1
|
Atkinson JS, Fernández-Esquer ME, Field C. At-Risk Drinking and Workplace Conditions among Latino Day Laborers. Subst Use Misuse 2023; 59:1-9. [PMID: 37727109 DOI: 10.1080/10826084.2023.2257315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Background: Latino Day Laborers (LDL) face a variety of factors which have been associated with at-risk drinking. The objective of this study was to assess the association of at-risk drinking with measures of work site conditions. Methods: Data from surveys conducted with 307 LDL in Houston, TX in 2015 were analyzed. Sociodemographic information and measures of exposures to hazardous products at the worksite, adverse working conditions, and work stressors were collected. Measures of positive working climate at the jobsite and a climate that promoted jobsite safety were also included. Participants were administered the Hazardous Use items from the Alcohol Use Disorders Identification Test of Consumption (AUDIT-C). Participants were classified as low-risk or at-risk drinkers based on AUDIT-C score. Logistic regression models were run to assess the associations of the sociodemographic and worksite related variables with drinking status. Results: One-hundred-five (34.2%) participants were classified as at-risk drinkers. At-risk drinking was associated with past-month income, being formerly married (compared to having never married), and lack of housing. At-risk drinking was also associated with measures of a positive working climate and a climate that promoted jobsite safety. Conclusions: One-third of our participants were classified as at-risk drinkers. At-risk drinking was associated with stressors in the form of lack of housing and no longer having a spouse but was also associated with increased income and with positive workplace factors. At-risk drinking was thus a function of both stressors and positive factors, including a positive work site.
Collapse
Affiliation(s)
- John S Atkinson
- Center for Health Promotion, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Maria Eugenia Fernández-Esquer
- Center for Health Promotion, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - Craig Field
- Latino Alcohol and Health Disparities Research Center, University of Texas at El Paso, El Paso, TX, USA
| |
Collapse
|
2
|
Wolfe DM, Hutton B, Corace K, Chaiyakunapruk N, Ngorsuraches S, Nochaiwong S, Presseau J, Grant A, Dowson M, Palumbo A, Suschinsky K, Skidmore B, Bartram M, Garner G, DiGioacchino L, Pump A, Peters B, Konefal S, Eves AP, Thavorn K. Service-level barriers to and facilitators of accessibility to treatment for problematic alcohol use: a scoping review. Front Public Health 2023; 11:1296239. [PMID: 38106884 PMCID: PMC10722420 DOI: 10.3389/fpubh.2023.1296239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/03/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Services to treat problematic alcohol use (PAU) should be highly accessible to optimize treatment engagement. We conducted a scoping review to map characteristics of services for the treatment of PAU that have been reported in the literature to be barriers to or facilitators of access to treatment from the perspective of individuals with PAU. Methods A protocol was developed a priori, registered, and published. We searched MEDLINE®, Embase, the Cochrane Library, and additional grey literature sources from 2010 to April 2022 to identify primary qualitative research and surveys of adults with current or past PAU requiring treatment that were designed to identify modifiable characteristics of PAU treatment services (including psychosocial and pharmacologic interventions) that were perceived to be barriers to or facilitators of access to treatment. Studies of concurrent PAU and other substance use disorders were excluded. Study selection was performed by multiple review team members. Emergent barriers were coded and mapped to the accessibility dimensions of the Levesque framework of healthcare access, then descriptively summarized. Results One-hundred-and-nine included studies reported an extensive array of unique service-level barriers that could act alone or together to prevent treatment accessibility. These included but were not limited to lack of an obvious entry point, complexity of the care pathway, high financial cost, unacceptably long wait times, lack of geographically accessible treatment, inconvenient appointment hours, poor cultural/demographic sensitivity, lack of anonymity/privacy, lack of services to treat concurrent PAU and mental health problems. Discussion Barriers generally aligned with recent reviews of the substance use disorder literature. Ranking of barriers may be explored in a future discrete choice experiment of PAU service users. The rich qualitative findings of this review may support the design of new or modification of existing services for people with PAU to improve accessibility. Systematic Review Registration Open Science Framework doi: 10.17605/OSF.IO/S849R.
Collapse
Affiliation(s)
| | - Brian Hutton
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kim Corace
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Substance Use and Concurrent Disorders Program, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, ON, Canada
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
- Informatics, Decision Enhancement, and Analytics Sciences (IDEAS) Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, United States
| | | | - Surapon Nochaiwong
- Department of Pharmaceutical Care, Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Justin Presseau
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Alyssa Grant
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | | | | | - Kelly Suschinsky
- Substance Use and Concurrent Disorders Program, Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | | | - Mary Bartram
- Mental Health Commission of Canada, Ottawa, ON, Canada
- School of Public Policy and Administration, Carleton University, Ottawa, ON, Canada
| | - Gordon Garner
- Community Addictions Peer Support Association, Ottawa, ON, Canada
| | | | - Andrew Pump
- Community Addictions Peer Support Association, Ottawa, ON, Canada
| | - Brianne Peters
- Community Addictions Peer Support Association, Ottawa, ON, Canada
| | - Sarah Konefal
- Canadian Centre on Substance Use and Addiction, Ottawa, ON, Canada
| | - Amy Porath Eves
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Knowledge Institute on Child and Youth Mental Health and Addictions, Ottawa, ON, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Pharmaceutical Care, Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| |
Collapse
|
3
|
Martinez-Donate AP, Zumaeta-Castillo C, Yamasaki Y, Perez C, Martinez O, Hassrick EM, Ventimiglia J, Lazo-Elizondo M. Feasibility and acceptability of CRiSOL: A pilot peer-based intervention to address syndemic health issues afflicting Latino immigrants in the U.S. PLoS One 2023; 18:e0287248. [PMID: 37874795 PMCID: PMC10597517 DOI: 10.1371/journal.pone.0287248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 06/01/2023] [Indexed: 10/26/2023] Open
Abstract
Substance use, HIV/AIDS, domestic violence and mental health (SAVAME) are syndemic health issues that disproportionately burden Latinos in the U.S. Yet, there are limited evidence-based interventions to address these interrelated syndemic issues and their shared socio-ecological determinants. This study sought to test the feasibility and acceptability of CRiSOL, a peer-based, resilience-focused intervention to reduce the impact of the SAVAME syndemic on Latino immigrants. Fifteen Latino immigrant community leaders were recruited and trained to serve as health promotion agents in their naturally existing social networks. The training was implemented with high fidelity, received with high satisfaction by the peer leaders, and associated with significant improvements in their knowledge, leadership skills, and social capital. During an 8-month outreach phase, nine leaders remained active in the program and documented 825 one-on-one interactions with community members, during which they provided advice/counseling (52.2% of interactions), health information/education (32.5%), referrals to health and social services (38.5%), food aid (39.9%), and service navigation/assistance (10.2%). While future research must be conducted to establish the effectiveness of CRiSOL, findings from this pilot evaluation indicate the feasibility, acceptability, and high level of reach of this intervention and suggest significant potential to reduce the SAVAME syndemic burden in Latino communities.
