Brief Intervention by Community Health Workers for Unhealthy Drinking in Latinos.

项目摘要 到2050年，拉丁裔将占人口的近30%，而社会弱势的拉丁裔将占人口的30%。 与饮酒有关的健康状况不佳和负面社会后果的负担比 非拉丁裔白人尽管需要服务，但治疗利用率低， 这表明，重要的是要使酒精干预更容易为拉丁美洲人。社区卫生工作者 是一种有效的方法，以帮助服务不足的人群管理慢性疾病，如糖尿病和 高血压，但它们很少用于成瘾服务。目前的研究将工作从一个 一项试点研究，利用社区卫生工作者提供一个简短的3个会议的酒精干预， 整合动机增强疗法和基于优势的案例管理MET/SBCM。基于 根据这些有希望的初步发现，我们建议在更广泛的 在社会上处于不利地位的拉丁裔人口从事不健康的饮酒。对于拟议的研究， 加州大学洛杉矶分校和一家大型社区医疗保健组织普罗维登斯将建立合作伙伴关系 社区健康改善中心普罗维登斯进行一项2期随机对照试验， MET/SBCM干预。 参与者n= 20将筛选出超过美国低风险饮酒指南的阳性， 寻求酒精治疗。他们将被随机分配到3个疗程的MET/SBCM酒精干预或 一本酒精控制教育小册子。酒精使用、与酒精有关的问题和 将在基线、3个月、12个月和12个月随访时评估健康和社会服务。它是假设 MET/SBCM干预将改善结果相比，信息讲义对照组。 候选人的行为变化机制也将在纵向框架内进行审查。的 调查的机制将包括1准备改变，2感知的回报价值和相关风险 饮酒者，3个饮酒规范的感知，4个改变谈话，5个一般自我效能感，自尊和 七是利用社区服务。 本项目的目标是为可持续的干预方法建立证据基础 由一个为拉丁美洲人服务的大型社区组织提供。与社区卫生工作者合作可以平衡这一点 采取干预措施，解决社区内的健康差距。该项目将有助于提高覆盖面， 有效的酒精干预措施在社会弱势拉丁美洲人中的影响，从而有助于 改善人口健康。

Project Summary Latinos will comprise nearly 30% of the population by 2050, and socially disadvantaged Latinos experience a greater burden of poor health and negative social consequences related to their alcohol use than non-Latino Whites. Despite the need for services, low treatment utilization rates and poor treatment retention suggest it is important to make alcohol interventions more accessible for Latinos. Community health workers are an effective way to help under-served populations manage chronic illnesses such as diabetes and hypertension, but they have been used very little in addiction services. The current study extends work from a pilot study that utilized community health workers to deliver a brief 3 session alcohol intervention that integrates Motivational Enhancement Therapy and Strengths-Based Case Management MET/SBCM . Based on those promising but preliminary findings, we propose to test the MET/SBCM intervention among a broader population of socially disadvantaged Latinos who engage in unhealthy drinking. For the proposed study a partnership will be formed between UCLA and a large community-based healthcare organization, Providence Center for Community Health Improvement Providence to conduct a phase 2 randomized controlled trial of the MET/SBCM intervention. Participants n=2 0 will screen positive for exceeding US low-risk drinking guidelines and will not be seeking alcohol treatment. They will be randomized to either the 3-session MET/SBCM alcohol intervention or to an alcohol educational booklet control condition. Alcohol use, alcohol-related problems and utilization of health and social services will be assessed at baseline, 3-, - and 12-month follow-ups. It is hypothesized that the MET/SBCM intervention will improve outcomes compared to the informational handout control group. Candidate mechanisms of behavior change will also be examined in a longitudinal framework. The mechanisms investigated will include 1 readiness to change, 2 perceived reward value and risks associated with alcohol use, 3 perception of drinking norms, 4 change talk, 5 general self-efficacy, self-esteem and 7 utilization of community services. The goal of this project is to establish an evidence base for an intervention approach that is sustainable by a large community-based organization serving Latinos. Working with community health workers poises this intervention to address health disparities within this community. The project will help improve the reach and impact of effective alcohol interventions among socially disadvantaged Latinos, thereby contributing to improved population health.