Do cultural and linguistic competence matter in Latinos’ completion of mandated substance abuse treatment?

Abstract

BackgroundIncreasing evidence suggests that culturally and linguistically responsive programs may improve substance abuse treatment outcomes among Latinos. However, little is known about whether individual practices or culturally and linguistically responsive contexts support efforts by first-time Latino clients to successfully complete mandated treatment.MethodsWe analyzed client and program data from publicly funded treatment programs contracted through the criminal justice system in California. A sample of 5,150 first-time Latino clients nested within 48 treatment programs was analyzed using multilevel logistic regressions.ResultsOutpatient treatment, homelessness, and a high frequency of drug use at intake were associated with decreased odds of treatment completion among Latinos. Programs that routinely offered a culturally and linguistically responsive practice—namely, Spanish-language translation—were associated with increased odds of completion of mandated treatment.ConclusionsThese preliminary findings suggest that concrete practices such as offering Spanish translation improve treatment adherence within a population that is at high risk of treatment dropout.

Does the implementation of evidence-based and culturally competent practices reduce disparities in addiction treatment outcomes?

“…Consistent with other studies (Guerrero, Campos, Urada et al, 2012; Guerrero, Cepeda, Duan et al, 2012; SAMHSA, 2009a), results suggest clients’ primary drug of choice and co-occurring substance use and mental health disorders play a role in successfully completing the goals of treatment. This suggests that beyond ethnicity, programs should tailor practices to respond effectively to the service needs of heroin users and those with co-occurring conditions.…”

“…Compare to non-Latino Whites, Latinos are more likely to drop out of substance use disorder (SUD) treatment (Guerrero & Andrews, 2011) and report lower rates of treatment completion (Guerrero, Campos, Urada, & Yang, 2012; Guerrero, Marsh, Duan, et al, 2013a; Substance Abuse and Mental Health Services Administration [SAMHSA], 2009a; Substance Abuse and Mental Health Services Administration [SAMHSA], 2009b). Evidence-based practices (EBPs) and culturally responsive treatment are considered promising approaches to improving treatment outcomes among Latinos (Bridge, Massie, & Mills, 2008; SAMHSA, 2014).…”

“…Cultural competence, defined as attitudes and behaviors that integrate into an organization or system appropriate for various cultural situations, has received increasing attention given that evidence indicates cultural competence in psychological interventions and treatments is highly valuable (see Sue, Zane, Nagayama Hall, & Berger, 2009, for detailed description). However, previous studies have identified program practices, such as matching clients and providers based on language and cultural background (Guerrero & Andrews, 2011) and ensuring Spanish language proficiency (Guerrero, Khachikian, Kim, Kong, & Vega, 2013), and connections with minority communities (Guerrero, 2013) as associated with higher treatment access and retention, whereas translation of material has been associated with Latino treatment completion (Guerrero, Campos, Urada et al, 2012). A meta-analysis also showed a small but significant treatment effect of culturally adapted interventions on substance use behaviors among Latinos (Smith & Trimble, 2016).…”

Discrimination and Substance Use Disorders Among Latinos: The Role of Gender, Nativity, and Ethnicity

“…The harmful health effects of discrimination should be considered when developing interventions aimed at preventing and treating substance use disorders among Latinos, because discrimination is rarely considered. At the interpersonal level, culturally competent practices, such as race/ethnicity matching, might not only assist in treatment retention, 2,56 but also help individuals feel more comfortable discussing discriminatory experiences, providing an alternative method for coping and building resilience. Similarly, promotores (community health workers) with shared lived experiences of substance use and discrimination might also strengthen prevention and treatment programs.…”

Who receives substance abuse treatment in the ‘real world’ of the prison? A register-based study of Finnish inmates

“…In liberty, different ethnic groups tend to use substance abuse services in different manners (Lundgren et al, 2005). Particularly, language barriers often hinder treatment participation (Guerrero, Campos, Urada, & Yang, 2012). Motivation for treatment is currently given high status as an entrance criterion to substance abuse treatment.…”