# Addressing Alcohol Use Related Health Disparities: A Hybrid Effectiveness Implementation Study of a Culturally Adapted MI for Latinx Alcohol and Drug Users

> **NIH NIH R01** · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · 2021 · $648,076

## Abstract

Abstract
Alcohol use is a significant problem among Latinxs because of the disproportionate burden of physical harms
and negative consequences associated with substance use relative to other racial/ethnic groups. Factors
associated with the stress related to being an immigrant increase risk for substance use. A theoretically-based
cultural adaptation of motivational interviewing (CAMI) that specifically integrated discussion of stressors
related to immigration (e.g., discrimination, stigma, social isolation) resulted in significant reductions in harms
related to alcohol for those Latinx heavy drinkers with high discrimination compared to standard MI, and
reduced anxiety and depressive symptoms one year later compared to MI. Rigorous tests that examine
theoretically-informed adaptation of efficacious interventions for addictions are not common, yet are needed to
advance implementation science because they address questions that are the basis for successful
implementation. The proposed Hybrid Type 1 Effectiveness-Implementation study is an important next step in
this line of research, which is to investigate the feasibility of implementing the CAMI intervention in a real-world
clinical setting. The key questions are: Would CAMI have positive effects among individuals who use both
drugs and alcohol? How do providers view this intervention? We will collaborate with a primary care center that
serves a mainly Latinx client population to train their Community Wellness Advocates (CWAs) to deliver the
CAMI to patients who are heavy drinkers. We will conduct a concurrent investigation on the process of
implementing the CAMI in primary care - a two-arm randomized clinical effectiveness trial will enroll Latinx
heavy drinkers (18 years or older) in primary care who use alcohol (and may use other drugs) - and follow
them for 12 months after the intervention. Specific Aims are: (1) To examine the impact of CAMI plus an in-
person booster session (vs. assessment only) on outcomes: % heavy drinking days, frequency of alcohol-
related consequences, depressive/anxiety symptoms, and number of illicit drug use days, using a Hybrid Type
1 Effectiveness-Implementation design and (2) To gather indicators of implementation outcome from multiple
stakeholders using a mixed-methods approach. We will follow Curran's framework to evaluate the process of
implementation and Proctor's framework to measure implementation outcomes: acceptability, adoption,
intervention appropriateness, feasibility, overall cost (i.e., CAMI vs. assessment only), and treatment fidelity.
Our study, a first to examine the acceptability of culturally-adapted addiction treatments in primary care
settings, will answer essential questions on implementing evidence-based care for Latinxs that can improve
health disparities related to substance use. Long term goals are to translate our lessons from the proposed
Hybrid study to the broader community to focus on population health for all primary care patients...

## Key facts

- **NIH application ID:** 10260640
- **Project number:** 5R01AA028507-02
- **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:** $648,076
- **Award type:** 5
- **Project period:** 2020-09-10 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10260640

## Citation

> US National Institutes of Health, RePORTER application 10260640, Addressing Alcohol Use Related Health Disparities: A Hybrid Effectiveness Implementation Study of a Culturally Adapted MI for Latinx Alcohol and Drug Users (5R01AA028507-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10260640. Licensed CC0.

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