Collapse
Affiliation(s)
- Ana P. Martinez-Donate
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Claudia Zumaeta-Castillo
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Yoshiaki Yamasaki
- The Philadelphia AIDS Consortium (TPAC)/World Health Care Infrastructures (WHCI), Philadelphia, Pennsylvania, United States of America
| | - Cristina Perez
- The Philadelphia AIDS Consortium (TPAC)/World Health Care Infrastructures (WHCI), Philadelphia, Pennsylvania, United States of America
| | - Omar Martinez
- College of Medicine, University of Central Florida, Orlando, Florida, United States of America
| | - Elizabeth McGhee Hassrick
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Jonas Ventimiglia
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Mariana Lazo-Elizondo
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, United States of America
| |
Collapse
|
4
|
Rangel ML, Arevalo M, Mercader C, Fernández-Esquer ME. "I Use Sunglasses . . . the Sun Can Ruin the Eyes": Latino Day Laborers' Lay Strategies to Reduce Dangers at Work. Health Promot Pract 2023; 24:886-894. [PMID: 36412246 DOI: 10.1177/15248399221135112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Latino day laborers (LDLs) are at a high risk for injury and accidents at work and have limited socioeconomic resources to deal with their consequences. While little is known about LDLs' perceptions of their own vulnerability at the workplace, less is known about the strategies they adopt to confront these risks. The purpose of this qualitative study was to assess LDLs' perceptions of their workplace dangers and to document the strategies they adopt and endorse to confront them. Guided by a participatory research approach, four focus groups stratified by age were conducted with 34 LDLs in Houston, Texas. Main focus group themes were identified using a combination of qualitative analysis methods involving a thematic analysis conducted by the interview team, LDL advisors, and bilingual Latino researchers. All participants were Latino males (mean age = 40), the majority reported having completed sixth grade or less (64.2%) and having lived in the United States for an average of 12.7 years. We described three categories of strategies to reduce risk for workplace injury generated by local LDLs (practical knowledge and job experience, interpersonal, and personal). These strategies should be explored and encouraged to assist in planning risk-reduction programs, presented in the voice and language of Latino "inside experts" with firsthand experience. The findings of the focus group suggest that LDLs already possess a broad repertoire of strategies to cope with risks at work that can be incorporated in safety programs for LDLs and other immigrant Latino workers.
Collapse
Affiliation(s)
| | - Mariana Arevalo
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Clara Mercader
- University of Texas Health Science Center, Houston, TX, USA
| | | |
Collapse
|
5
|
Brown MC, Hawley C, Ornelas IJ, Huber C, Best L, Thorndike AN, Beresford S, Howard BV, Umans JG, Hager A, Fretts AM. Adapting a cooking, food budgeting and nutrition intervention for a rural community of American Indians with type 2 diabetes in the North-Central United States. HEALTH EDUCATION RESEARCH 2023; 38:13-27. [PMID: 36342521 PMCID: PMC9853931 DOI: 10.1093/her/cyac033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 09/06/2022] [Accepted: 10/18/2022] [Indexed: 05/24/2023]
Abstract
American Indian (AI) communities experience persistent diabetes-related disparities, yet few nutrition interventions are designed for AI with type 2 diabetes or address socio-contextual barriers to healthy eating. We describe our process of adapting the evidence-based Cooking Matters® program for use by AI adults with type 2 diabetes in a rural and resource-limited setting in the North-Central United States. We conducted three focus groups with AI adults with diabetes to (i) identify Cooking Matters® adaptations and (ii) gather feedback on appropriateness of the adapted intervention using Barrera and Castro's cultural adaptation framework. Transcripts were coded using an inductive, constant comparison approach. Queries of codes were reviewed to identify themes. Contextual considerations included limited access to grocery stores and transportation barriers, reliance on government food assistance and the intergenerational burden of diabetes. Adaptations to content and delivery included incorporating traditional and locally available foods; appealing to children or others in multigenerational households and prioritizing visual over written content. Our use of Barrera and Castro's framework adds rigor and structure to the cultural adaptation process and increases the likelihood of future intervention success. Other researchers may benefit from using this framework to guide the adaptation of evidence-based interventions in AI communities.
