PROJECT SUMMARY: Understanding disparities in alcohol treatment services utilization Introduction: Despite their high need for treatment, Latinos greatly underutilize specialty alcohol treatment. Evidence suggests that Latinos are less likely to use specialty alcohol treatment than other racial/ethnic groups, with the greatest disparity being between Latinos and Whites. Underutilization of specialty treatment is particularly pronounced among Latina women and Latinos low in acculturation. Researchers have suggested that Latinos may experience more barriers to accessing specialty treatment than other racial/ethnic groups. However, studies examining treatment barriers by race/ethnicity are scant, are inconclusive, and face multiple methodological limitations. Aims: In Aim 1, we seek to validate a newly developed, theoretically informed, measure that will sensitively capture key barriers to explain Latino-White disparities in the use of specialty alcohol treatment. In Aim 2, we seek to determine which treatment barriers are most significant to Latinos (vs. Whites). Aim 3 will compare treatment barriers among Latinos only to better understand gender and acculturation disparities. Design and Methods: The proposed study will consist of two phases. In Phase I, we will recruit 40 White and Latino participants with recent (i.e., past-5-year) alcohol use disorders (AUD) for cognitive interviews to further refine our novel, theory-driven scale: The Barriers to Specialty Alcohol Treatment Scale (BSAT). The BSAT was informed by findings from a recently completed pilot study and the Theory of Planned Behavior. Barriers are measured using a 5-point Likert scale response. Data from these interviews will inform the refinement, deletion, and creation of items, resulting in a finalized BSAT scale. In Phase II, we will recruit a national sample of 1,200 White and Latino participants with recent AUD to complete a structured questionnaire that will include the BSAT, resulting from Phase I. Measures of alcohol use disorders, drug use disorders, problem severity, mental health status, acculturation, and socio-demographics will also be collected. These data will be used to conduct psychometric testing for scale validation (Aim 1). We will also conduct separate linear regression models analyzing each barrier as an outcome, while controlling for socio-demographic characteristics and potential confounders, to (a) test for Latino-White differences (Aim 2) and (b) gender and acculturation differences (among Latinos-only; Aim 3). Participants in both phases will be recruited via web panels, a cost- effective approach to effectively sample our target population. Impact: The proposed study is significant because it will uncover new knowledge that is critical to the development of effective and culturally tailored intervention strategies that meet the specific needs of Latinos with AUD and can reduce existing racial/ethnic health disparities.