权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Mechanisms of Behavior Change in a Cultural Adaptation of Motivational Interviewing

动机访谈文化适应中行为改变的机制

基本信息

批准号：
10086231
负责人：
CHRISTINA S LEE
金额：
$ 49.33万
依托单位：
BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-03-01 至 2022-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10086231
关键词：
Acculturation Adult Alcohol consumption Alcoholic beverage heavy drinker Alcohols Anxiety Awareness Behavior Therapy Behavioral Mechanisms Client Code Complex Data Empathy Equation Ethnic group Evidence based intervention Evidence based treatment Group Processes Guidelines Health behavior Heavy Drinking Improve Access Intervention Investigation Knowledge Latino Link Literature Mediation Mediator of activation protein Mental Depression Meta-Analysis Methodology Modeling National Institute on Alcohol Abuse and Alcoholism Outcome Parents Patient Self-Report Population Process Randomized Controlled Trials Recommendation Research Research Design Sampling Science Series Services Source Strategic Planning Stress Structure Testing Therapeutic Training Treatment Efficacy Work active comparator active method alcohol abuse therapy alcohol response base behavior change behavioral outcome burden of illness causal model community setting evidence base follow-up health disparity improved improved outcome innovation motivational enhancement therapy novel pilot trial preservation primary outcome racial and ethnic skills social disadvantage theories trial comparing

项目摘要

Proposal Summary/Abstract Project Title: Mechanisms of Behavior Change in Culturally Adapted Motivational Interviewing The NIAAA Five Year Strategic Plan prioritizes health disparities research for socially disadvantaged Latinos to reduce the disproportionate burden of negative consequences related to alcohol use compared to other racial/ethnic groups (NIAAA, 2013/2016). Cultural adaptation of evidence-based treatments, such as motivational interviewing (MI), can improve access and overall response to alcohol treatment. However, research progress has been hindered by the few theoretically-guided tests of adaptation and limited knowledge about the active ingredients and mechanisms of behavior change that might discriminate an adapted, compared to non-adapted, intervention. The proposed study will fill this important gap by testing a series of theory-driven hypotheses regarding the within-session predictors of MI outcome and a novel mechanism of culturally adapted MI (CAMI) (self-exploration → decreases in perceived acculturation stress, reduced depression and anxiety → reduced heavy drinking and consequences). The proposed study codes and examines within-session, process data from a parent RCT (AAR01021136, Lee: PI) guided by adaptation theory initially tested in a small RCT (AAK23021136, Lee: PI) that showed promising effects in favor of CAMI (Lee et al., 2013). The ongoing parent CAMI trial compared single session MI to single session CAMI delivered to Latino heavy drinkers (N=301, 18-65 yrs old). The parent study design (e.g., assessment of multiple self-report mediators) permits examination of a causal model, while attending to key recommendations on examining mechanisms of change (Kazdin & Nock, 2003). Up-to-date statistical approaches will be used to examine the MI causal hypothesis, such as investigating change and sustain talk together as a proportion estimate (Magill et al., 2014). The parent study design, which used an active comparator (MI), permits between-condition tests of within-session ingredients and mechanisms, which is a level of contrast rare in MI theory and one of the first a- priori investigations of processes of change in an adaptation study. The first task in adaptation is to confirm that key active treatment ingredients and mechanisms are preserved, so study aims are first, to assess MI ingredients and mechanisms among Latino adults, second, to examine novel MI ingredients and mechanisms potentially relevant to both conditions, and third, to test the theory, ingredients, and mechanisms specific to the adaptation. Long term objectives. Findings will improve dissemination of MI to Latinos by providing empirically-based guidelines on therapist training and on critical MI intervention ingredients. It will also improve understanding of the stress-health behavior link observed among health disparities populations and how MI can be used to disrupt this association. The proposed study will be one of the first to contribute to the emerging science on mechanisms of behavior change with health disparities populations and will yield important recommendations on the science of adaptation and ways to improve MI dissemination to community settings.

建议总结/文摘