Collapse
Affiliation(s)
- Meagan C Brown
- Department of Epidemiology, University of Washington School of Public Health, Hans Rosling Center for Population Health, 3980 15th Ave NE, Seattle, WA 98195, USA and Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA 98101, USA
| | - Caitie Hawley
- Department of Medicine, University of Washington, Health Sciences Building, Box 356420, 1959 NE Pacific Street, Seattle, WA 98195-6420, USA
| | - India J Ornelas
- Department of Health Systems and Population Health, University of Washington School of Public Health, Hans Rosling Center for Population Health, 3980 15th Ave NE, Seattle, WA 98195, USA
| | - Corrine Huber
- Missouri Breaks Industries Research Inc., 18 South Willow Street, P.O. Box 1824, Eagle Butte, SD 57625, USA
| | - Lyle Best
- Missouri Breaks Industries Research Inc., 18 South Willow Street, P.O. Box 1824, Eagle Butte, SD 57625, USA
| | - Anne N Thorndike
- Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA and Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Shirley Beresford
- Department of Epidemiology, University of Washington School of Public Health, Hans Rosling Center for Population Health, 3980 15th Ave NE, Seattle, WA 98195, USA
| | - Barbara V Howard
- Field Studies Division, Medstar Health Research Institute, 6525 Belcrest Rd #700c, Hyattsville, MD 20782, USA
- Georgetown and Howard Universities Center for Clinical and Translational Science, 4000 Reservoir Rd NW #7, Washington, DC 20057, USA
| | - Jason G Umans
- Georgetown and Howard Universities Center for Clinical and Translational Science, 4000 Reservoir Rd NW #7, Washington, DC 20057, USA
- Field Studies Division and Biomarker, Biochemistry, and Biorepository Core, Medstar Health Research Institute, 6525 Belcrest Rd #700c, Hyattsville, MD 20782, USA
| | - Arlette Hager
- Cheyenne River Sioux Tribe Adult Diabetes Program, 24276 166th St. Airport Road, P.O. Box 590 Eagle Butte, SD 57625, USA
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington School of Public Health, Hans Rosling Center for Population Health, 3980 15th Ave NE, Seattle, WA 98195, USA
| |
Collapse
|
6
|
Venner K, Hernandez-Vallant A, Hirchak KA, Herron J. A scoping review of cultural adaptations of substance use disorder treatments across Latinx communities: Guidance for future research and practice. J Subst Abuse Treat 2022; 137:108716. [DOI: 10.1016/j.jsat.2021.108716] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/26/2021] [Accepted: 12/14/2021] [Indexed: 11/24/2022]
|
7
|
Hai AH, Lee CS, Abbas BT, Bo A, Morgan H, Delva J. Culturally adapted evidence-based treatments for adults with substance use problems: A systematic review and meta-analysis. Drug Alcohol Depend 2021; 226:108856. [PMID: 34274617 DOI: 10.1016/j.drugalcdep.2021.108856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND This systematic review/meta-analysis aimed to synthesize empirical evidence from randomized controlled trials on the efficacy of culturally adapted interventions (CAIs) for substance use and related consequences for adults of color. METHODS Six electronic databases were searched to identify eligible studies. Two reviewers independently screened studies, extracted data, and assessed risks of bias. We used robust variance estimation in meta-regression to synthesize effect size estimates and conduct moderator analyses. RESULTS Twenty-two studies met the inclusion criteria and were included in the review. The overall effect size was 0.23 (95 % Confidence Interval [CI] = 0.12, 0.35). The subgroup effect sizes for comparing CAIs with inactive controls and with active controls were 0.31 (CI = 0.14, 0.48) and 0.14 (CI=-0.02, 0.29), respectively. The effect sizes for alcohol use, illicit drug use, unspecified substance use outcomes, and substance use related consequences were 0.25 (CI = 0.08, 0.43), 0.35 (CI =-0.30, 1.00), 0.22 (CI=-0.17, 0.62), and 0.02 (CI=-0.11, 0.16), respectively. Moderator analysis showed that CAIs' effects might not vary significantly by treatment model, dose, country, follow-up assessment timing, participant age, or gender/sex. CONCLUSIONS Research on substance use interventions that are culturally adapted for people of color is growing, and more high-quality studies are needed to draw definitive conclusions about CAIs' treatment effects. Our study found CAIs to be a promising approach for reducing substance use and related consequences. We call for more efficacy/effectiveness and implementation research to further advance the development and testing of evidence-based CAIs that meet the unique needs and sociocultural preferences of diverse populations.
Collapse
Affiliation(s)
- Audrey Hang Hai
- Center for Innovation in Social Work & Health, School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA.
| | - Christina S Lee
- Center for Innovation in Social Work & Health, School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA
| | - Bilal T Abbas
- Department of General Internal Medicine, Albert Einstein College of Medicine, 3300 Kossuth Ave, Bronx, NY, 10467, USA
| | - Ai Bo
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Avenue, Milwaukee, WI, 53211, USA
| | - Henry Morgan
- Sociology Department, Vassar College, 124 Raymond Avenue, Poughkeepsie, NY, 12604, USA
| | - Jorge Delva
- Center for Innovation in Social Work & Health, School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA
| |
Collapse
|
8
|
Ornelas IJ, Yamanis TJ, Ruiz RA. The Health of Undocumented Latinx Immigrants: What We Know and Future Directions. Annu Rev Public Health 2021; 41:289-308. [PMID: 32237989 DOI: 10.1146/annurev-publhealth-040119-094211] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Undocumented Latinx immigrants experience unique factors prior to migration, during migration, and after migration that shape their health. Our review summarizes the limited but growing literature highlighting how exposure to trauma, immigration enforcement, changes to social networks, and discrimination negatively affect the mental and physical health of undocumented Latinx immigrants. We also discuss how policies and social ties can promote their health. We focus on areas of particular concern, including health care, mental health, and HIV. Future research should use interdisciplinary approaches and intersectional frameworks to understand and address health inequities. Conducting research with undocumented Latinx immigrant communities requires community engagement, assurance of confidentiality, and creative recruitment and retention strategies. Recommendations for public health practice include investing in community health centers and organizations to ensure access to health and social services; presenting results with sufficient contextualization to interpret their generalizability; and advocating for federal-, state-, and local-level policy changes that reduce the negative health consequences associated with being undocumented.
