Reducing Unhealthy Alcohol Use in Older Hispanic Day Laborers

描述(由申请人提供)：需要采取干预措施，以减少美国低收入、边缘就业人群中不健康的酒精使用，其中许多人是少数族裔。在这一群体中，拉美裔是增长最快的少数群体，拉美裔男性比其他少数群体更有可能大量饮酒。此外，拉美裔比其他种族/民族更有可能死于与饮酒有关的肝病和事故。我们针对中年和老年拉美裔男性进行干预，以减少不健康的饮酒行为，因为他们由于年龄增大，以及可能因酒精而导致或恶化的并发症，导致与酒精相关的伤害的风险更高。整合现有的行为疗法用于拉美裔移民人口，并由社区健康促进者(促进者)在他们的社区提供疗法，可能会提高治疗参与度和保留率，并减少不健康的酒精使用。南加州教育大众研究所(IDEPSCA)是一个以社区为基础的非营利性教育组织，有一个工人健康计划，以满足大洛杉矶地区主要是移民日间劳工和家政工人的健康需求。该组织还运营着6个就业中心，临时工可以来这里找工作。我们建议与IDEPSCA合作，整合两种基于证据的行为疗法：激励增强疗法和基于优势的案例管理，并试行测试使用这种整合方法的干预措施，以减少在IDEPSCA组织的就业中心寻找工作的中老年男性、西班牙裔临时工中的不健康饮酒。干预将由在IDEPSCA志愿服务的推动者进行。拟议工作的总体目标是整合这两种疗法，并开始测试一种方法，以最大限度地提高治疗参与度和保留率，并减少低收入、就业人数较少的中老年拉美裔男性中的不健康饮酒。我们的假设是，与接受简短反馈的人相比，综合干预将改善接受干预的人的结果。这项研究的长期目标是通过开发一种有效的、相关的和相对简短的干预措施来改善社会弱势拉美裔男性不健康饮酒的识别和治疗，社区健康促进者可能会提供这种干预。该项目的一个重要目标是开发一种从IDEPSCA的角度来看最终可持续的干预方法。 公共卫生相关性：需要采取干预措施，以减少美国低收入、边缘就业人群中不健康的饮酒行为，这些人中有许多是西班牙裔，他们的共病和症状可能会因饮酒而恶化。整合循证行为疗法，并培训社区健康推动者(推动者)将其提供给所在社区的拉美裔移民人口，可能会增加成功吸引和留住他们接受治疗并减少酒精使用的可能性。这项拟议工作的总体目标是与南加州教育流行研究所(IDEPSCA)合作，以满足以移民为主的临时工的健康需求，整合两种基于证据的行为疗法：激励增强疗法和基于优势的病例管理，并开始测试一种相关和可持续的干预措施，以减少低收入、边缘就业的拉美裔中老年男性人群中的不健康饮酒。IDEPSCA是一家以社区为基础的非营利性教育组织，拥有工人健康计划。

DESCRIPTION (provided by applicant): Interventions are needed to reduce unhealthy alcohol use among low-income, marginally employed persons in the US, many of whom are minority populations. Among this population, Hispanics are the most rapidly growing minority group and Hispanic males are more likely than other minority groups to engage in heavy episodic drinking. Further, Hispanics are more likely than other racial/ethnic groups to die from liver disease and accidents; conditions associated with alcohol use. We are targeting midlife and older Hispanic men for interventions to reduce unhealthy alcohol use as they are higher risk for alcohol-related harm due to their advancing age and comorbidities that may be attributable to or worsened by alcohol. Integrating existing behavioral therapies for use in immigrant Hispanic populations and providing the therapies in their communities by community health promoters (promotoras) may improve the likelihood of treatment engagement and retention and reduce unhealthy alcohol use. The Instituto de Educacisn Popular del Sur de California (IDEPSCA) is a non-profit community-based educational organization that has a Workers Health Program to address the health needs of mostly immigrant day laborers and household workers in the greater Los Angeles area. The organization also operates 6 job centers where day laborers can come to find work. We propose to collaborate with IDEPSCA to integrate two evidence-based behavioral therapies: Motivational Enhancement Therapy and Strengths- Based Case Management and pilot test an intervention employing this integrated approach to reduce unhealthy drinking among middle-aged and older male, Hispanic day laborers who seek work at the job centers organized by IDEPSCA. The intervention will be delivered by promotoras who volunteer with IDEPSCA. The overall goal of the proposed work is to integrate the two therapies and begin to test an approach to maximize treatment engagement and retention and to reduce unhealthy drinking among a low income, marginally employed population of middle-aged and older Hispanic men. Our hypothesis is that the integrated intervention will improve outcomes of those who receive it compared to those who receive brief feedback. The long-term goal of this research is to improve identification and treatment of unhealthy alcohol use among socially disadvantaged Hispanic men by developing an effective, relevant, and relatively brief intervention that may be provided by community health promoters. An important aim of this project is to develop an intervention approach that is ultimately sustainable from IDEPSCA's standpoint. PUBLIC HEALTH RELEVANCE: Interventions are needed to reduce unhealthy alcohol use among low-income, marginally employed persons in the US, many of whom are Hispanic and who have comorbidities and symptoms that may be worsened by alcohol use. Integrating evidence-based behavioral therapies, and training community health promoters (promotoras) to deliver them to immigrant Hispanic populations in their communities may increase the likelihood of success in engaging and retaining them in treatment and in reducing alcohol use. The overall goal of the proposed work is to partner with the Instituto de Educacisn Popular del Sur de California (IDEPSCA), a non-profit community-based educational organization that has a Workers Health Program, to address the health needs of mostly immigrant day laborers to integrate two evidence-based behavioral therapies: Motivational Enhancement Therapy and Strengths-Based Case Management, and begin to test a relevant and sustainable intervention to reduce unhealthy drinking among a low income, marginally employed population of middle-aged and older Hispanic men.