A randomized controlled trial of motivational interviewing tailored for heavy drinking latinxs

Abstract

Objective: This randomized controlled trial (Clinicaltrials.gov NCT [01996280]) compared the efficacy of a brief motivational interview (MI) adapted to address social stressors and cultural influences (culturally adapted MI [CAMI]) to a standard MI for heavy-drinking Latinxs. CAMI was hypothesized to reduce heavy drinking days and frequency of alcohol-related consequences more than MI. Moderators of treatment effect were explored.

Method: Latinxs (N = 296; 63% male, M age = 41 years) who reported 2+ past month heavy drinking episodes received a single-session (MI/CAMI), with assessments at baseline and 3, 6, and 12 months.

Results: Both conditions showed significant reductions in percent heavy drinking days and frequency of alcohol-related consequences through 12-month follow-up when compared with baseline; reductions were not significantly different by condition. Acculturation moderated treatment condition effect on alcohol-related problems at 3 months (d = .22, 95% CI [.02, .41]); less acculturated individuals experienced less frequent consequences of drinking after CAMI than MI (d = .34, 95% CI [-.60, -.08]). Discrimination moderated condition effect on frequency of alcohol-related consequences at 3 months (d = .17, 95% CI [-.33, -.01]); individuals with higher levels of baseline discrimination had less frequent consequences after CAMI than MI (d = .20, 95% CI [-.39, -.01]).

Conclusions: Participants in both groups improved with no significant differences between groups. Moderation effects suggest that cultural adaptation has particular benefit for more vulnerable individuals and support the theory of change in this adaptation model. MI is efficacious with Latinx heavy drinkers and should be used to mitigate health disparities related to alcohol misuse. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Trial registration: ClinicalTrials.gov NCT01996280.

Figures

Figure 1.

Consort Flow Diagram.

Figure 2.

Treatment condition differences on Percent Heavy Drinking Days across 12 months. Each follow-up contrast is significant when compared to baseline values. No treatment condition differences at any time point.

Figure 3.

Treatment condition differences on Alcohol-Related Negative Consequences (DrInC) across 12 months. Each follow-up contrast is significant when compared to baseline values. No treatment condition differences at any time point.

Figure 4.

Moderation Effects for Acculturation by Alcohol-Related Negative Consequences (DrInC) across 12 months. Moderation effects for Acculturation, Discrimination on alcohol-related negative consequences (DrInC). At lower levels of acculturation, DrInC scores for CAMI condition were significantly lower than MI at 3 months.

Figure 5.

Moderation Effects for Discrimination by Alcohol-Related Negative Consequences (DrInC) across 12 months. At higher levels of discrimination at baseline, DrInC scores for CAMI condition were significantly lower than MI at 3 months.