Collapse
Affiliation(s)
- India J Ornelas
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA; ,
| | - Thespina J Yamanis
- School of International Service, American University, Washington, DC 20016-8071, USA;
| | - Raymond A Ruiz
- Department of Health Services, University of Washington, Seattle, Washington 98195, USA; ,
| |
Collapse
|
9
|
"The solitude absorbs and it oppresses": 'Illegality' and its implications on Latino immigrant day laborers' social isolation, loneliness and health. Soc Sci Med 2021; 273:113737. [PMID: 33609966 DOI: 10.1016/j.socscimed.2021.113737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/14/2021] [Accepted: 01/27/2021] [Indexed: 12/13/2022]
Abstract
Despite a well-documented relationship between social isolation and health among men, this link has been understudied among marginalized populations such as undocumented immigrant men whose structural social exclusion may impede the cultivation and maintenance of social connections in the United States. This may be particularly so in new immigrant settlement cities that may lack an established Latina/o community or the social infrastructure often needed to ease the process of social integration. Studies that have examined social disconnectedness, social isolation, and/or loneliness have largely focused on individual level factors (i.e., older age) that may precipitate or contextualize experiences of social isolation, social support and social networks. Missing from such conceptualizations is a consideration of the role of structural factors, such as "illegality" among undocumented immigrant men, on experiences of social disconnection, social exclusion, social isolation and loneliness and resultant adverse health behaviors. This study, through in-depth qualitative participant narratives, explores the social condition of one group of "illegal" immigrant men, Latino immigrant day laborers (LIDL), and their experiences of social exclusion, social isolation, loneliness and health in the new immigrant settlement city of Baltimore. Using an ethnographic methodological approach, eight focus groups (N = 37) were conducted with participants recruited from two day labor sites from 2016 to 2019. Thematic analysis revealed a structural process of social exclusion and disconnection that exposed LIDLs to experiences of racism, structural vulnerability, and dehumanization which in turn may have heightened social isolation and loneliness and patterned substance use and sexual risk taking. Findings further emphasize the potential conceptual significance of structurally induced social disconnection, as distinct from lack of social support, in the study of LIDLs' social isolation, loneliness and health.
Collapse
|
10
|
Torres VN, Williams EC, Ceballos RM, Donovan DM, Duran B, Ornelas IJ. Participant engagement in a community based participatory research study to reduce alcohol use among Latino immigrant men. HEALTH EDUCATION RESEARCH 2020; 35:627-636. [PMID: 33025021 PMCID: PMC7768666 DOI: 10.1093/her/cyaa039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
Although Latino immigrant men experience many health disparities, they are underrepresented in research to understand and address disparities. Community Based Participatory Research (CBPR) has been identified to encourage participant engagement and increase representation in health disparities research. The CBPR conceptual model describes how partnership processes and study design impact participant engagement in research. Using this model, we sought to describe how these domains influenced participant engagement in a pilot randomized controlled trial of brief intervention for unhealthy alcohol use (n = 121) among Latino immigrant men. We conducted interviews with a sample of study participants (n = 25) and reviewed logs maintained by 'promotores'. We identified facilitators of participant engagement, including the relevance of the study topic, alignment with participants' goals to improve their lives, partnerships with study staff that treated participants respectfully and offered access to resources. Further, men reported that the study time and location were convenient and that they appreciated being compensated for their time. Barriers to participant engagement included survey questions that were difficult to understand and competing demands of work responsibilities. Findings suggest that engaging underserved communities requires culturally responsive and community engagement strategies that promote trust. Future studies should further investigate how CBPR partnership processes can inform intervention research.
Collapse
Affiliation(s)
- Vanessa N Torres
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Emily C Williams
- Department of Health Services, University of Washington, Seattle, WA, USA
- Health Services Research & Development (HSR&D), Center of Innovation for Veteran-Centered Value-Driven Care, Veteran Affairs (VA), Puget Sound Health Care System, Seattle, WA, USA
| | - Rachel M Ceballos
- Department of Health Services, University of Washington, Seattle, WA, USA
- Fred Hutchison Cancer Research Center, Seattle, WA, USA
| | - Dennis M Donovan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Alcohol and Drug Abuse Institute (ADAI), Seattle, WA, USA
| | - Bonnie Duran
- School of Social Work, University of Washington, Seattle, WA, USA
| | - India J Ornelas
- Department of Health Services, University of Washington, Seattle, WA, USA
| |
Collapse
|
11
|
Torres VN, Williams EC, Ceballos RM, Donovan DM, Ornelas IJ. Participant Satisfaction and Acceptability of a Culturally Adapted Brief Intervention to Reduce Unhealthy Alcohol Use Among Latino Immigrant Men. Am J Mens Health 2020; 14:1557988320925652. [PMID: 32602803 PMCID: PMC7328216 DOI: 10.1177/1557988320925652] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/19/2020] [Accepted: 04/16/2020] [Indexed: 11/16/2022] Open
Abstract
Latino immigrant men are at increased risk for unhealthy alcohol use, yet few interventions have been designed to meet their unique needs. The current study assessed participant satisfaction and acceptability of a culturally adapted brief intervention to reduce unhealthy alcohol use in this population. Adaptations to the brief intervention included delivering it in Spanish by promotores in a community setting. The mixed methods approach included surveys (N = 73) and in-depth interviews (N = 20) with participants in a pilot randomized controlled trial. The study drew on Sekhon's theoretical framework of acceptability to asses affective attitude, burden, and perceived effectiveness of the intervention, along with satisfaction with the content, setting, and promotor. Participants' survey responses indicated that they were highly satisfied with the content, setting, and delivery of the brief intervention. In interviews participants noted that the brief intervention helped them reflect on their drinking behaviors, that they perceived promotores to be a trusted source of health information, and that they liked receiving personalized feedback via tablets. Some participants found the feedback did not match their own perceptions of their alcohol use and wanted clearer advice on how to reduce their drinking. Men felt they would benefit from more contact with promotores. These findings suggest that Latino immigrant men in this study were receptive to the culturally adapted brief intervention. Future interventions may be more effective if they include multiple contacts with promotores and more directive guidance on strategies to reduce drinking.
