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患者和提供者之间的种族匹配对西班牙裔人群进行简短酒精干预的效果的影响。

The role of ethnic matching between patient and provider on the effectiveness of brief alcohol interventions with Hispanics.

机构信息

Center for Social Work Research, School of Social Work, University of Texas at Austin, Health Behavior Research and Training Institute, Austin, Texas 78703, USA.

出版信息

Alcohol Clin Exp Res. 2010 Feb;34(2):262-71. doi: 10.1111/j.1530-0277.2009.01089.x. Epub 2009 Nov 24.

Abstract

BACKGROUND

Evaluating the effectiveness of treatments such as brief alcohol interventions among Hispanics is essential to effectively addressing their treatment needs. Clinicians of the same ethnicity as the client may be more likely to understand the culture-specific values, norms, and attitudes and, therefore, the intervention may be more effective. Thus, in cases in which Hispanic patients were provided intervention by a Hispanic clinician improved drinking outcomes were expected.

METHODS

Patients were recruited from an urban Level I Trauma following screening for an alcohol-related injury or alcohol problems. Five hundred thirty-seven Hispanics were randomly assigned to brief intervention or treatment as usual. Hierarchical linear modeling was used to determine the effects of ethnic match on drinking outcomes including volume per week, maximum amount, and frequency of 5 or more drinks per occasion. Analyses controlled for level of acculturation and immigration status.

RESULTS

For Hispanics who received brief motivational intervention, an ethnic match between patient and provider resulted in a significant reduction in drinking outcomes at 12-month follow-up. In addition, there was a tendency for ethnic match to be most beneficial to foreign-born Hispanics and less acculturated Hispanics.

CONCLUSION

As hypothesized, an ethnic match between patient and provider significantly enhanced the effectiveness of brief intervention among Hispanics. Ethnic concordance between patient and provider may have impacted the effectiveness of the intervention through several mechanisms including cultural scripts, ethnic-specific perceptions pertaining to substance abuse, and ethnic-specific preferred channels of communication.

摘要

背景

评估简短酒精干预等治疗方法在西班牙裔人群中的效果对于有效满足他们的治疗需求至关重要。与客户同种族的临床医生可能更能理解特定于文化的价值观、规范和态度,因此干预可能更有效。因此,在为西班牙裔患者提供西班牙裔临床医生干预的情况下,预计饮酒结果会得到改善。

方法

在对与酒精相关的损伤或酒精问题进行筛查后,从城市一级创伤中招募了患者。537 名西班牙裔人被随机分配到简短干预或常规治疗。分层线性模型用于确定种族匹配对饮酒结果的影响,包括每周饮酒量、最大量和每次 5 次或更多次饮酒的频率。分析控制了文化适应水平和移民身份。

结果

对于接受简短动机干预的西班牙裔人,患者和提供者之间的种族匹配导致在 12 个月随访时饮酒结果显著降低。此外,种族匹配似乎对出生在国外的西班牙裔人和文化适应程度较低的西班牙裔人最有益。

结论

正如假设的那样,患者和提供者之间的种族匹配显着提高了西班牙裔人群中简短干预的效果。患者和提供者之间的种族一致性可能通过几种机制影响干预的效果,包括文化脚本、与物质滥用相关的特定于种族的感知以及特定于种族的首选沟通渠道。

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