Disaggregating trends in alcohol involvement among Hispanic, Black, and White female and male U.S. adolescents: 2002 to 2019.

OBJECTIVE: Alcohol involvement is declining among U.S. adolescents, however studies examining population-level trends in alcohol involvement among females and males from diverse racial and ethnic backgrounds are scarce. Therefore, the current study examined alcohol involvement from 2002 to 2019 among Hispanic, Black, and White U.S. adolescent females and males. METHOD: Data were from the National Survey on Drug Use and Health, years 2002-2019. Participants were between 12 to 17 years old and Hispanic, non-Hispanic Black, or non-Hispanic White. Annualized change estimates within each subgroup were analyzed separately for four alcohol variables: 1) lifetime alcohol use; 2) age at alcohol initiation; 3) past-year drinking days; 4) respondent's perceived risk of alcohol misuse. RESULTS: Lifetime alcohol use decreased for all groups, and the decrease was strongest for Hispanic males. Age at alcohol initiation similarly increased for Hispanic and White females and males, with no change in age at alcohol initiation for Black adolescents. Past-year drinking days declined for all groups but was not significant for Black females. Perceiving alcohol misuse as a "great risk" increased only for Hispanic males and females. CONCLUSIONS: Although alcohol involvement is declining among U.S. adolescents, results from this study highlight that engaging with alcohol is normative among many adolescent groups. Also, when considering sex as well as race and ethnicity, there are important distinctions in patterns of decline in alcohol involvement that should be accounted for to inform future research and screening.

Acculturative stress, collectivistic coping, and drinking in a predominantly Latino college sample.

OBJECTIVES: The present study explored the association of acculturative stress with alcohol consumption and problems, and whether these associations varied by collectivistic coping style in a predominantly Latino college sample. METHOD: Participants were 192 (58.9% female; Mage = 23.4 years, SD = 6.6; 89.6% Hispanic or Latino) undergraduate students from the University of Texas at El Paso that participated in a survey that assessed their acculturative stress, collectivistic coping styles, alcohol use, and associated problems. Hierarchical regression analyses were used to determine the potential moderating effect of collectivistic coping styles on the relationship between acculturative stress and drinking variables. RESULTS: Hierarchical regression analyses revealed a significant two-way interaction between acculturative stress and seeking social support in predicting monthly drinking frequency, heavy drinking frequency, peak number of drinks, and alcohol problems. They also revealed a significant two-way interaction between acculturative stress and forbearance in predicting heavy drinking frequency and peak number of drinks. The associations between acculturative stress and each of the outcomes were positive at low levels of collectivistic coping style. However, these relationships became increasingly negative as the collectivistic coping style increased. CONCLUSIONS: The present study extends the literature on collectivistic coping by exploring the protective effects of collectivistic coping styles against drinking among Latino college students. Based on current findings, it appears that among Latino students, seeking social support may serve as a protective factor against the effects of acculturative stress on alcohol use and problems and that forbearance may serve as a protective factor against the effects of acculturative stress on alcohol use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Men of Mexican ethnicity, alcohol use, and help-seeking: "I can quit on my own."

INTRODUCTION: Hispanics report higher rates of problematic alcohol use compared to non-Hispanic Whites while also reporting lower rates of alcohol treatment utilization compared to non-Hispanics. The study employs Anderson's Behavioral Model of Healthcare Utilization Model to guide the exploration of alcohol use, help-seeking and healthcare utilization. METHODS: The present qualitative study explored help-seeking and alcohol treatment utilization for Hispanic men of Mexican ethnicity. A total of 27 participants (Mage = 35.7, SD = 10.82) completed a semi-structured interview that explored the treatment experiences and underlying psychological mechanisms that shaped their help-seeking. RESULTS: Through a thematic content analysis, the following themes emerged: 1) perceiving need with subthemes of familismo, role as protector and provider, and positive face; 2) predisposing beliefs on help-seeking; and 3) treatment experiences and elements of patient satisfaction with subthemes of monetized treatment, respect, and perceiving professional stigma. CONCLUSIONS: The findings in this article may assist in improving strategies for increasing alcohol treatment utilization among men of Mexican ethnicity. By exploring beliefs, values, and experiences health researchers can develop culturally informed intervention strategies.