Collapse
Affiliation(s)
- Vanessa N. Torres
- Department of Health Services,
University of Washington, Seattle, USA
| | - Emily C. Williams
- Department of Health Services,
University of Washington, Seattle, USA
- Health Services Research &
Development (HSR&D), Center of Innovation for Veteran-Centered Value-Driven
Care, Veteran Affairs (VA), Puget Sound Health Care System, Seattle, USA
| | - Rachel M. Ceballos
- Department of Health Services,
University of Washington, Seattle, USA
- Fred Hutchison Cancer Research Center,
Seattle, USA
| | - Dennis M. Donovan
- Department of Psychiatry and Behavioral
Sciences, University of Washington, Seattle, USA
- Alcohol and Drug Abuse Institute (ADAI),
Seattle, USA
| | - India J. Ornelas
- Department of Health Services,
University of Washington, Seattle, USA
- Latino Center for Health (LCH), Seattle,
USA
| |
Collapse
|
12
|
Ornelas IJ, Doyle SR, Torres VN, Serrano SE, Duran B, Donovan DM. 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. Transl Behav Med 2019; 9:1233-1243. [PMID: 31206579 PMCID: PMC6875653 DOI: 10.1093/tbm/ibz071] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Latino immigrant men are at increased risk for unhealthy alcohol use. Vida PURA is a culturally adapted evidence-based intervention that consists of promotores providing screening and brief intervention to reduce unhealthy alcohol use among Latino immigrant men. The purpose was to assess the efficacy of Vida PURA in a pilot randomized control trial. Participants were screened for eligibility at a day labor worker center using the Alcohol Use Disorders Identification Test (AUDIT). Those with an AUDIT score ≥ 6 (N = 121) were randomized into an intervention (N = 77) or control group (N = 44). Participants in the intervention group received a brief intervention from a promotor including personalized feedback, motivational interviewing to assess their readiness to change, and referral to services. Participants in the control group received information about local substance use treatment services. We assessed changes in AUDIT scores, drinks per drinking day, drinking days, and frequency of heavy episodic drinking at 2 and 8 weeks following the baseline survey using a mixed-effects regression model. Many men had high AUDIT scores, indicating dependence. Both the intervention and control groups reduced their alcohol-related behaviors over time, but there were no significant differences between the groups. A culturally adapted brief intervention may not be enough to significantly reduce alcohol use among Latino day laborers, especially among those that are dependent. We discuss lessons learned from this trial, including the value of community-based approaches to reaching high-risk and underserved populations.
Collapse
Affiliation(s)
- India J Ornelas
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Suzanne R Doyle
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA
| | - Vanessa N Torres
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Samantha E Serrano
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Bonnie Duran
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Dennis M Donovan
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA, USA
| |
Collapse
|
13
|
Valle CG, Padilla N, Gellin M, Manning M, Reuland DS, Rios P, Lane G, Lewis V, Rosenstein DL. ¿Ahora qué?: Cultural Adaptation of a Cancer Survivorship Intervention for Latino/a Cancer Survivors. Psychooncology 2019; 28:1854-1861. [PMID: 31260139 DOI: 10.1002/pon.5164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/08/2019] [Accepted: 06/17/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE With a steadily increasing number of Latino/a cancer survivors, there is a need for supportive care programs for this underserved survivor subgroup. METHODS In this study, the authors culturally adapted an evidence-based survivorship program, Cancer Transitions: Moving Beyond Treatment (CT) for this population. Guided by Barrera and Castro's heuristic model for cultural adaptation of interventions, we conducted five focus groups (FG) among Latino/a cancer survivors (n = 54) in several US sites to inform the preliminary adaptation of program materials. We conducted four additional FGs (n = 38) to obtain feedback on adapted materials. RESULTS Common themes from initial FGs were related to program delivery and logistics, and general recommendations for CT modification. Program adaptations addressed information needs, including health care system navigation, employment concerns, and sexuality. Other adaptations included an emphasis on family, spirituality, culturally appropriate translation and features, and role plays. Participants in the second round of FGs confirmed adaptations incorporated earlier findings and suggested additional refinements. CONCLUSION This project helps guide the cultural adaptation of survivorship programs for Latino/a cancer survivors.
Collapse
Affiliation(s)
- Carmina G Valle
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Neda Padilla
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mindy Gellin
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Michelle Manning
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Daniel S Reuland
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Peggy Rios
- Cancer Support Community, Washington, DC.,Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | | | - Virginia Lewis
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Donald L Rosenstein
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
14
|
Arcury TA, Furgurson KF, O’Hara HM, Miles K, Chen H, Laurienti PJ. Conventional and Complementary Therapy Use among Mexican Farmworkers in North Carolina: Applying the I-CAM-Q. J Agromedicine 2019; 24:257-267. [PMID: 30860961 PMCID: PMC6570560 DOI: 10.1080/1059924x.2019.1592049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objectives: This analysis documents the use of conventional health-care providers, traditional healers, and complementary therapies by Mexican farmworkers; identifies the purposes and perceived helpfulness of these modalities; and delineates variation in the use of traditional healers and complementary therapies. Methods: Two-hundred Mexican farmworkers in North Carolina completed interviews May-September, 2017. The International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) elicited use of conventional health-care providers, traditional healers, and complementary therapies in the previous 12 months. Results: Most of the farmworkers had been treated by a conventional provider (63.0%). One-in-five had been treated by any traditional healer; 19.5% had been treated by a sobador, 4.5% by a curandero, 2.0% by an herbalist, and 2.0% by a spiritual healer. Conventional providers (69.8%) and sobadores (84.6%) most often treated acute conditions; 62.5% had used an herb, 46.0% a vitamin, 57.0% an over-the-counter medicine, and 13.5% a home remedy. Participants used various self-care practices, including music (36.5%), sleep (18.0%), prayer for health (15.0%), and social media (14.0%). Education was inversely associated with the use of a traditional healer and herbs; treatment by a conventional health-care provider was positively associated with using a traditional healer and vitamins. Conclusions: Mexican farmworkers use conventional health-care providers as well as traditional healers and complementary therapies. Research on how use of complementary therapies and a system of medical pluralism affects farmworker health is needed. Health-care providers need to recognize complementary therapy use and provide patient education about ineffective or harmful therapies.
