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Although Latino immigrant men experience many health disparities, they are underrepresented in research to understand and address disparities. Community Based Participatory Research (CBPR) has been identified to encourage participant engagement and increase representation in health disparities research. The CBPR conceptual model describes how partnership processes and study design impact participant engagement in research. Using this model, we sought to describe how these domains influenced participant engagement in a pilot randomized controlled trial of brief intervention for unhealthy alcohol use (n = 121) among Latino immigrant men. We conducted interviews with a sample of study participants (n = 25) and reviewed logs maintained by 'promotores'. We identified facilitators of participant engagement, including the relevance of the study topic, alignment with participants' goals to improve their lives, partnerships with study staff that treated participants respectfully and offered access to resources. Further, men reported that the study time and location were convenient and that they appreciated being compensated for their time. Barriers to participant engagement included survey questions that were difficult to understand and competing demands of work responsibilities. Findings suggest that engaging underserved communities requires culturally responsive and community engagement strategies that promote trust. Future studies should further investigate how CBPR partnership processes can inform intervention research.

Latino immigrant men are at increased risk for unhealthy alcohol use and related consequences due to social stressors associated with immigration. We assessed the associations of, and examined whether social stressors moderated associations between, alcohol use and alcohol-related consequences in a community-based sample of Latino immigrant men in Washington (N = 187). The mean Alcohol Use Disorders Identification Test Consumption (AUDIT-C) score was 6.3 (scores ≥ 4 indicate unhealthy alcohol use). More than half of the men (61.5%) reported experiencing discrimination in at least one setting and mean acculturative stress score was 18.3 indicating moderate levels of acculturative stress. Linear regression models were fit to assess main effects (associations between both alcohol use and social stressors and alcohol-related consequences) and moderation (whether the association between alcohol use and consequences varied based on experience of social stressors using multiplicative interaction) after adjustment for potential confounders. Alcohol use (β = 0.47, 95% CI = 0.20-0.73; p =.001), discrimination (β = 0.85, 95% CI = 0.27-1.43; p =.004), and acculturative stress (β = 0.13, 95% CI = 0.02-0.24; p =.025) were all associated with increased experience of alcohol-related consequences. The association between alcohol use and alcohol-related consequences was stronger for those with high levels of acculturative stress (p =.025) but not experience of discrimination (p =.587). Findings underscore the importance of social and cultural context in alcohol use and related consequences. Efforts to reduce negative consequences of drinking may include focus on reducing exposure to discrimination and acculturative stress. [ABSTRACT FROM AUTHOR]

Objective: The use of psychoactive substances increases university students' general morbidity and mortality. Universities run programs to prevent psychoactive substance use since they are associated with the risk of poor academic outcomes. The University of Nairobi (UoN) trains peer mentors who counsel students to prevent substance use. There is, however, inadequate feedback and no evaluation of the effectiveness of this method. This study will pilot mobile health (mHealth) based peer mentoring, evaluate and provide feedback about implementation. It will be based in two campuses of UoN, Nairobi, Kenya. Methods: Three phases study. In the first phase, a baseline survey determines students' knowledge about, attitudes toward, and prevalence of substance use at baseline and the end of the intervention phase. Second phase, mHealth based intervention using a quasi-experimental design. Participants 100 mentors (50 intervention and 50 control groups). Intervention group using mHealth screens for substance use, provide structured brief intervention and treatment referral. A comparative control group, using a paper-based guide will deliver the same program. Phase three, mentors during focussed group discussions will share their experiences. Results: Data will be collected on implementation, acceptability and substance use patterns. Data analysis using descriptive, inferential statistics and thematic content analysis for qualitative data. Conclusions: The study will provide evidence on the implementation and acceptability of mHealth among university students. This will inform national and regional substance use prevention policy and practice. Abbreviations: ASSIST: Assessment of Smoking and Substance Involvement Test; AUDIT: Alcohol Use Disorder Identification Tool; KAP: Knowledge, Attitude, and Prevalence; mHealth: Mobile Health; RDSDQ: Researcher Designed Socio-Demographic Questionnaire; UNODC: United Nations Office on Drugs and Crime; USA: United States of America; WHO: World Health Organization [ABSTRACT FROM AUTHOR]

Though substance use disorders complicate adherence to combination antiretroviral therapy (cART), cognitive--behavioral therapy (CBT), contingency management (CM), and motivational interviewing (MI) each demonstrate efficacy to improve cART adherence among substance-using patients. To inform dissemination of these therapies, this mixed-method study was undertaken involving a full-day site visit to each of four HIV care settings. At each setting, an initial administrator interview elicited setting data. Paired focus groups with setting staff and patients then served as forums for open discussion and live polling of the therapies' respective contextual compatibility. Focus group recordings were subjected to a phenomenological narrative analysis by multidisciplinary investigators, and staff/patient compatibility ratings were analyzed via generalized linear models. Findings include: (1) emergent themes among staff of adaptability, patient-centeredness, and mission-congruence as desired therapy attributes, (2) emergent themes among patients of intrinsic motivation, respect for patient autonomy in illness management, and fairness among service recipients as desired therapy attributes; and (3) comparatively stronger staff perception of compatibility for MI than CBT or CM, and a similar albeit less robust or reliable pattern among patients. Collective findings support MI as a behavior therapy of choice for broad dissemination to HIV care settings to improve cART adherence of patients with substance use disorders. [ABSTRACT FROM AUTHOR]