Engaging community pharmacies in practice-based research: Lessons from opioid-focused research.

There is an established need to translate evidence-based practices into real-world practice. Community pharmacists and their corresponding pharmacies are well-positioned to be effective partners as researchers seek to study and implement practice-based research. Challenges exist when partnering with community pharmacies which can vary based on the study type, the nature of the community pharmacy, and stakeholder groups (i.e., patients, staff, leadership, physicians). This commentary seeks to describe these challenges and provide recommendations that can help mitigate and/or overcome these challenges. Recommendations are provided for team structure, communication, research tools/technology, motivational factors, workflow, and sustainability. These recommendations are based on the authors' experience in partnering with community pharmacy for opioid-related research in a variety of study types, states, and pharmacy environments.

At-Risk Drinking and Workplace Conditions among Latino Day Laborers.

Background: Latino Day Laborers (LDL) face a variety of factors which have been associated with at-risk drinking. The objective of this study was to assess the association of at-risk drinking with measures of work site conditions. Methods: Data from surveys conducted with 307 LDL in Houston, TX in 2015 were analyzed. Sociodemographic information and measures of exposures to hazardous products at the worksite, adverse working conditions, and work stressors were collected. Measures of positive working climate at the jobsite and a climate that promoted jobsite safety were also included. Participants were administered the Hazardous Use items from the Alcohol Use Disorders Identification Test of Consumption (AUDIT-C). Participants were classified as low-risk or at-risk drinkers based on AUDIT-C score. Logistic regression models were run to assess the associations of the sociodemographic and worksite related variables with drinking status. Results: One-hundred-five (34.2%) participants were classified as at-risk drinkers. At-risk drinking was associated with past-month income, being formerly married (compared to having never married), and lack of housing. At-risk drinking was also associated with measures of a positive working climate and a climate that promoted jobsite safety. Conclusions: One-third of our participants were classified as at-risk drinkers. At-risk drinking was associated with stressors in the form of lack of housing and no longer having a spouse but was also associated with increased income and with positive workplace factors. At-risk drinking was thus a function of both stressors and positive factors, including a positive work site.

The indirect effects of self-regulation on the association of social support with increased protective drinking behavior and decreased alcohol problems in a predominantly Hispanic college student sample.

BACKGROUND: Research suggests that self-regulation, which refers to one's ability to manage a behavior, and social support are related to alcohol use. Other research suggests that social support may serve as a precursor to self-regulation and health-promoting behaviors. We examined whether self-regulation has an indirect effect on the association between social support and both protective drinking behaviors and alcohol problems. METHODS: A random sample of students at a Hispanic Serving Institution completed an online survey, which included sociodemographic questions, the Multidimensional Perceived Social Support Scale, the Short Self-Regulation Questionnaire, the Protective Behavioral Strategies (PBS) Scale, and the Rutgers Alcohol Problem Index. Undergraduate students (n = 192) who reported drinking in the last month were included in the analysis. A path analysis using Mplus8 was conducted to investigate the relationships among social support, self-regulation, PBS, and alcohol-related problems. RESULTS: The sample was mostly female (58.9) and of Hispanic ethnicity (89.6). Analyses showed that social support had a significant positive association with PBS and a significant negative association with alcohol-related problems. When self-regulation was added to the models, these associations were no longer significant, and self-regulation had a significant indirect effect on the relationship between social support and both PBS and alcohol-related problems. CONCLUSIONS: The results of the current cross-sectional study suggest that a viable hypothesis in future longitudinal studies is that self-regulation is a mechanism by which social support increases PBS and reduces alcohol problems. Future research should assess longitudinally both the mediating effects of self-regulation between social support and drinking outcomes and potential moderators, such as ethnicity.

Development and refinement of a corner-based injury prevention programme for Latino day labourers.

