Juramentos and Recovery: The Use of A Religious-Based Alcohol Intervention Among Mexican Immigrant Farmworkers

Indiana University Of Pennsylvania, Indiana PA

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Abstract

The proposed R15 project will investigate the use of the juramento among Mexican immigrant farmworkers in southeastern Pennsylvania. The juramento is a ritualized pledge that Catholics make to a saint for divine intervention in abstaining from alcohol. It is a religious-based alcohol intervention with origins in Mexico and a strong and growing presence in Mexican immigrant communities. Mexican farmworkers have been identified as a high-risk group for developing substance use disorders (SUDs), and too often experience extraordinary barriers that keep them from formal alcohol treatments, when available in their communities. Unable to access treatments, they turn to alternative interventions in their communities, such as immigrant-specific and Spanish-language Alcoholics Anonymous meetings and anexos, including juramentos. The Latino Immigrant SUDs Help-Seeking Model, currently under development in another study, drives our R15 project. It will help us to explain why Mexican immigrant farmworkers do not use conventional treatments, as a consequence of individual-level, treatment and intervention-level, and structural factors in and beyond their communities that produce inequitable access to treatment services; and to explain how the farmworkers learn about the juramento and use it to initiate sobriety, to stay sober, and to work on their recovery. We modify the model to include the religiosity of the farmworkers, opening the model?s aperture and increasing our understanding of a religious-based indigenous alcohol intervention. That is, an alcohol intervention with origins in the homeland of the immigrants and adopted in the United States. With the data gathered, our model will be developed into an empirically-informed indigenous recovery systems paradigm that includes the juramento and other indigenous alcohol interventions and treatments in farmworker communities. It will also allow us to generate scientific knowledge of an indigenous and religious-based alcohol intervention not addressed in the ethnic-specific alcohol treatment literature. The extant literature highlights farmworker and other migrant laborers? alcohol prevalence and the many barriers to alcohol and other SUDs treatment, but tends to ignore their help-seeking pathways and the indigenous interventions and treatments available in their communities. The specific aims of this exploratory study are: 1. To establish who in the Mexican immigrant farmworker population (e.g., age, marital status, migration history) makes a juramento and why; 2. To identify the individual-level factors (e.g., age, marital status, immigration background), treatment and intervention-level factors (e.g., program language and rituals), and structural factors (e.g., immigration policy, health access policy, and labor conditions) that shape the help-seeking pathways of Mexican immigrant farmworkers that include juramento use. 3. To examine the sobriety and recovery practices of the juramentos (e.g., prayer, prayer cards, church attendance); 4. To ascertain the farmworkers? perceptions of the juramento?s benefits (e.g., faith-based intervention and cultural familiarity) and possible drawbacks (e.g., short-term sobriety and lack of continuous support). The proposed project is designed around the qualitative method?an appropriate approach for exploratory studies such as ours?and the preparation of students for qualitative health research through field praxis. We will use semi- structured interviews to collect qualitative data on juramento use among Mexican immigrant farmworkers in Southern Chester County, PA, who will be recruited using purposive sampling. First, we will use semi-structured interviews to query two priests, who perform juramentos in the region, about the juramentos and the farmworkers who use them. Second, we will conduct exploratory semi-structured interviews with 30 farmworkers: 15 who made juramentos, irrespective of if they are in an alcohol treatment program or not, and 15 who did not but are in alcohol treatment. We will use these interviews to gather information on their use of juramentos, their religious background, their personal histories of alcohol use, and their experience with other interventions and treatments, if any. Third, we will conduct two focus groups with farmworkers with anywhere from eight to 12 participants per focus group. One focus group will be comprised of men who have made juramentos and the other with men who have not made juramentos but are in alcohol treatment. The focus groups will help us to gain a more nuanced understanding of how and why they use juramentos, and what they believe in regards to how the juramento contributes to their sobriety and recovery. The exploratory interviews and focus groups will also include the DUREL and the AUDIT instruments. All interview transcripts will be analyzed using standard qualitative data analysis and the instruments, together with basic demographic characteristics from exploratory and focus group samples, will be analyzed using basic statistical analyses. From our findings, we expect to be able to: (1) identify who in the Mexican farmworker population use juramentos and why; (2) describe the juramento and how it contributes to sobriety; (3) inform cultural competence efforts in alcohol treatments of the religious and spiritual elements of the juramento; and (4) develop novel research on religious recovery practices. Our short-term goal is to learn more about the juramento and farmworker use of the juramento and to advance a student-centered qualitative health research program at Indiana University of Pennsylvania. Our mid-term goals are to prepare an R01 study on efficacy of the juramentos in regards to sobriety and recovery to sustain the qualitative health research program and to improve a burgeoning public health research infrastructure on campus. Our long-term goal is to generate new scientific knowledge on these sobriety promoting features that will inform alcohol treatment services for Mexican and other Latino immigrants.