Cultural accommodation of group substance abuse treatment for Latino adolescents: Results of an RCT.

Abstract

Objectives Comparative studies examining the difference between empirically supported substance abuse treatments versus their culturally accommodated counterparts with participants from a single ethnic minority group are frequently called for in the literature but infrequently conducted in practice. This RCT was conducted to compare the efficacy of an empirically supported standard version of a group-based cognitive-behavioral treatment (S-CBT) to a culturally accommodated version (A-CBT) with a sample of Latino adolescents primarily recruited from the juvenile justice system. Development of the culturally accommodated treatment and testing was guided by the Cultural Accommodation Model for Substance Abuse Treatment (CAM-SAT). Methods Seventy Latino adolescents (mean age = 15.2; 90% male) were randomly assigned to one of two group-based treatment conditions (S-CBT = 36; A-CBT = 34) with assessments conducted at pretreatment, posttreatment, and 3-month follow-up. Longitudinal Poisson mixed models for count data were used to conduct the major analyses. The primary outcome variable in the analytic models was the number of days any substance was used (including alcohol, except tobacco) in the past 90 days. In addition, the variables ethnic identity, familism, and acculturation were included as cultural moderators in the analysis. Results Although both conditions produced significant decreases in substance use, the results did not support a time by treatment condition interaction; however, outcomes were moderated by ethnic identity and familism. Conclusions The findings are discussed with implications for research and practice within the context of providing culturally relevant treatment for Latino adolescents with substance use disorders.

Parent-adolescent relationships in Hispanic versus Caucasian families: Associations with alcohol and marijuana use onset

“…Hispanic adolescents also tend to initiate alcohol and marijuana use earlier compared to Caucasians and so may be at greater risk for future escalation of use and comorbid mental health problems (Miech et al, 2015). Additionally, ethnic minority adolescents (e.g., Hispanics) tend to underutilize programs for substance use more so than Caucasians (Burrow-Sánchez, Minami, & Hops, 2015; Saloner, Carson, & Cook, 2014). Although efforts to improve underutilization of substance use treatment programs have been evaluated across cultural groups (Greenfield et al, 2007; Hser et al, 2001), few studies have focused on Hispanic adolescents (Burrow-Sánchez et al, 2015; Saloner et al, 2014).…”

“…Additionally, ethnic minority adolescents (e.g., Hispanics) tend to underutilize programs for substance use more so than Caucasians (Burrow-Sánchez, Minami, & Hops, 2015; Saloner, Carson, & Cook, 2014). Although efforts to improve underutilization of substance use treatment programs have been evaluated across cultural groups (Greenfield et al, 2007; Hser et al, 2001), few studies have focused on Hispanic adolescents (Burrow-Sánchez et al, 2015; Saloner et al, 2014). This is particularly true for substance use programs that incorporate parents into treatment (Coatsworth, Pantin, & Szapocznik, 2002; Estrada, 2015; Prado et al, 2012; Szapocznik et al, 1991; Szapocznik et al, 1988).…”

Cultural adaptations to augment health and mental health services: a systematic review

“…Burrow-Sanchez and Wrona, and Burrow-Sanchez, Minami, and Hops found no significant group differences in drinking outcomes or treatment satisfaction among Latino adolescents, however, treatment outcome was moderated by recipients’ ethnic identity and measures of familism [76, 77]. Lee et al observed greater reductions in alcohol-induced problem behavior for Latinos in the culturally-adapted motivational-interviewing group [54].…”

“…For example, Wang et al found that a culturally adapted video was more effective for women who were lower in acculturation [48]. Pan et al, Gondolf, and Burrow-Sanchez et al likewise found that adapted programs were more effective amongst Asian Americans less-acculturated to U.S. culture, African Americans with high racial identification, and Latino adolescents with high ethnic identity commitment, respectively [47, 65, 77]. These findings provide some support for tailoring based on level of acculturation, which was featured in three reviewed studies: Huey and Pan and Pan et al, Kreuter et al, and Resnicow et al [60–65].…”

“…Researchers strove to involve cultural consultants and community members in the development of their interventions and focus-group testing of the interventions to ensure their validity [37, 46, 48, 49, 54–56, 60–67, 71, 72, 76, 77, 80]. It was not possible to determine to what degree this engagement involved true partnerships with the community versus less involved approaches such as brief consultation.…”