Objective: Latino day labourers (LDLs) in the USA are at increased risk for non-fatal and fatal occupational injuries, which are compounded by stressors that include wage theft, job insecurity and discrimination. This paper describes the development and refinement of Vales+Tú (You are Worthy of More), an injury prevention programme currently being evaluated as part of a cluster randomised trial in which health promotion is taken directly to the 'corners' (e.g. street corners, home improvement store parking lots, and public parks) where workers gather to seek employment. Design: Vales+Tú comprises two corner-based intervention approaches, group problem-solving (small group discussions) and brief motivational interviewing (one-on-one dialogue), that aim to activate LDL agency to control their safety and that of their peers. Setting: Corners in Houston, Texas, where LDLs seek employment. Method: Intervention Mapping informed the refinement of Vales+Tú for the current trial. We provide a narrative review of the development process based on needs assessment and formative development activities (surveys, focus group discussions and pilot tests). Results: In addition to documenting the need for LDL injury prevention, with 20.2%-41.6% of Houston-based LDLs surveyed between 2013-2014 and 2019 reporting a severe work-related injury in the past year, we describe key facets of the Vales+Tú corner-based intervention approaches - including their theoretical basis and LDL-centred activities, as well as enhancements made informed by formative evaluation. Conclusion: The community-engaged development process of Vales+Tú resulted in two practical intervention approaches that can be adopted by worker centres and other organisations to promote LDL worker safety.

Impact of Trauma-Informed Care Training on Attitudes Among Emergency Department Personnel, Staff Advocates, and Nursing Students.

BACKGROUND: Health care providers may risk retraumatizing patients and intensifying patient distress unless they practice trauma-informed care. As the first line of defense in assisting trauma survivors' physical and emotional recovery, health care providers must use a strengths-based framework that promotes resilience and expands on the trauma survivor's existing resources. OBJECTIVE: This study aimed to compare the effect of trauma-informed care training on the attitudes of emergency department personnel, staff advocates, and nursing students toward trauma-informed care. METHODS: This study used a pretest-posttest design. Assessment of attitudes toward trauma-informed care was done before and after trauma-informed care training. Data collection occurred from February 2021 through August 2021. Participants included three cohorts of emergency department staff, advocates for trauma survivors, and nursing students. Attitudes toward trauma-informed care were measured using the Attitudes Related to Trauma-Informed Care (ARTIC) Scale. RESULTS: A total of 433 participants were studied, including 88 emergency department staff, 123 staff advocates, and 222 nursing students. All three cohorts significantly increased ARTIC Scale scores posttraining (p < .001). At preintervention, all three cohorts significantly differed from each other on ARTIC Scale scores (p < .01). In contrast, postintervention, ARTIC Scale scores did not significantly differ between nursing students and advocates (p = .99). Nursing students showed a significant increase in scores from pre- to postintervention compared with either advocates or emergency department staff. CONCLUSION: The results strongly suggest that health care providers can improve attitudes toward trauma-informed care after completing training on the principles and application of trauma-informed care.

Co-use of Opioid Medications and Alcohol Prevention Study (COAPS).

While there is limited research in the field regarding the various dimensions of co-use of alcohol and opioid medication, particularly related to co-use and levels of severity, our research has shown 20% to 30% of community pharmacy patients receiving opioid pain medications are engaged in co-use. Co-use of alcohol and opioid medications is a significant risk factor for opioid-related overdose. Community pharmacy is a valuable yet underutilized resource and setting for addressing the US opioid epidemic, with an untapped potential for identification of and intervention for risks associated with co-use of alcohol and opioids. This commentary describing the "Co-use of Opioid Medications and Alcohol Prevention Study (COAPS)" offers an innovative and promising approach to mitigating serious risks associated with co-use of alcohol (risk and non-risk use) and opioids in community pharmacy. COAPS aim 1involves adapting an existing opioid misuse intervention to target co-use of alcohol and opioid mediations. COAPS aim 2 involves testing the adapted intervention within a small-scale pilot randomized controlled trial (N = 40) to examine feasibility, acceptability and preliminary efficacy of the intervention versus standard care. COAPS aim 3 involves conducting key informant interviews related to future implementation of larger scale studies or service delivery in community pharmacy settings.

