A randomized clinical trial of culturally adapted (CAMI) and un-adapted motivational interviewing (MI) to reduce drinking and related problems among heavy drinking Latinos randomized and assessed 58 participants at baseline, at 2 (86% retention) and 6 months (84% retention). Significant declines across both were found in heavy drinking days/month and drinking consequences (p < .001), with greater reductions for drinking consequences for CAMI at 2 months (p = .009) and continuing reductions in CAMI at 6 months. Findings provide preliminary support for the value of culturally adaptation to enhance the efficacy of motivational interviewing with Latino heavy drinkers.
Although the need for cultural adaptations is often noted in addiction research, there are few templates to guide the process. The rationale for a social contextual framework to culturally adapt Motivational Interviewing for an immigrant heavy drinking Latino population in the U.S. Northeast is presented. The aim of the pilot study was to obtain data on acceptability of this approach. Participant responses to the adaptation were examined qualitatively and quantitatively in a preliminary study. Procedure: Participants recruited from the community met criteria for risky drinking (men, ≥ 5 drinks/occasion or ≥14 drinks/week; women, ≥ 4 drinks/occasion or ≥7 drinks/week). Participants (n=25) who completed baseline assessments and a culturally adapted brief motivational interview (CAMI) were asked to complete a qualitative exit interview to give feedback on their interview experience. Participants reported being highly engaged with treatment (M=3.58 on a scale of 1 - 4, SD = .50), and felt very satisfied with treatment (M=3.58 on a scale of 1 - 4, SD = .93). Nearly all (95%) reported that understanding their culture was important to understanding their drinking behavior. Results support the acceptability and relevance of this adaptation from participants’ perspectives.
Few studies have examined the behavioral and protective correlates of alcohol use among young Hispanics. Using a national sample (N = 7,606), logistic regression and latent profile analysis (LPA) are employed to examine the relationships between alcohol use, psychosocial factors, and externalizing behavior among Hispanics during early adolescence. Early drinkers are more likely to report truancy, fighting, smoking, and drug use. LPA results revealed a three class solution. Classes identified included: psychosocial risk (41.11%), moderate protection (39.44%), and highly religious (19.44%). Alcohol use is clearly associated with externalizing behavior; however, an important degree of psychosocial and behavioral heterogeneity nevertheless exists.
This study investigates the relationship between level of acculturation and acculturation stress, and the extent to which each predicts problems related to drinking. Hispanics who met criteria for hazardous drinking completed measures of acculturation, acculturation stress, and drinking problems. Sequential multiple regression was used to determine whether levels of self-reported acculturation stress predicted concurrent alcohol problems after controlling for the predictive value of acculturation level. Acculturation stress accounted for significant variance in drinking problems while adjusting for acculturation, income, and education. Choosing to drink in response to acculturation stress should be an intervention target with Hispanic heavy drinkers.
Objective
The primary aim of this study was to identify distinct classes of trajectories of adolescent substance use following a brief motivational interviewing (MI) intervention in an Emergency Department (ED). The secondary aim was to identify predictors of class membership.
Methods
Latent growth mixture modeling was used with 177 adolescents who participated in two randomized clinical trials evaluating MI for an alcohol-related event.
Results
Three classes were identified: (1) moderate use, decreasers consisting of 56.8% of participants; (2) heavy use, decreasers, consisting of 10.5% of participants, and (3) heavy use sustainers, consisting of 32.7% of participants. Hispanic ethnicity, parental monitoring, and days of high-volume drinking were significant predictors of class membership. Hispanic ethnic status and high levels of parental monitoring were associated with decreased likelihood of belonging to either of the two heavy use classes. More frequent high-volume drinking at baseline was associated with increased likelihood of belonging to the heavy use, sustainer class, and decreased likelihood of belonging to the heavy use, decreaser class. Across all three classes, being female and having frequent high-volume drinking at baseline were associated with worse response to the intervention.
Conclusions
These findings have important implications for identifying adolescents who may benefit from different or additional intervention, and for anticipating and informing families of adolescents’ potential drinking course following treatment.
Objectives: The objective was to determine if adolescents presenting to a pediatric emergency department (PED) for an alcohol-related event requiring medical care differ in terms of substance use, behavioral and mental health problems, peer relationships, and parental monitoring based on their history of marijuana use.Methods: This was a cross-sectional comparison of adolescents 13-17 years old, with evidence of recent alcohol use, presenting to a PED with a self-reported history of marijuana use. Assessment tools included the Adolescent Drinking Inventory, Adolescent Drinking Questionnaire, Young Adult Drinking and Driving Questionnaire, Center for Epidemiologic Studies Depression Scale, Behavioral Assessment System for Children, and Peer Substance Use and Tolerance of Substance Use Scale.Results: Compared to adolescents using alcohol only (AO), adolescents who use alcohol and marijuana (A+M) have higher rates of smoking (F = 23.62) and binge drinking (F = 11.56), consume more drinks per sitting (F = 9.03), have more externalizing behavior problems (F = 12.53), and report both greater peer tolerance of substance use (F = 12.99) and lower parental monitoring (F = 7.12).Conclusions: Adolescents who use A+M report greater substance use and more risk factors for substance abuse than AO-using adolescents. Screening for a history of marijuana use may be important when treating adolescents presenting with an alcohol-related event. A+M co-use may identify a high-risk population, which may have important implications for ED clinicians in the care of these patients, providing parental guidance, and planning follow-up care.
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