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


CONCLUSIONS
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.
Field
Craig
C
Center for Social Work Research, School of Social Work, University of Texas at Austin, Health Behavior Research and Training Institute, Austin, Texas 78703, USA. Craig.field@austin.utexas.edu
Caetano
Raul
R
D000069:Acculturation; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D015992:Body Mass Index; D004641:Emigration and Immigration; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000523:psychology*; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011614:Psychotherapy, Brief; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology