Vida PURA: An assessment of the fidelity of promotor-delivered screening and brief intervention to reduce unhealthy alcohol use among Latino day laborers

Abstract

We assessed the fidelity of promotores conducting screening and brief intervention (SBI) to reduce unhealthy alcohol use among Latino immigrant day laborers in the Vida PURA study. We reviewed 32 audio-recorded brief interventions to assess promotor adherence to the intervention protocol and to evaluate their motivational interviewing (MI) technique with the Motivational Interviewing Treatment Integrity (MITI) 4.2.1 tool. Promotores delivered three core intervention steps in 78% of recordings and achieved basic MI competence across all domains and proficiency in 50% of measures. Our results suggest that promotores can be trained to deliver SBI in community settings with fidelity.

The Health of Undocumented Latinx Immigrants: What We Know and Future Directions

“…In addition, clinics have begun using community health workers to provide counseling and referral services in both clinical and community settings (33,120). Community health workers who have a shared racial/ethnic or immigrant background, as well as Spanish language skills, can incorporate social and cultural context and increase access to mental health programs (88,115). Community-based mental health programs can provide an alternative for those who may be reluctant to seek mental health care in clinical settings owing to fear or stigma (87,126).…”

Vida PURA: results from a pilot randomized trial of a culturally adapted screening and brief intervention to reduce unhealthy alcohol use among Latino day laborers

“…Training included an overview of alcohol-related disorders and disease, as well as basic information about alcohol use, including what is considered a "standard drink," AUDIT risk levels, and National Institute for Alcohol Abuse and Alcoholism (NIAAA) guidelines for unhealthy alcohol use [35]. They also received specialized training in motivational interviewing (several days in person in Spanish), in addition to ongoing supervision and evaluation of intervention fidelity using the Motivational Interviewing Treatment Integrity Tool [36].…”

Differences in the delivery of motivational interviewing across three countries

“…The MITI is recently refined to reflect the developments in the theory of MI and to improve reliability of the measures (MITI 4) (Moyers et al, 2014). The MITI 4 has been applied in some studies so far supporting the reliability to MI and to some extend the validity (Copeland et al, 2019;Moyers et al, 2016;Owens et al, 2017;Serrano, 2018). The MITI 4 provides information on the technical elements of MI by means of a measure of the therapist's ability to cultivate change talk and soften sustain talk; the relational elements empathy and partnership; in addition, detailed information on MI-adherent therapist behavior (affirmation, seeking collaboration, emphasizing autonomy) and MI-non-adherent therapist adherent (confront and persuade) (Moyers et al, 2014) is collected.…”