Collapse
Affiliation(s)
- Thomas A. Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Katherine F. Furgurson
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Heather M. O’Hara
- Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee, USA
| | - Kenya Miles
- Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee, USA
| | - Haiying Chen
- Department of Biostatistical Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Paul J. Laurienti
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| |
Collapse
|
15
|
Hill CM, Williams EC, Ornelas IJ. Help Wanted: Mental Health and Social Stressors Among Latino Day Laborers. Am J Mens Health 2019; 13:1557988319838424. [PMID: 30880547 PMCID: PMC6438433 DOI: 10.1177/1557988319838424] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/28/2019] [Accepted: 02/22/2019] [Indexed: 12/22/2022] Open
Abstract
Latino day laborers may be especially vulnerable to poor mental health due to stressful life experiences, yet few studies have described patterns of mental health outcomes and their correlates in this population. Patterns of depression (PHQ-9) and anxiety (GAD-7), and associations with demographic characteristics, social stressors, and substance use in a recruited sample of male Latino day laborers ( n = 101) are described. High rates of depression and anxiety were identified. Specifically, 39% screened positive for moderate or severe depression and 25% for moderate or severe anxiety. Higher levels of depression and anxiety symptoms were associated with being single, being homeless or in temporary housing, experiencing discrimination, acculturation stress, and marijuana use. While tobacco and unhealthy alcohol use were common in this sample (39% and 66%, respectively), they were not associated with depression and anxiety. These findings suggest that depression and anxiety are common among Latino day laborers and associated with stressful life experiences. Future research should further assess ways to ameliorate social stressors and reduce risk for poor mental health.
Collapse
Affiliation(s)
- Clara M. Hill
- Veterans Health Administration (VA),
Seattle-Denver Center of Innovation for Veteran-Centered & Value-Driven Care, VA
Puget Sound Health Services Research & Development, Seattle, WA, USA
- Department of Health Services,
University of Washington, Seattle, WA, USA
| | - Emily C. Williams
- Veterans Health Administration (VA),
Seattle-Denver Center of Innovation for Veteran-Centered & Value-Driven Care, VA
Puget Sound Health Services Research & Development, Seattle, WA, USA
- Department of Health Services,
University of Washington, Seattle, WA, USA
| | - India J. Ornelas
- Department of Health Services,
University of Washington, Seattle, WA, USA
| |
Collapse
|
16
|
Serrano SE, Serafini K, Eller N, Torres VN, Donovan D, Ornelas IJ. Vida PURA: An assessment of the fidelity of promotor-delivered screening and brief intervention to reduce unhealthy alcohol use among Latino day laborers. J Ethn Subst Abuse 2018; 17:519-531. [PMID: 28375699 PMCID: PMC7141813 DOI: 10.1080/15332640.2017.1300557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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.
Collapse
Affiliation(s)
| | - Kelly Serafini
- b Swedish Family Medicine Residency , Seattle , Washington
| | - Nikki Eller
- a University of Washington , Seattle , Washington
| | | | | | | |
Collapse
|
17
|
Valdez LA, Garcia DO, Ruiz J, Oren E, Carvajal S. Exploring Structural, Sociocultural, and Individual Barriers to Alcohol Abuse Treatment Among Hispanic Men. Am J Mens Health 2018; 12:1948-1957. [PMID: 30051746 PMCID: PMC6199428 DOI: 10.1177/1557988318790882] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Hispanic men have poor access to alcohol abuse treatment, low treatment engagement, and low treatment completion rates despite the contrasting burden of alcohol-related consequences they face. The purpose of this study was to examine Hispanic male perspectives regarding alcohol abuse treatment-seeking behaviors and the structural, sociocultural, and individual factors that may influence initiation and continued engagement in treatment in this population. Individual interviews were conducted with a sample of 20 Hispanic men (age: 44.6 ± 11.3 years). Thematic analysis was completed using a hybrid deductive–inductive approach centered in an a priori codebook that was further supplemented with iterative exploration of transcripts. Results suggested treatment-seeking behaviors were highly influenced by (a) structural factors related to poor treatment access, as well as lack of linguistic- and cultural-responsiveness of available treatment; (b) sociocultural factors related to difficulties problematizing alcohol abuse due to lack of community awareness, societal normalization of consumption, and stigmatization of alcohol abuse treatment; and (c) individual factors related to lack of individual knowledge. This work highlights the perceived lack of congruency between available treatment and the linguistic, cultural, and gender norms of Hispanic men. There is need for responsive treatment strategies that comprehensively consider the gendered- and sociocultural-factors that govern treatment seeking and engagement behaviors. Findings also suggest a need for targeted alcohol abuse awareness building efforts in the Hispanic community. Specifically, the detrimental effects of alcohol-related problems and potential benefits of treatment should be addressed in order to diminish social stigma of abuse and of treatment.
