Stage II Efficacy Trial of an Adapted Brief Intervention to enhance healthcare and health outcomes among Hispanics

University Of Texas El Paso, El Paso TX

Investigators

Abstract

Our prior Stage III Randomized Clinical Trial (n=1496) evaluating ethnic differences in response to brief intervention showed that, compared to non-Hispanic Whites, Hispanics were more likely to reduce alcohol use in response to standard brief alcohol interventions that are not adapted to be responsive to the needs of the population (NA-BMI) versus treatment as usual. In Stage I Community Based Participatory Research (Stage I CBPR), we developed a contextualized brief motivational intervention (C-BMI), which adopts a harm reduction approach and focuses on reducing alcohol problems and increasing treatment utilization. Through a flexible core approach, C-BMI introduces substantial modifications to standard brief alcohol interventions to be contextualized to the population and is theoretically grounded in self-determination theory (SDT). The result of the Stage I CBPR was C-BMI, which 1) leverages specific values and strengths of the target community while addressing the social stressors relevant to the target community; 2) is explicitly designed to meet the basic psychological needs of autonomy, relatedness, and competence to enhance autonomous motivation to change drinking behavior; and 3) focuses on harm reduction. Our Stage I CBPR-based pilot study (n=87) demonstrated that C-BMI is feasible and acceptable. In the current study, we hypothesize that C-BMI will lead to increased engagement in protective drinking behaviors, fewer alcohol problems, as well as reduce barriers to help-seeking and increased treatment utilization among non-treatment-seeking Hispanics. The proposed Stage II Efficacy Trial of CI-BMI will randomize 600 Hispanics who engage in at-risk drinking to either NA-BMI or C-BMI. The primary aims of the proposed study are to 1) test the efficacy of C-BMI in comparison to NA-BMI on alcohol related harm reduction behaviors, alcohol problems, barriers to help seeking and treatment utilization among non-treatment seeking Hispanics engaging in at-risk drinking and 2) examine the theoretically informed mechanisms of behavior change based on SDT including providing autonomy support to meet the basic psychological needs that enhance autonomous motivation to change drinking behavior. Because the psychological processes underlying the intrasession mechanisms of change remain poorly understood, C-BMI based on SDT will significantly advance the science and practice of brief interventions. In addition, planned secondary data analysis will assess the influence of social stressors relevant to the target community on alcohol related outcomes. The results of this study will lead to a theoretically informed brief motivation intervention with enhanced generalizability to effectively address alcohol outcomes and treatment utilization among non-treatment-seeking Hispanics who engage in at-risk drinking.