Funding: NIAAA R01AA027767
Project PI: Sarah E. Zemore, subcontract
Primary: Miguel Pinedo, University of Texas, Austin
Despite their high need for treatment, Latinos greatly under-utilize specialty alcohol treatment. Evidence suggests that Latinos are less likely to use specialty alcohol treatment than other racial/ethnic groups, with the greatest disparity being between Latinos and Whites. Underutilization of specialty treatment is particularly pronounced among Latina women and Latinos low in acculturation.
Researchers have suggested that Latinos may experience more barriers to accessing specialty treatment than other racial/ethnic groups. However, studies examining treatment barriers by race/ethnicity are scant, are inconclusive, and face multiple methodological limitations.
This alcohol treatment services utilization study is focused on understanding barriers that contribute to Latino- White disparities in the use of specialty alcohol treatment. Underutilization of specialty alcohol treatment by Latinos, the largest and fastest growing minority racial/ethnic group, is troublesome given that these services have been shown to be effective regardless of race/ethnicity. Findings will address gaps in our understanding of barriers that prevent people from seeking and receiving appropriate care for alcohol use disorders and will aid in the development of strategies to enhance treatment use.
Aim 1: we will validate a newly developed, theoretically informed, measure that will sensitively capture key barriers to explain Latino-White disparities in the use of specialty alcohol treatment.
Aim 2: we will determine which treatment barriers are most significant to Latinos (vs. Whites).
Aim 3: we will compare treatment barriers among Latinos only to better understand gender and acculturation disparities.
Design and Methods
Phase I: We will recruit 40 White and Latino participants with recent (i.e., past-5-year) alcohol use disorders (AUD) for cognitive interviews to further refine our novel, theory-driven scale: The Barriers to Specialty Alcohol Treatment Scale (BSAT). The BSAT was informed by findings from a recently completed pilot study and the Theory of Planned Behavior. Barriers are measured using a 5-point Likert scale response. Data from these interviews will inform the refinement, deletion, and creation of items, resulting in a finalized BSAT scale.
Phase II: We will recruit a national sample of 1,200 White and Latino participants with recent AUD to complete a structured questionnaire that will include the BSAT, resulting from Phase I. Measures of alcohol use disorders, drug use disorders, problem severity, mental health status, acculturation, and socio-demographics will also be collected. These data will be used to conduct psychometric testing for scale validation (Aim 1). We will also conduct separate linear regression models analyzing each barrier as an outcome, while controlling for socio-demographic characteristics and potential confounders, to (a) test for Latino-White differences (Aim 2) and (b) gender and acculturation differences (among Latinos-only; Aim 3).
Participants in both phases will be recruited via web panels, a cost- effective approach to effectively sample our target population.
The proposed study is significant because it will uncover new knowledge that is critical to the development of effective and culturally tailored intervention strategies that meet the specific needs of Latinos with AUD and can reduce existing racial/ethnic health disparities.