THE IMPACT OF ACCULTURATION AMONG HISPANICS ON DRINKING OUTCOMES FOLLOWING BRIEF INTERVENTION IN THE TRAUMA CARE SETTING

Abstract

Background: In a study of brief intervention in the trauma care setting, a significant interaction between treatment and ethnicity was found among Hispanics. Hispanics receiving brief intervention based on motivational interviewing were significantly more likely to reduce their drinking. This study evaluates the unique role of acculturation among Hispanics on drinking outcomes following brief alcohol intervention in the trauma care setting.Methods: A randomized controlled trial of brief intervention based on motivational interviewing and semi‐structured interview was conducted in an urban level I trauma center. Among the patients recruited for this study were 537 Hispanics including 253 Spanish speaking only participants. Six and 12 month follow ups were completed with a 65% and 53% follow up rate, respectively. A lost to follow up analysis was conducted using logistic regression. Hierarchical Linear Modeling was used to evaluate the role of acculturation among Hispanics including place of birth and level of acculturation on drinking outcomes including volume per week, maximum amount consumed in one day, frequency of five or more per occasion, percent days abstinent and percent days heavy drinking. Analyses controlled for age, gender, employment status, marital status, prior alcohol treatment, type of injury and injury severity.Results: Ethnicity was a significant predictor of loss to follow up at 6 months (p<.01) but not 12 months. Hispanics born in the US were less likely to be lost to follow up at 6 and 12 months (OR=.4, 95% CI=.3‐.7). Acculturation was not significantly associated with loss to follow up at 6 or 12 months. Hispanics born in the US had higher volume per week (β=.7, se=.3, p<.01) and maximum amount consumed in one day (β=.6, se=.2, p<.01). Hispanics with low acculturation, had lower average volume per week (β=‐.9, se=.3, p<.01), maximum amount consumed in one day (β=‐.5,se=.2, p<.05) and frequency of five or more per occasion (β=‐.7, se=.3, o<.05). No significant interactions between treatment and acculturation or place of birth was observed (p>.50)Conclusions: While brief intervention based on motivational interviewing is effective among Hispanics in the trauma care setting, place of birth and acculturation influence treatment outcome.