Mechanisms of Behavior Change in a Cultural Adaptation of Motivational Interviewing

动机访谈文化适应中行为改变的机制

基本信息

批准号：
10116231
负责人：
CHRISTINA S LEE
金额：
$ 40.62万
依托单位：
BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-03-01 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10116231
关键词：
Acculturation Adult Alcohol consumption Alcoholic beverage heavy drinker Alcohols Anxiety Awareness Behavior Therapy Behavioral Mechanisms Client Code Complex Data Empathy Equation Ethnic group Evidence based intervention Evidence based treatment Group Processes Guidelines Health behavior Heavy Drinking Improve Access Intervention Investigation Knowledge Latino Link Literature Mediation Mediator of activation protein Mental Depression Meta-Analysis Methodology Modeling National Institute on Alcohol Abuse and Alcoholism Outcome Parents Patient Self-Report Population Process Randomized Controlled Trials Recommendation Research Research Design Sampling Science Series Services Source Strategic Planning Stress Structure Testing Therapeutic Training Treatment Efficacy Work active comparator active method alcohol abuse therapy alcohol response base behavior change behavioral outcome burden of illness causal model community setting evidence base follow-up health disparity health disparity populations improved improved outcome innovation motivational enhancement therapy novel pilot trial preservation primary outcome racial and ethnic skills social disadvantage theories trial comparing

项目摘要

Proposal Summary/Abstract Project Title: Mechanisms of Behavior Change in Culturally Adapted Motivational Interviewing The NIAAA Five Year Strategic Plan prioritizes health disparities research for socially disadvantaged Latinos to reduce the disproportionate burden of negative consequences related to alcohol use compared to other racial/ethnic groups (NIAAA, 2013/2016). Cultural adaptation of evidence-based treatments, such as motivational interviewing (MI), can improve access and overall response to alcohol treatment. However, research progress has been hindered by the few theoretically-guided tests of adaptation and limited knowledge about the active ingredients and mechanisms of behavior change that might discriminate an adapted, compared to non-adapted, intervention. The proposed study will fill this important gap by testing a series of theory-driven hypotheses regarding the within-session predictors of MI outcome and a novel mechanism of culturally adapted MI (CAMI) (self-exploration → decreases in perceived acculturation stress, reduced depression and anxiety → reduced heavy drinking and consequences). The proposed study codes and examines within-session, process data from a parent RCT (AAR01021136, Lee: PI) guided by adaptation theory initially tested in a small RCT (AAK23021136, Lee: PI) that showed promising effects in favor of CAMI (Lee et al., 2013). The ongoing parent CAMI trial compared single session MI to single session CAMI delivered to Latino heavy drinkers (N=301, 18-65 yrs old). The parent study design (e.g., assessment of multiple self-report mediators) permits examination of a causal model, while attending to key recommendations on examining mechanisms of change (Kazdin & Nock, 2003). Up-to-date statistical approaches will be used to examine the MI causal hypothesis, such as investigating change and sustain talk together as a proportion estimate (Magill et al., 2014). The parent study design, which used an active comparator (MI), permits between-condition tests of within-session ingredients and mechanisms, which is a level of contrast rare in MI theory and one of the first a- priori investigations of processes of change in an adaptation study. The first task in adaptation is to confirm that key active treatment ingredients and mechanisms are preserved, so study aims are first, to assess MI ingredients and mechanisms among Latino adults, second, to examine novel MI ingredients and mechanisms potentially relevant to both conditions, and third, to test the theory, ingredients, and mechanisms specific to the adaptation. Long term objectives. Findings will improve dissemination of MI to Latinos by providing empirically-based guidelines on therapist training and on critical MI intervention ingredients. It will also improve understanding of the stress-health behavior link observed among health disparities populations and how MI can be used to disrupt this association. The proposed study will be one of the first to contribute to the emerging science on mechanisms of behavior change with health disparities populations and will yield important recommendations on the science of adaptation and ways to improve MI dissemination to community settings.

提案摘要/摘要项目名称：文化适应动机访谈的行为变化机制 NIAAA五年战略计划优先考虑对社会扰乱拉丁裔的健康差异研究与其他种族/族裔群体（NIAAA，2013/2016年）。循证治疗的文化适应，例如动机访谈（MI）可以改善酒精治疗的获取和总体反应。然而，少数理论指导的适应和有限的知识测试阻碍了研究进度关于行为变化的主动成分和机制，可能会区分适应的，与未适应的干预相比。拟议的研究将通过测试一系列重要的差距来填补这一重要空白理论驱动的假设关于MI结果的会议内预测指标和一种新颖的机制文化适应的MI（CAMI）（自探测→减少感知的培养压力，减少抑郁和动画→减少饮酒和后果）。拟议的研究代码和检查会议内，来自父级（AAR01021136，Lee：pi）的处理数据以适应理论为指导最初在小的RCT（AAK23021136，Lee：pi）中测试，显示有希望效应CAMI（Lee et eT Al。，2013）。正在进行的父母CAMI试验将单个会话MI与交付给的单个会话CAMI进行了比较拉丁裔重饮者（n = 301，18 - 65岁）。家长研究设计（例如，评估多个自我报告调解员）允许检查因果模型，同时又遵守了检查的关键建议变化机制（Kazdin＆Nock，2003）。最新的统计方法将用于检查 MI因果假设，例如研究变化并将其作为比例估计的交谈（Magill et） Al。，2014）。使用主动比较器（MI）的家长研究设计允许在条件间测试中会议内的刺激性和机制，这在MI理论中是罕见的对比度，也是第一个A-之一在适应研究中对变化过程的先验研究。适应的第一个任务是确认保留了关键的主动治疗方法和机制，因此首先要进行研究目标，以评估MI 拉丁裔成年人中的成分和机制，其次是检查新型的MI成分和机制可能与两种条件和第三条件有关，以测试特定于改编。长期目标。调查结果将通过提供MI向拉丁裔的传播基于经验的治疗师培训和关键MI干预成分的准则。它也会提高对健康分布人群中观察到的压力健康行为链接的理解和如何使用MI来破坏这种关联。拟议的研究将是最早为此做出贡献的研究之一新兴的科学与健康分布人群的行为改变机制，并将产生关于适应科学的重要建议以及改善MI传播的方法社区设置。