Latino Migrant Laborers' Use of Drug Abuse Recovery Houses

描述（由申请人提供）：墨西哥和中美洲移民劳工（城市日工和农场工人）具有物质使用障碍（sud）的高风险。当他们为严重的sud寻求治疗时，他们遇到了很大的障碍（例如，就业需求、英语水平有限、缺乏医疗保险、由于公民身份而没有资格）。考虑到美国拉丁裔移民劳工人口的巨大规模（估计约为300万），他们对美国经济的重要性，以及与药物使用相关的健康问题的高成本，确定具有成本效益，文化上可接受且可为患有SUD的移民劳工使用的SUD康复资源至关重要。提出的探索性研究将调查墨西哥和中美洲移民劳工广泛使用的跨国恢复模型，但文献中没有：附件（附件）。anexo是一项经过修改的墨西哥康复计划，20年前由患有sud的移民劳工引入美国。这些住宿互助的康复项目提供结构化的日常生活、同伴支持和每日西班牙语的匿名戒酒会（AA）会议，该会议结合了墨西哥匿名戒酒会的特定语言、仪式和其他文化元素。提出的定性R21研究将探讨(1)这些跨国恢复计划的结构和实践，以及(2)拉丁裔移民劳工如何以及为什么进入这些计划。本探索性研究的具体目的是：(1)确定个人层面的因素（如年龄、婚姻状况、移民史、收入）、项目层面的因素（如项目语言和仪式）和结构性因素（如移民政策、健康准入政策、劳动条件），这些因素塑造了使用anexos的墨西哥和中美洲移民劳工寻求帮助的途径；(2)审查美国各附属机构促进康复的做法（例如，互戒会、同伴支持、规则、日常工作），并确定各附属机构在做法（如有）方面的差异；(3)确定客户对附件的好处（例如，低成本，西班牙语，文化熟悉度）和可能的缺点（例如，过度拥挤，等候名单，非专业人员）的看法。我们将使用人种学研究方法（参与者观察、探索性访谈和案例研究）在加州的3个地区收集定性探索性数据。我们的长期目标是利用我们的探索性发现设计并开展一项全国范围内的研究，从而完善拉丁裔移民劳工低成本、文化上可接受和可获得的SUD治疗方案的知识。

DESCRIPTION (provided by applicant): Mexican and Central American migrant laborers (both urban day laborers and farmworkers) are at high risk for developing substance use disorders (SUDs). When they seek treatment for severe SUDs, they encounter substantial barriers (e.g., employment demands, limited English proficiency, lack of health insurance, non- eligibility due to citizenship status). Given the significant size of the Latino migrant laborer population in the U.S. (estimated at around 3 million), their importance to the US economy, and the high cost of substance use- related health problems, it is critically important to identify SUD recovery resources that are cost-effective, culturally accepted, and accessible for migrant laborers with SUDs. The proposed exploratory study will investigate a transnational recovery model that is widely used by Mexican and Central American migrant laborers, but is absent from the literature: anexos (annexes). The anexo is a modified Mexican recovery program that was introduced into the U.S. twenty years ago by migrant laborers struggling with SUDs. These residential, mutual-help recovery programs provide a structured daily routine, peer support, and daily Spanish- language Alcoholics Anonymous (AA) meetings that incorporate specific language, rituals, and other cultural elements from AA in Mexico. The proposed qualitative R21 study will explore (1) the structure and practices of these transnational recovery programs, and (2) how and why Latino migrant laborers access them. The specific aims of this exploratory study are: (1) to identify the individual-level factors (e.g., age, marital status, migration histoy, income), program-level factors (e.g., program language and rituals), and structural factors (e.g., immigration policy, health access policy, labor conditions) that shape the help-seeking pathways of Mexican and Central American migrant laborers who use anexos; (2) to examine the recovery-promoting practices (e.g., AA meetings, peer support, rules, daily routine) of U.S.-based anexos and identify variations in practices (if any) across the anexos; and (3) to ascertain clients' perceptions of the benefits (e.g., low cost, Spanish language, cultural familiarity) and possible drawbacks (e.g., overcrowding, wait list, non-professional staff) of the anexos. We will use ethnographic research methods (participant observation, exploratory interviewing, and case studies) to gather qualitative exploratory data at 3 California anexos. Our long-term goal is to use our exploratory findings to design and conduct a nationwide study of anexos, thereby refining knowledge of low-cost, culturally accepted and accessible SUD treatment options for Latino migrant laborers.