Category: Dissemination / Implementation
Keywords: Motivational Interviewing | Diversity | Substance Abuse
Presentation Type: Symposium
Background: The NIAAA Draft 2016 Strategic Plan (2017-2022) prioritizes disseminating EBTs to populations that suffer health inequities related to substance use. Background: Delivering EBTs like MI in Spanish can enhance outcomes (Cabassa & Baumann, 2013), but key details on quality assurance procedures (Miller & Rollnick, 2014) and clinical implications are limited. This presentation, from data collected as part of a randomized clinical trial (R01AA021146, PI: Lee) that delivered culturally adapted MI in Spanish and English to reduce heavy drinking among Latinos, offers a unique look at MI intervention quality delivered in Spanish and English. Goals are to discuss quality assurance procedures and clinical implications of treatment fidelity data. Methods: In the RCT, Latinos who met criteria for problem drinking were recruited via newspaper ads and received one MI session from a bilingual paraprofessional, in the patient’s preferred language. To monitor treatment fidelity, the PI trained bilingual research staff to code tapes using the MITI coding system (Houck et al., 2013). A total of 199 sessions were MITI coded (34% Spanish, 66% English). Results: MITI ratings were significantly higher in English compared to Spanish for MI Globals (e.g., SPIRIT, English M= 4.22 (.46) vs Spanish M = 3.68 (.67), p < .001; Collaboration, English M = 4.15 (.56) vs Spanish M = 3.62 (.71), p < .001), and MI behaviors (e.g., % Complex Reflections, English M = 35.84 (15.20) vs Spanish M = 29.13 (19.16), p < .01; Reflection to Question ratio, English M = 1.55 (1.02) vs Spanish M = 1.18 (.77), p < .05). Conclusions: Nearly 66% of all the clinical audiotapes were MITI coded, exceeding recommended Quality Assurance guidelines for a clinical trial (20%; Miller & Rollnick, 2014). Higher ratings in English compared to Spanish offer ideas for further investigation re: training, supervising, and delivering Spanish MI. Spanish fluency for day-to day activities may not be enough to effectively deliver MI. Level of therapist skill should be considered in addition to Spanish fluency. Implications regarding differences between linguistic and cultural adaptation will be discussed.
Sunday, November 19
10:15 AM – 11:45 AM
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