Collapse
Affiliation(s)
- Luis A Valdez
- 1 Mel and Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, USA
| | - David O Garcia
- 1 Mel and Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, USA
| | - John Ruiz
- 2 College of Science, Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Eyal Oren
- 3 Graduate School of Public Health, Department of Biostatistics and Epidemiology, San Diego State University, San Diego, CA, USA
| | - Scott Carvajal
- 1 Mel and Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
18
|
Glass JE, Williams EC. The Future of Research on Alcohol Health Disparities: A Health Services Research Perspective. J Stud Alcohol Drugs 2018; 79:322-324. [PMID: 29553364 PMCID: PMC6019777 DOI: 10.15288/jsad.2018.79.322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Joseph E. Glass
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave., Suite 1600, Seattle, WA 98101,
| | - Emily C. Williams
- Denver–Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Services Research & Development, Seattle, Washington,Department of Health Services, University of Washington, Seattle, Washington
| |
Collapse
|
19
|
Boyas JF, Negi NJ, Valera P. Factors Associated to Health Care Service Use among Latino Day Laborers. Am J Mens Health 2017; 11:1028-1038. [PMID: 28625117 PMCID: PMC5675338 DOI: 10.1177/1557988317694297] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/19/2016] [Accepted: 01/18/2017] [Indexed: 11/18/2022] Open
Abstract
Latino day laborers (LDLs) are at elevated risks for disease and injury because of the environments in which they work. Despite this recognition, a comprehensive examination of factors related to LDLs' health service use remains unexamined. Using the Andersen model, the current exploratory study examined predisposing (age, education level, location of educational training, legal status, and marital status), enabling (income, trust in medical personnel, whether the respondent has someone they consider their personal doctor, and whether their doctor speaks the same language, perceived barriers to care), and need (self-rated health, number of chronic conditions) variables to predict use of health services among a purposive sample of LDLs ( N = 150). Cross-sectional data were collected in 2012 from 4 day laborer sites in Dallas and Arlington, Texas. Regression results suggest that the strongest predictor of health care use was trust in medical providers (β = .41). LDLs who were U.S legal residents (β = .21), reported multiple chronic conditions (β = .16), and had a doctor who spoke their language (β = .15) reported significantly higher levels of health care usage. In terms of barriers, not being able to pay for services (β = -.23), lacking health care insurance coverage (β = -.22), and being embarrassed or having a family member not approve of utilizing services (β = -.18) were significantly associated with lower health care usage among LDLs. These findings suggest that LDLs are faced with a number of predisposing, enabling, and need factors that comprise health care use.
Collapse
Affiliation(s)
| | | | - Pamela Valera
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
- New York School of Medicine, Department of Psychiatry, NY, USA
| |
Collapse
|
20
|
Adapting Screening, Brief Intervention, and Referral to Treatment for Alcohol and Drugs to Culturally Diverse Clinical Populations. J Addict Med 2016; 9:343-51. [PMID: 26428359 DOI: 10.1097/adm.0000000000000150] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To review the literature on the screening, brief intervention, and referral to treatment (SBIRT) approach to alcohol and drug use with racial and ethnic subgroups in the United States and to develop recommendations for culturally competent SBIRT practice. METHODS Articles reporting on the use of SBIRT components (screening, brief intervention, referral to treatment) for alcohol and drug use were identified through a comprehensive literature search of PubMed from 1995 to 2015. RESULTS A synthesis of the published literature on racial and ethnic considerations regarding SBIRT components (including motivational interviewing techniques) was created using evidence-based findings. Recommendations on culturally competent use of SBIRT with specific ethnic groups are also described. CONCLUSIONS On the basis of the literature reviewed, SBIRT offers a useful set of tools to help reduce risky or problematic substance use. Special attention to validated screeners, appropriate use of language/literacy, trust building, and incorporation of patient and community health care preferences may enhance SBIRT acceptability and effectiveness. PRACTICE IMPLICATIONS Providers should consider the implications of previous research when adapting SBIRT for diverse populations, and use validated screening and brief intervention methods. The accompanying case illustration provides additional information relevant to clinical practice.
Collapse
|
21
|
Ornelas IJ, Torres VN, Serrano SE. Patterns of Unhealthy Alcohol Use among Latino Day Laborers. HEALTH BEHAVIOR AND POLICY REVIEW 2016; 3:361-370. [PMID: 36329723 PMCID: PMC9629356 DOI: 10.14485/hbpr.3.4.7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
OBJECTIVE We sought to describe patterns of unhealthy alcohol use among Latino immigrant day laborers and identify correlates of these behaviors. METHODS Participants (N = 104) completed surveys on substance use, alcohol-related problems, mental health, and demographics. We assessed differences in unhealthy alcohol use by subject characteristic using chi-square tests of independence and 2-sample tests of proportions. RESULTS Unhealthy alcohol use was common with 65% having an AUDIT score of 8 or higher. Living situation and income were significantly associated with unhealthy alcohol use and high levels of depression and anxiety were associated with increased alcohol-related problems. CONCLUSIONS Interventions to reduce unhealthy alcohol use should consider the role of stable housing, income and mental health.
Collapse
Affiliation(s)
- India J Ornelas
- University of Washington, Department of Health Services, Seattle, WA
| | - Vanessa N Torres
- University of Washington, Department of Health Services, Seattle, WA
| | | |
Collapse
|
22
|
Cochran G, Gordon AJ, Field C, Bacci J, Dhital R, Ylioja T, Stitzer M, Kelly T, Tarter R. Developing a framework of care for opioid medication misuse in community pharmacy. Res Social Adm Pharm 2016; 12:293-301. [PMID: 26048710 PMCID: PMC4726478 DOI: 10.1016/j.sapharm.2015.05.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 05/01/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Prescription opioid misuse is a major public health concern in the US. Few resources exist to support community pharmacists engaging patients who misuse or are at risk for misuse. OBJECTIVES This report describes the results of the execution of the ADAPT-ITT model (a model for modifying evidence-based behavioral interventions to new populations and service settings) to guide the development of a behavioral health framework for opioid medication misuse in the community pharmacy setting. METHODS Pharmacy, addiction, intervention, and treatment experts were convened to attend a one-day meeting to review the empirical knowledgebase and discuss adapting the screening, brief intervention, and referral to treatment (SBIRT) protocol for addressing opioid medication misuse in community pharmacy. Qualitative data gathered from the meeting were analyzed by 2 independent coders in a 2-cycle process using objective coding schemes. Percentage of agreement and Cohen's Kappa were calculated to assess coder agreement. RESULTS First-cycle coding identified 4 distinct themes, with coder percentage of agreement ranging from 93.5 to 99.6% and with Kappa values between 0.81 and 0.93. Second-cycle coding identified 10 sub-themes, with coder percentage of agreement ranging from 83 to 99.8% and with Kappa values between 0.58 and 0.93. Identified themes and sub-themes encompassed patient identification, intervention, prevention, and referral to treatment. CONCLUSIONS Focus of screening efforts in the emerging model should capitalize on pharmacists' knowledge of medication management. Screening likewise should be multidimensional in order to facilitate patient-centered interventions that activate additional disciplines able to interface with patients at risk or involved in medication misuse.
