International Latino Research Partnership (ILRP)

描述（由申请人提供）：未经治疗的物质使用障碍与过早死亡、生产力丧失、高残疾率和艾滋病毒风险增加有关。物质使用也使使用者面临抑郁症状加重和高度焦虑的风险。以相互的方式，有心理健康问题从根本上增加了吸毒、吸烟、酗酒和偶尔酗酒的可能性。尽管有大量证据证明双重诊断患者的高患病率，但很少有严格的干预措施用于治疗患有共病物质使用和精神健康障碍的个体。在全球范围内，大多数有药物使用和/或心理健康问题的人得不到治疗。拟议的国际拉丁美洲研究伙伴关系（ILRP）直接回应了文献中的这一差距。 ILRP汇集了研究机构及其在波士顿，马德里和巴塞罗那的合作社区诊所，以加强国际合作伙伴关系，并开发必要的研究证据，以应对拉丁美洲移民的行为健康服务需求。我们将重点转向拉丁美洲移民，因为经济机会使前所未有的拉丁美洲移民数量转移到西班牙和美国等东道国。西班牙拥有世界上第二大拉丁裔移民，仅次于美国，美国的大多数移民都是拉丁裔。拉美移民面临着行为健康的巨大障碍。在适应东道国文化的过程中，移民饮酒和使用毒品的情况有所增加，这给卫生保健系统和公共安全造成了压力，并增加了他们感染艾滋病毒的风险。 我们提出三个目标：1）发展国际伙伴关系和研究合作，以支持研究，可以提高可及性，质量和结果的综合行为健康服务的移民拉丁美洲人与共同发生的物质使用，心理健康问题和/或艾滋病毒的风险在初级保健诊所; 2）协调数据跨研究站点;和3）进行行为健康服务研究，重点是快速筛查，转诊和综合行为健康服务研究的移民拉丁美洲人口与共同发生的物质使用，心理健康问题和艾滋病毒风险在初级保健诊所。对于目标3，我们遵循筛查，简短干预和转诊治疗（SBIRT）模型，首先测试西班牙语人群的简短行为健康筛查的有效性。在这项工作的基础上，我们测试的可行性，可接受性和有效性的“双重问题和早期行动的综合干预”（IIDEA）干预解决物质使用，吸烟和精神健康障碍。因此，拟议的ILRP多地点国际项目是为大量和多样化的拉丁美洲移民人口制定综合护理模式的关键一步，更广泛地理解如何最好地整合循证评估和治疗同时发生的物质和精神健康问题以及艾滋病毒风险。

DESCRIPTION (provided by applicant): Untreated substance use disorders are associated with premature mortality, productivity loss, high rates of disability, and increased risk for HIV. Substance use also places users at risk for elevated depression symptoms and high levels of anxiety. In reciprocal fashion, having mental health problems radically increases the likelihood of augmented drug use, smoking, binge drinking and heavy episodic drinking. Despite a substantial body of evidence documenting the high prevalence of dual-diagnosis patients, few rigorous interventions have been conducted to treat individuals with comorbid substance use and mental health disorders. Globally, most people with substance use and/or mental health problems receive no treatment. The proposed International Latino Research Partnership (ILRP) directly responds to this gap in the literature. The ILRP brings together research institutions an their partnering community clinics in Boston, Madrid and Barcelona to enhance a collaborative international partnership and to develop the research evidence necessary to respond to Latino migrants' behavioral health service needs. We turn our focus to Latino migrants because economic opportunities have moved unprecedented numbers of migrants from Latin America to host countries like Spain and the US. Spain has the second largest number of Latino migrants in the world behind only the US, where most immigrants are Latino. Migrant Latinos confront colossal barriers to behavioral health. During the process of acculturation to the host culture, migrants have been shown to drink more alcohol and use more drugs straining the health care system, public safety, and increasing their risk for HIV. We propose three aims: 1) Develop an international partnership and research collaboration to support research that can improve accessibility, quality and outcomes of integrated behavioral health services for migrant Latinos with co-occurring substance use, mental health problems and/or HIV risk in primary care clinics; 2) Harmonize data across research sites; and 3) Conduct behavioral health services research focused on rapid screening, referral, and integrated behavioral health services research for migrant Latino populations with co-occurring substance use, mental health problems, and HIV risk in primary care clinics. For Aim 3, we follow a Screening, Brief Intervention and Referral to Treatment (SBIRT) model, where we first test the validity of a brief behavioral health screener for Spanish-Speaking populations. Building on that work, we test the feasibility, acceptability and efficacy of the "Integrated Intervention for Dual Problems and Early Action" (IIDEA) intervention addressing substance use, smoking and mental health disorders. As such, the proposed ILRP multi-site international project is a critical step towards developing models of integrated care for the large and diverse Latino migrant population and more broadly towards understanding how best to integrate evidence- based assessment and treatments for co-occurring substance and mental health problems and HIV risks.