The association of allostasis with alcohol use: A case-control study in males with and without alcohol use disorder.

BACKGROUND: Allostatic load (AL) is associated with a heightened predisposition to disease due to prolonged activation of biological stress-response systems. Alcohol use disorder (AUD) is known to activate these systems. The primary aim of the current study was to examine the relationship between AL and AUD. METHODS: Participants were males (100%) with DSM-IV Alcohol Dependence (n = 48) and healthy participants with no history of substance use disorder (n = 17). Participants with AUD were 4-6 weeks abstinent. The AL index used cortisol, interleukin-6 (IL-6), fibrinogen, tumor necrosis factor-alpha (TNFα), C-reactive protein (CRP), glucose, insulin, leptin, pulse, systolic blood pressure readings, diastolic blood pressure readings, and body mass index (BMI). Physiological dysregulation for each biological measure was determined based on values within the 25th or 75th percentiles; AL was calculated as the total number of physiologically dysregulated biological measures. RESULTS: No differences in mean AL scores between the cases and controls [t(63) = .48, p = .633] were observed. Among cases, AL was not associated with lifetime drinks per drinking day (F(2,42) = .42, p = .662), lifetime total drinks (F(2,42) = 0.48, p = .620), total drinks 6 months prior to participating in the study (F(2,43) = 0.58, p = .563), or drinks per drinking day at 3-month follow-up (F(2,35) = 1.93, p = .161). AL was negatively associated with drinks per drinking day 6 months prior to study participation (F(2,42) = 3.71, p = .033). CONCLUSIONS: The hypotheses were not supported. Given that alcohol is likely to lead to physiological dysregulation, the apparent absence of a relationship between biomarkers of cumulative stress as indicated by AL and drinking status was both unanticipated and remarkable. Based on the results, AL in the context of drinking status or drinking among males with AUD may not be applicable.

Use of an Automated Bilingual Digital Health Tool to Reduce Unhealthy Alcohol Use Among Latino Emergency Department Patients: A Randomized Clinical Trial.

Importance: Alcohol use disorders have a high disease burden among US Latino groups. In this population, health disparities persist, and high-risk drinking has been increasing. Effective bilingual and culturally adapted brief interventions are needed to identify and reduce disease burden. Objective: To compare the effectiveness of an automated bilingual computerized alcohol screening and intervention (AB-CASI) digital health tool with standard care for the reduction of alcohol consumption among US adult Latino emergency department (ED) patients with unhealthy drinking. Design, Setting, and Participants: This bilingual unblinded parallel-group randomized clinical trial evaluated the effectiveness of AB-CASI vs standard care among 840 self-identified adult Latino ED patients with unhealthy drinking (representing the full spectrum of unhealthy drinking). The study was conducted from October 29, 2014, to May 1, 2020, at the ED of a large urban community tertiary care center in the northeastern US that was verified as a level II trauma center by the American College of Surgeons. Data were analyzed from May 14, 2020, to November 24, 2020. Intervention: Patients randomized to the intervention group received AB-CASI, which included alcohol screening and a structured interactive brief negotiated interview in their preferred language (English or Spanish) while in the ED. Patients randomized to the standard care group received standard emergency medical care, including an informational sheet with recommended primary care follow-up. Main Outcomes and Measures: The primary outcome was the self-reported number of binge drinking episodes within the last 28 days, assessed by the timeline followback method at 12 months after randomization. Results: Among 840 self-identified adult Latino ED patients (mean [SD] age, 36.2 [11.2] years; 433 [51.5%] male; and 697 [83.0%] of Puerto Rican descent), 418 were randomized to the AB-CASI group and 422 to the standard care group. A total of 443 patients (52.7%) chose Spanish as their preferred language at enrollment. At 12 months, the number of binge drinking episodes within the last 28 days was significantly lower in those receiving AB-CASI (3.2; 95% CI, 2.7-3.8) vs standard care (4.0; 95% CI, 3.4-4.7; relative difference [RD], 0.79; 95% CI, 0.64-0.99). Alcohol-related adverse health behaviors and consequences were similar between groups. The effect of AB-CASI was modified by age; at 12 months, the relative reduction in the number of binge drinking episodes within the last 28 days in the AB-CASI vs standard care group was 30% in participants older than 25 years (RD, 0.70; 95% CI, 0.54-0.89) compared with an increase of 40% in participants 25 years or younger (RD, 1.40; 95% CI, 0.85-2.31; P = .01 for interaction). Conclusions and Relevance: In this study, US adult Latino ED patients who received AB-CASI had a significant reduction in the number of binge drinking episodes within the last 28 days at 12 months after randomization. These findings suggest that AB-CASI is a viable brief intervention that overcomes known procedural barriers to ED screening, brief intervention, and referral to treatment and directly addresses alcohol-related health disparities. Trial Registration: ClinicalTrials.gov Identifier: NCT02247388.

