Randomized Controlled Trial Demonstrates Efficacy of a Culturally Adapted Behavioral Intervention Delivered in Spanish by Community Health Workers to Reduce Unhealthy Alcohol Use Among Latino/as

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Objective: Latino/as comprise nearly 20% of the US population; 25% report past month binge drinking, and disparities in care persist. Culturally adapted interventions may improve outcomes and access. We tested the efficacy of a culturally adapted behavioral intervention to reduce unhealthy alcohol use, delivered in Spanish to Latino/a adults. Method: We conducted a parallel, two-group, randomized controlled trial with 12- and 26-week follow-ups to test a 3-session intervention delivered by community health workers (CHWs) from a community-based agency in Los Angeles, California. The intervention combined culturally-adapted Motivational Enhancement Therapy and Strengths Based Case Management (CA-MET/SBCM) and was compared to the “Rethinking Drinking“ booklet. Participants were 236 non-treatment seeking Latino/a adults who exceeded NIAAA low risk drinking limits. The primary outcome was percentage of heavy drinking days (≥ 5 drinks for men, ≥ 4 drinks for women) in the past 90 days at 26 weeks. Secondary outcomes were average number of drinks per week and alcohol-related problems. Results: The CA-MET/SBCM group had greater reductions in heavy drinking days and average drinks per week at week 26 compared to the Rethinking Drinking group (-21.7 vs -12.9 for percent heavy drinking days; -15.9 vs -9.8 for average drinks per week). At week 12, heavy drinking days were also significantly reduced in the CA-MET/SBCM group (-18.5 vs -10.3). Conclusions: A culturally adapted behavioral intervention, combining MET and SBCM, delivered by Spanish-speaking CHWs significantly reduced unhealthy alcohol use among Latino/as. These results are promising in addressing health disparities, though continued research is essential to further reduce unhealthy drinking and advance health equity for Latino/as.

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