This application is a request for a Mentored Patient-Oriented Research Career Award (K23) to develop as an independent clinical trials researcher specializing in the implementation and evaluation of alcohol treatment research with underserved groups. In a prior grant, I found that clinicians responded to minority drinkers with less pity and rated white male drinkers to have less control over their alcohol consumption. Bias, lack of access to treatment, and the language barrier, contribute to health care disparities. These factors explain the accelerated course from drinking to hazardous drinking for Hispanics, who experience a disproportionately higher rate of alcohol problems compared with non-Hispanics. The proposed research study hopes to address these barriers by developing a culturally adapted motivational interview for use by English-speaking clinicians working with Hispanic patients. Primary research aims of this application are to develop and evaluate a culturally adapted motivational interview (CAMI), and to compare the efficacy of this intervention with standard motivational interview (SMI). CAMI foci will be on: 1) the integration of cultural norms and attitudes about drinking into the intervention, and 2) methods to deliver the intervention in a culturally sensitive manner. CAMI development will follow stage guidelines. The significance of this research will be to increase understanding on whether integrating cultural factors into an existing psychosocial treatment enhances treatment efficacy, and whether training English-speaking clinicians to deliver an intervention in a culturally sensitive manner enhances clinical process and outcome. Training goals are to: 1) broaden conceptual knowledge of the factors that influence Hispanic alcohol use in the Northeast, 2) increase expertise in the delivery and evaluation of motivational interviewing, 3) enhance skills in clinical trials methodology and statistics, 4) scholarly productivity, and 5) receive training in research ethics, including ethical issues regarding the conduct of community research. Training goals will be achieved through resources available at 1) the Center for Alcohol and Addiction Studies, Brown University, 2) mentorship, 3) focused coursework and clinical experiences, and 4) the proposed research project.