The influence of cognitive and affective components of the sentinel event on alcohol use following a brief intervention with trauma patients.

OBJECTIVE: Alcohol-related injury is a sentinel event, an unanticipated medical event that may prompt a re-evaluation of health behaviors, such as alcohol use. Few studies have examined the psychological components of the sentinel event that motivate behavior change. In the present study, we examined the influence of cognitive and affective components of an alcohol-related injury on changes in alcohol use following a brief intervention. METHOD: Injured patients (n = 411) who were drinking prior to their injury admission were recruited from three urban Level I trauma centers and randomized to receive brief advice or brief motivational intervention with or without a 1-month booster session. Assessments were completed at baseline and 3-, 6-, and 12-month follow-ups. Three groups were created based on endorsement (yes/no) of items assessing cognitive and affective components of the injury event: neither component, the cognitive component only, and both the cognitive and affective components. RESULTS: Mixed-effects models indicated that participants who endorsed both the cognitive and affective components had greater reductions in peak alcohol use from baseline to 3-month follow-up than those who did endorsed neither component. By contrast, participants who endorsed the cognitive component, but not the affective component, had greater increases in average drinks per week and percentage of days of heavy drinking from 3- to 12-month follow-ups than those who endorsed neither component. CONCLUSION: These results provide preliminary support for further consideration of an affective component of alcohol-related injuries that may motivate subsequent reductions in drinking following a sentinel event.

The Associations of Basic Psychological Need Satisfaction and Need Frustration with Cannabis-Related Outcomes in a Multi-Site Sample of College Students.

Psychological need satisfaction and need frustration, proposed by self-determination theory, may serve as conditions that foster health-promoting and health-impairing behaviors related to cannabis use. In the present study, we examined the measurement model of psychological need satisfaction and need frustration and their associations with cannabis protective behavioral strategies use, negative cannabis-related consequences, and cannabis use severity. Data were from 1394 college students from 10 universities across the U.S. who reported past-month cannabis use. A higher-order factor model representing general psychological need satisfaction and need frustration provided a good fit to the data. Regressing the three observed cannabis outcome variables onto these higher-order latent factors, we found that greater need satisfaction was associated with more frequent cannabis protective behavioral strategies use and fewer negative cannabis-related consequences. Greater need frustration was associated with greater negative cannabis-related consequences and cannabis use severity. Further, an interaction effect between need satisfaction and need frustration emerged for each cannabis outcome such that greater need satisfaction attenuated the associations between need frustration and cannabis outcomes and greater need frustration strengthened the associations between need satisfaction and cannabis outcomes. Implications for the roles of need satisfaction and need frustration in cannabis use and future intervention development are discussed.

Alcohol Use Severity among Hispanic Emerging Adults: Examining Intragroup Marginalization, Bicultural Self-Efficacy, and the Role of Gender within a Stress and Coping Framework.

