Gender and Cultural Adaptations for Diversity: A Systematic Review of Alcohol and Substance Abuse Interventions for Latino Males

BACKGROUND

Latino men are disproportionately affected by the consequences of alcohol and substance abuse when compared to non-Latino white men. Latino men also face greater barriers to accessing, engaging, and completing alcohol and substance abuse treatment services. Culturally adapted interventions are promoted to overcome these barriers. However, the effectiveness of these efforts is unclear.

OBJECTIVES

The purpose of this review was to summarize the published evidence regarding gender-adapted and culturally adapted alcohol and substance abuse treatment that aims to improve physical, behavioral, and social outcomes in Latino men.

METHODS

A systematic literature search was conducted for articles reporting on culturally and/or gender-adapted alcohol and/or substance abuse interventions designed exclusively for Latino adults, including a Latino population sample of at least 10% and any proportion of Latino male participants. A thematic analysis based on predetermined themes was used to evaluate the nature of adaptations.

RESULTS

Searches yielded 2685 titles, resulting in 12 articles that fit review parameters. The most scientifically rigorous findings suggest culturally adapted interventions may outperform standard treatment. Nevertheless, a fraction of the interventions did not improve outcomes compared to standard treatment. Considering the scarce number of publications, it is difficult to discern if null findings reflect ineffective interventions or methodological limitations.

CONCLUSIONS

While studies are limited and findings are mixed, culturally tailored work shows promise. The growth rate of the Latino population and the current epidemic nature of substance abuse in the United States generate urgency to identify methods to diminish the disparate burden of alcohol and substance abuse in Latinos.

The Role of Confirmation Bias in the Treatment of Diverse Patients

Providing effective treatment within a diverse population is complex and difficult. Issues such as a limited amount of time that can be spent with patients and the need to make decisions based on limited information can lead to information processing errors that have a detrimental impact on treatment outcomes. Cognitive biases (e.g., confirmation bias) may further compound this issue by making it less likely that a health care provider will make adjustments to treatment plans. Steps to minimize the potential for cognitive biases are discussed.