The proposed study will conduct a translational randomized trial comparing Structural Ecosystems Therapy (SET) as an enhancement of substance abuse aftercare treatment, to aftercare treatment as usual (TAU) among 172 Black, Hispanic and White non-Hispanic mothers discharged from residential substance abuse treatment. The study will be conducted with a community partner that delivers integrated substance abuse treatment and primary care. Agency staff will conduct data collection and agency nurse practitioners will deliver SET. Data will be collected at baseline and 4, 8, and 12 month post-randomization.
The Specific Aims of the proposed study are to: 1) test the effectiveness of SET for improving physical and mental health and reducing relapse of mothers in substance abuse recovery;2) test the effectiveness of SET for improving health and mental health outcomes of children of mothers in recovery;3) test mechanisms of action of SET (self care, environmental risk, family functioning and stigma);4) assess SET implementation and sustainability factors and the relationship between fidelity and outcomes;and 5) examine the interactions of ethnicity and ethnicity-related factors on outcomes. SET is a manualized, strength-based, directive and process-oriented family-ecosystemic intervention developed to address the needs of minority women. SET targets the woman's social environment by building on existing adaptive interactions and reducing maladaptive interactions within the family and between the woman, family and supportive resources. A recently completed randomized trial with minority women in drug recovery who were also HIV+ found that for women who were raising children, SET resulted in reduced relapse and psychological distress in the mothers, and reduced symptoms of depression, anxiety and behavioral problems in the children. The proposed study will aim to demonstrate SET'S effectiveness, acceptability and feasibility for implementation in a community setting. The partnership between El Centro and Banyan Health Systems, a substance abuse and primary care provider with considerable research experience, provides a unique opportunity to rigorously test substance abuse aftercare treatment enhanced by SET in a real-world setting.

Public Health Relevance

Substance abuse is a chronic and relapsing condition. Women with substance abuse disorders experience poor health and their children are at risk for negative consequences related to their mother's substance abuse and the resulting disruptions in parenting and family life. Family interventions hold promise for addressing these interrelated health problems but there are currently no empirically supported interventions that attempt to simultaneously address mother's relapse and children's health.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Comprehensive Center (P60)
Project #
2P60MD002266-06
Application #
8352601
Study Section
Special Emphasis Panel (ZMD1-RN (02))
Project Start
2012-05-15
Project End
2017-04-30
Budget Start
2012-05-15
Budget End
2013-04-30
Support Year
6
Fiscal Year
2012
Total Cost
$211,782
Indirect Cost
$67,069
Name
University of Miami Coral Gables
Department
Type
DUNS #
625174149
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
McCabe, Brian E; Schaefer Solle, Natasha; Gattamorta, Karina et al. (2016) Development and psychometric evaluation of a condom use self-efficacy measure in Spanish and English. HIV Clin Trials 17:212-7
Cianelli, Rosina; Villegas, Natalia (2016) Social Determinants of Health for HIV Among Hispanic Women. Hisp Health Care Int 14:4-9
De Oliveira, Giovanna; Cianelli, Rosina; Gattamorta, Karina et al. (2016) Social Determinants of Depression Among Hispanic Women. J Am Psychiatr Nurses Assoc :
McCabe, Brian E; Gonzalez-Guarda, Rosa M; Peragallo, Nilda P et al. (2016) Mechanisms of Partner Violence Reduction in a Group HIV-Risk Intervention for Hispanic Women. J Interpers Violence 31:2316-37
Gonzalez-Guarda, Rosa M; Jones, Emily J; Cohn, Elizabeth et al. (2016) Advancing Nursing Science Through Community Advisory Boards: Working Effectively Across Diverse Communities. ANS Adv Nurs Sci :
Matsuda, Yui (2016) Actor-Partner Interdependence Model Analysis of Sexual Communication and Relationship/Family Planning Factors Among Immigrant Latino Couples in the United States. Health Commun :1-9
Schirle, Lori; McCabe, Brian E (2016) State variation in opioid and benzodiazepine prescriptions between independent and nonindependent advanced practice registered nurse prescribing states. Nurs Outlook 64:86-93
Koskan, Alexis M; LeBlanc, Natalie; Rosa-Cunha, Isabella (2016) Exploring the Perceptions of Anal Cancer Screening and Behaviors Among Gay and Bisexual Men Infected With HIV. Cancer Control 23:52-8
McCabe, Brian E; Schaefer Solle, Natasha; Peragallo Montano, Nilda et al. (2016) Alcohol misuse, depressive symptoms, and HIV/STI risks of US Hispanic women. Ethn Health :1-13
Gonzalez-Guarda, Rosa M; Ferranti, Dina; Halstead, Valerie et al. (2016) Experiences with Dating Violence and Help Seeking Among Hispanic Females in Their Late Adolescence. Issues Ment Health Nurs 37:229-38

Showing the most recent 10 out of 79 publications