Most research on cultural stressors and alcohol has focused on intercultural stressors. Continuing to exclude intracultural stressors (e.g., intragroup marginalization) from alcohol research will yield a biased understanding of the experiences of Hispanics living in a bicultural society. As we amass more studies on intracultural stressors, research will be needed to identify mutable sociocultural factors that may mitigate the association between intracultural stressors and alcohol. To address these limitations, we examined the association between intragroup marginalization and alcohol use severity and the extent to which gender and bicultural self-efficacy may moderate this association. A convenience sample of 200 Hispanic emerging adults ages 18-25 (men = 101, women = 99) from Arizona (n = 99) and Florida (n = 101) completed a cross-sectional survey. Data were analyzed using hierarchical multiple regression and moderation analyses. Higher intragroup marginalization was associated with higher alcohol use severity. Gender functioned as a moderator whereby intragroup marginalization was associated with higher alcohol use severity among men, but not women. Also, higher social groundedness functioned as a moderator that weakened the association between intragroup marginalization and alcohol use severity. Role repertoire did not function as a moderator. Our findings are significant because they enhance the reliability of the association between intragroup marginalization and alcohol use severity, and the moderating effect of gender in this respective association. This emerging line of research suggests that alcohol interventions targeting Hispanics may have a significant limitation by not accounting for intracultural stressors.

Vales+Tú: a cluster-randomized pilot study to reduce workplace injuries among US Latino day laborers.

Latino day laborers (LDL) are a vulnerable population of workers facing considerable risk for occupational injury. Under the guidance of our Community Advisory Board, we developed and tested the feasibility, acceptability and preliminary effects of Vales+Tú (You Are Worth More), a workplace injury risk-reduction program implemented by promotores on street-corners where LDL seek employment. The program was informed by theoretical perspectives emphasizing individual and group agency and self-determination. A pilot three-arm cluster-randomized community trial was conducted among 75 LDL. The intervention arms consisted of an individualized Brief Motivational Interview, a Group Problem Solving activity and a standard of care control (OSHA safety cards). We met our study goal of 25 LDL per intervention arm, and contacted 88% of participants post intervention. Participants evaluated the interventions favorably. At post-test, the Brief Motivational Interview group reported significant reductions in exposure to workplace hazards and increases in risk-reduction practices. The Group Problem Solving participants showed significant reductions in exposure to hazards (t-test -4.16, p < 0.001). Both intervention groups increased their reliance on corner peers, a measure of social support. Standard of care participants increased in self-efficacy to work safely. Overall, the only significant different between the three study conditions was in self-efficacy. These findings provide evidence of the feasibility and acceptability of Vales+Tú and show preliminary program efficacy. A large-scale replication trial will permit a more formal modeling of the study findings. Clinical Trial Registration (ClinicalTrials.gov): NCT04378348.

This pilot-randomized trial tested the feasibility and initial efficacy of an injury risk-reduction program among Latino day laborers (LDL). The study tested two alternative interventions consisting of a Brief Motivational Interview (Individual) and a Group Problem Solving (Group) conditions that were compared with a Standard-of-Care control group receiving safety cards. We then tested the extent to which the study conditions reduced exposure to workplace hazards and increased safety practices at work. Results indicate that intervening at day labor corners is a feasible intervention strategy acceptable to these immigrant workers. Initial results also indicate that there were multiple within-group significant differences in risk reduction, mostly in the individual condition, and that there was one significant between-group difference in safety self-efficacy at post-test. A larger more rigorous trial can further test the stability of these results and determine the extent to which these intervention approaches can reduce the risk for injury that LDL confront at work.

Addressing opioid medication misuse at point of service in community pharmacy: A study protocol for an interdisciplinary behavioral health trial.

BACKGROUND: >1 in 3 of the 9 million individuals engaged in opioid medication misuse obtain legitimate opioid prescriptions and fill these in community pharmacies, which are subsequently misused. This study is testing the efficacy of a pharmacist-led intervention-Brief Intervention-Medication Therapy Management (BI-MTM)-compared to standard medication counseling (SMC) to address opioid medication misuse. METHODS: Design. This study is a single-blinded 2-group parallel randomized trial within 13 community pharmacies that will enroll 350 individuals. Participant Recruitment. Pharmacy staff approach patients and ask about interest in completing a brief confidential screening tool, which includes opioid medication misuse assessment. Interested patients who report misuse are asked to provide informed consent. Enrolled patients are assessed for behavioral and physical health at enrollment, 2-months post-enrollment, and 6-months post-enrollment. INTERVENTIONS: Following baseline assessment, participants are randomized (1:1 ratio) to: SMC, a medication information/counseling intervention or BI-MTM, an intervention comprised by 4 evidence-based components: medication therapy management, brief intervention, naloxone dispensing, and patient navigation. ANALYSES: Primary analyses involve estimating 3-level generalized linear mixed models to relate repeated assessments across time of opioid medication misuse (i.e., the Prescription Opioid Misuse Index) to the intervention. CONCLUSION: Study results will provide the first critical step towards integrating a highly accessible, low-cost approach to managing risks related to opioid use. Community pharmacies provide an incredibly important setting in which patients can receive high quality care to support health behavior change. Successfully completing this project sets the stage for a large-scale effectiveness study. (NCT#: NCT05141266).

