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 in 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 brief intervention at a day labor worker center provided 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.

Keywords:

• Latino
• alcohol
• brief intervention
• cultural adaptation

AUTHOR CONTRIBUTIONS

India J. Ornelas contributed to the research conception, design, data collection, analysis, interpretation of results, and drafting the manuscript. Claire Allen contributed to the research design, data collection, analysis, interpretation of results, and drafting the manuscript. Catalina Vaughan contributed to the research design, data collection, analysis, and interpretation of results. Emily C. Williams contributed to the research design, interpretation of results, and revisions of the manuscript. Nalini Negi contributed to the interpretation of results and revisions of the manuscript.

Funding

Dr. Ornelas is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (KL2TR000421). Dr. Williams is supported by a Career Development Award from VA Health Services Research & Development (CDA 12-276) and a fellowship from the Implementation Research Institute (IRI) at the George Warren Brown School of Social Work at Washington University. IRI is supported through an award from the National Institute of Mental Health (R25 MH080916-01A2) and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative (QUERI). Other than providing funding for the study and authors’ time, the funding agencies acknowledged were not involved in the work reported in the paper or preparing the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors report no conflicts of interest.