Vida PURA: A Cultural Adaptation of Screening and Brief Intervention to Reduce Unhealthy Drinking Among Latino Day Laborers

Abstract

Background Brief intervention is known to reduce drinking in primary care, however because health care access is limited for Latino immigrants, traditional brief interventions are unlikely to reach this population. Methods Using Barrera and Castro’s framework, our study aims to culturally adapt a screening and brief intervention program to reduce unhealthy alcohol use among Latino day laborers, a particularly vulnerable group of Latino immigrant men. We conducted 18 interviews with Latino day laborers and 13 interviews with mental health and substance use providers that serve Latino immigrant men. Interviews were conducted until saturation of themes was reached. Themes from interviews were used to identify sources of mismatch between traditional screening and brief intervention and our target population. Results Unhealthy alcohol use was common, culturally accepted, and helped relieve immigration-related stressors. Men had limited knowledge about how to change their behavior. Men preferred to receive information from trusted providers in Spanish. Men faced significant barriers to accessing health and social services, but were open to receiving brief interventions in community settings. Findings were used to design Vida PURA, a preliminary adaptation design of brief intervention for Latino day laborers. Key adaptations include providing brief intervention at a day labor worker center, by promotores trained to incorporate the social and cultural context of drinking for Latino immigrant men. Conclusions Culturally adapted brief intervention may help reduce unhealthy drinking in this underserved population.

Exploring Structural, Sociocultural, and Individual Barriers to Alcohol Abuse Treatment Among Hispanic Men

“…Dissatisfaction with treatment as perceived by this study’s sample was centered in; (a) deprecation created by poor experiences with treatment begetting distrust of sliding-scale and free treatment, and (b) the lack of appropriate linguistically and culturally responsive communication between patient and provider. Evidence highlights the scarcity of Spanish-speaking treatment providers, resulting in a lack of linguistically appropriate services that continue to be a major barrier to seeking and using alcohol abuse treatment for Hispanics ( Amaro & Aguiar, 1998 ; Ornelas, Allen, Vaughan, Williams, & Negi, 2015 ; Pagano, 2014 ). It is imperative that treatment efforts consider the preferred language of clientele from outreach to completion as this can make efforts more effective with this population.…”

“…It is imperative that treatment efforts consider the preferred language of clientele from outreach to completion as this can make efforts more effective with this population. Findings from Ornelas et al (2015) indicate that some Hispanic men prefer to discuss their alcohol use in Spanish with trusted providers and have therefore suggested the use of promotores as a viable strategy. Promotores are community health advisors that often share sociodemographic, linguistic, and cultural characteristics with the people they serve and have been demonstrated to enhance participant comfort and trust making intervention communication more efficacious ( Ornelas et al, 2015 ).…”

“…Research suggests that stigmatization of alcoholism itself keeps people from seeking treatment ( Fortney et al, 2004 ; Keyes et al, 2010 ); stigma that exists at higher rates among Hispanics ( Smith, Dawson, Goldstein, & Grant, 2010 ). Stigma may be exacerbated by lack of knowledge and recent findings that suggest some Hispanic men may have limited knowledge about how to seek help or change alcohol misuse-related behaviors ( Ornelas et al, 2015 ). Participants in the present study attributed both the social stigma and self-stigmatization to a lack of understanding of alcohol abuse and treatment.…”

Factors Associated to Health Care Service Use among Latino Day Laborers

“…LDLs’ hazardous work conditions compounded by marginalization and social isolation have led to disproportionately high rates of on-the-job-related injuries and fatalities among LDLs when compared with other workers in the United States ( Lowry et al, 2010 ; Williams, Ochsner, Marshall, Kimmel, & Martino, 2010 ). Furthermore, LDLs have been reported to be at risk for sexually transmitted infections ( Hong, Murga, Plankey-Videla, & Chavez, 2015 ; Organista & Kubo, 2005 ; Wong et al, 2003 ), are likely to experience chronic stress ( Galvin et al, 2015 ; Salgado, Castañeda, Talavera, & Lindsay, 2012 ), and engage in unhealthy drinking( Ornelas, Allen, Vaughan, Williams, & Negi, 2015 ).…”

¿Ahora qué?: Cultural Adaptation of a Cancer Survivorship Intervention for Latino/a Cancer Survivors

“…We adapted an existing program, with six classes and materials for participants and facilitators. Other studies have adapted multimedia decision aids, printed health education materials, and brief health interventions for Latino/a populations. Previous interventions focused specifically on Latino/a survivors developed out of partnerships among community‐based organizations, Latino/a survivors, caregivers and researchers, and community health outreach services .…”