an MBSR-L condition (8 weekly 1-hour adapted MBSR-L sessions) or an assessment-only control condition. Secondary Aim 2.1 - Examine initial evidence of the efficacy of the MBSR-L intervention. We hypothesize that, relative to the participants in the control condition, participants in the MBSR-L condition will report: (a) greater reductions in frequency of binge drinking episodes and number of drinks per drinking occasion, and (b) greater impacts on putative mechanisms of change (e.g., reduced stress, greater self-regulation, and enhanced well-being). The proposed study has significant public health implications by contributing to translational efforts to reduce alcohol misuse and disparities among Latinx emerging adults who would otherwise not seek treatment.