Collapse
Affiliation(s)
- Gerald Cochran
- University of Pittsburgh School of Social Work, 4200 Fifth Ave., Pittsburgh, PA 15260, USA; University of Pittsburgh, Department of Psychiatry, 3811, Pittsburgh, PA 15213, USA.
| | - Adam J Gordon
- University of Pittsburgh School of Medicine, Department of Medicine, M240 Scaife Hall, 3550 Terrace St, Pittsburgh, PA 15261, USA; VA Pittsburgh Healthcare System, University Drive C (151-C), Pittsburgh, PA 15240-1001, USA
| | - Craig Field
- University of Texas El Paso, Department of Psychology, El Paso, TX 79968, USA
| | - Jennifer Bacci
- University of Pittsburgh School of Pharmacy, 501 Terrace St, Pittsburgh, PA 15213, USA
| | - Ranjita Dhital
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Thomas Ylioja
- University of Pittsburgh School of Social Work, 4200 Fifth Ave., Pittsburgh, PA 15260, USA
| | - Maxine Stitzer
- Johns Hopkins Medicine, Behavioral Pharmacology Research Unit, 5510 Nathan Shock Drive, Baltimore, MD 21224-6823, USA
| | - Thomas Kelly
- University of Pittsburgh, Department of Psychiatry, 3811, Pittsburgh, PA 15213, USA
| | - Ralph Tarter
- University of Pittsburgh School of Pharmacy, 501 Terrace St, Pittsburgh, PA 15213, USA
| |
Collapse
|
23
|
Moore AA, Karno MP, Ray L, Ramirez K, Barenstein V, Portillo MJ, Rizo P, Borok J, Liao DH, Barron J, del Pino HE, Valenzuela A, Barry KL. Development and Preliminary Testing of a Promotora-Delivered, Spanish Language, Counseling Intervention for Heavy Drinking among Male, Latino Day Laborers. J Subst Abuse Treat 2016; 62:96-101. [PMID: 26738641 PMCID: PMC4744478 DOI: 10.1016/j.jsat.2015.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 11/10/2015] [Accepted: 11/15/2015] [Indexed: 12/23/2022]
Abstract
This study developed and then tested the feasibility, acceptability and initial efficacy of a 3-session, culturally adapted, intervention combining motivational enhancement therapy (MET) and strengths-based case management (SBCM) delivered by promotoras in Spanish to reduce heavy drinking among male, Latino day laborers. A pilot two-group randomized trial (N=29) was conducted to evaluate the initial efficacy of MET/SBCM compared to brief feedback (BF). Alcohol-related measures were assessed at 6, 12 and 18weeks after baseline. Most intervention group participants (12/14) attended all counseling sessions and most participants (25/29) remained in the study at 18weeks. Alcohol related measures improved in both groups over time with no statistically significant differences observed at any of the time points. However the comparative effect size of MET/SBCM on weekly drinking was in the large range at 6-weeks and in the moderate range at 12-weeks. Post hoc analyses identified a statistically significant reduction in number of drinks over time for participants in the intervention group but not for control group participants. Despite the extreme vulnerability of the population, most participants completed all sessions of MET/SBCM and reported high satisfaction with the intervention. We feel our community partnership facilitated these successes. Additional studies of community-partnered and culturally adapted interventions are needed to reduce heavy drinking among the growing population of Latinos in the U.S.
Collapse
Affiliation(s)
- Alison A Moore
- University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA, 90095.
| | - Mitchell P Karno
- University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA, 90095.
| | - Lara Ray
- University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA, 90095.
| | - Karina Ramirez
- University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA, 90095.
| | - Veronica Barenstein
- University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA, 90095.
| | - Marlom J Portillo
- IDEPSCA, Workers Health Program, 1565W. 14th Street, Los Angeles, CA, 90015.
| | - Patricia Rizo
- IDEPSCA, Workers Health Program, 1565W. 14th Street, Los Angeles, CA, 90015.
| | - Jenna Borok
- University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA, 90095.
| | - Diana H Liao
- University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA, 90095.
| | - Juan Barron
- University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA, 90095.
| | - Homero E del Pino
- University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA, 90095.
| | - Abel Valenzuela
- University of California, Los Angeles, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA, 90095.
| | - Kristin L Barry
- University of Michigan, 2800 Plymouth Road, Building 16, Room 217W, Ann Arbor, MI, 48109.
| |
Collapse
|
24
|
Sudhinaraset M, Wigglesworth C, Takeuchi DT. Social and Cultural Contexts of Alcohol Use: Influences in a Social-Ecological Framework. Alcohol Res 2016; 38:35-45. [PMID: 27159810 PMCID: PMC4872611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Alcohol use and misuse account for 3.3 million deaths every year, or 6 percent of all deaths worldwide. The harmful effects of alcohol misuse are far reaching and range from individual health risks, morbidity, and mortality to consequences for family, friends, and the larger society. This article reviews a few of the cultural and social influences on alcohol use and places individual alcohol use within the contexts and environments where people live and interact. It includes a discussion of macrolevel factors, such as advertising and marketing, immigration and discrimination factors, and how neighborhoods, families, and peers influence alcohol use. Specifically, the article describes how social and cultural contexts influence alcohol use/misuse and then explores future directions for alcohol research.
Collapse
|
25
|
Gordon AJ, Haibach J. Screening and Intervening on Alcohol and Other Drug Use in General Wellness Programs: Challenges and Opportunities. Subst Abus 2015; 36:255-6. [PMID: 26275177 DOI: 10.1080/08897077.2015.1073975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Adam J Gordon
- a Section of Treatment, Research, and Education in Addiction Medicine , Division of General Internal Medicine, University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA
| | | |
Collapse
|