# Mechanisms of Behavior Change in a Cultural Adaptation of Motivational Interviewing

> **NIH NIH R01** · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · 2021 · $406,172

## Abstract

Proposal Summary/Abstract
Project Title: Mechanisms of Behavior Change in Culturally Adapted Motivational Interviewing
The NIAAA Five Year Strategic Plan prioritizes health disparities research for socially disadvantaged Latinos to
reduce the disproportionate burden of negative consequences related to alcohol use compared to other
racial/ethnic groups (NIAAA, 2013/2016). Cultural adaptation of evidence-based treatments, such as
motivational interviewing (MI), can improve access and overall response to alcohol treatment. However,
research progress has been hindered by the few theoretically-guided tests of adaptation and limited knowledge
about the active ingredients and mechanisms of behavior change that might discriminate an adapted,
compared to non-adapted, intervention. The proposed study will fill this important gap by testing a series of
theory-driven hypotheses regarding the within-session predictors of MI outcome and a novel mechanism of
culturally adapted MI (CAMI) (self-exploration → decreases in perceived acculturation stress, reduced
depression and anxiety → reduced heavy drinking and consequences). The proposed study codes and
examines within-session, process data from a parent RCT (AAR01021136, Lee: PI) guided by adaptation theory
initially tested in a small RCT (AAK23021136, Lee: PI) that showed promising effects in favor of CAMI (Lee et
al., 2013). The ongoing parent CAMI trial compared single session MI to single session CAMI delivered to
Latino heavy drinkers (N=301, 18-65 yrs old). The parent study design (e.g., assessment of multiple self-report
mediators) permits examination of a causal model, while attending to key recommendations on examining
mechanisms of change (Kazdin & Nock, 2003). Up-to-date statistical approaches will be used to examine the
MI causal hypothesis, such as investigating change and sustain talk together as a proportion estimate (Magill et
al., 2014). The parent study design, which used an active comparator (MI), permits between-condition tests of
within-session ingredients and mechanisms, which is a level of contrast rare in MI theory and one of the first a-
priori investigations of processes of change in an adaptation study. The first task in adaptation is to confirm
that key active treatment ingredients and mechanisms are preserved, so study aims are first, to assess MI
ingredients and mechanisms among Latino adults, second, to examine novel MI ingredients and mechanisms
potentially relevant to both conditions, and third, to test the theory, ingredients, and mechanisms specific to
the adaptation. Long term objectives. Findings will improve dissemination of MI to Latinos by providing
empirically-based guidelines on therapist training and on critical MI intervention ingredients. It will also
improve understanding of the stress-health behavior link observed among health disparities populations and
how MI can be used to disrupt this association. The proposed study will be one of the first to contribute to the...

## Key facts

- **NIH application ID:** 10116231
- **Project number:** 5R01AA025485-04
- **Recipient organization:** BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
- **Principal Investigator:** CHRISTINA S LEE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $406,172
- **Award type:** 5
- **Project period:** 2020-03-01 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10116231

## Citation

> US National Institutes of Health, RePORTER application 10116231, Mechanisms of Behavior Change in a Cultural Adaptation of Motivational Interviewing (5R01AA025485-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10116231. Licensed CC0.

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