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