Focusing on protective factors, resilience and thriving to reduce health disparities and treatment inequities.

This special issue seeks to characterize the current state of the science regarding risk and protective factors influencing resilience and thriving in relation to substance use among ethnic minorities and other underserved populations. This epilogue examines the scope of work presented in this special issue, the added value of the research presented herein, and how it can inform future research directions. Health disparities research can be conducted using two key approaches: 1) documenting between-group differences comparing ethnic/racial minorities groups and majority populations; or, 2) documenting within-group differences in a single racial or ethnic group. While characterization of between-group differences is useful to identify existing health disparities, it is essential to understand within-group diversity to fully address these inequities. Studies in this special issue identifying between- group differences focus on resiliency characteristics that could be present across all racial and ethnic groups. The studies examining within-group differences included in this special issue examine novel factors that influence resilience of protective health behaviors. Overall, this special issue examines several potential protective factors in the context of health promoting behaviors related to substance use using a wide range of research methodologies. While it is not exhaustive in its representation of all underserved populations experiencing health disparities and treatment inequities, this special issue includes a broad array of populations from various racial, ethnic, and national groups. Although we have to adequately explore thriving, the current special issue establishes a firm foundation for research on resilience that may extend to thriving.

The role of resilience in alcohol use, drinking motives, and alcohol-related consequences among Hispanic college students.

Background: Hispanic college students experience minority stressors and are therefore at greater risk of experiencing alcohol-related consequences. Resilience may protect against problem drinking and related consequences, yet its relationship to drinking motives remains unexplored. Given that drinking motives precede both alcohol use and its consequences, investigating the role of resilience in such associations may inform interventions to reduce alcohol-related health disparities.Objectives: The current study investigated whether greater resilience predicted fewer drinking motives, lower alcohol consumption, and reduced the negative impact of drinking motives on alcohol consequences among Hispanic college students.Methods: Resilience, drinking motives and alcohol consequences were assessed among 443 students living on the U.S./Mexico border recruited via e-mail (68% female; Mage = 22.6 years, SD = 5.09). Linear regressions assessed whether drinking motives (i.e., coping, conformity, social, enhancement) and resilience predicted alcohol consumption. A linear regression also assessed resilience, drinking motives, and alcohol consumption as potential predictors of alcohol consequences. Lastly, linear regressions tested the moderating effects of resilience between each drinking motive and alcohol consumption as well as alcohol consequences.Results: Greater resilience predicted fewer alcohol-related consequences (ß = -.024, p = .028). Additionally, resilience moderated the relationships social (ß = -.095, p = .050) and enhancement drinking motives (ß = -.084, p = .050) had with alcohol consequences. Higher social and enhancement motives were not associated with alcohol consequences among resilient individuals.Conclusion: Strengthening resilience among Hispanic students whose drinking is motivated by a desire for socialization or mood enhancement may protect against alcohol-related consequences.

Antecedente: Estudiantes universitarios Hispanos pueden presentar condiciones de estrés de minoría y por tanto corren un mayor riesgo de sufrir consecuencias relacionadas con el alcohol. Puede que la resiliencia proteja contra de beber en exceso y consecuencias relacionadas, aún su relación con motivos de beber permanece inexplorada. Dado que motivos para beber preceden el consumo de beber en exceso y sus consecuencias, investigar el rol de resiliencia en estas asocia-ciones puede informar intervenciones para reducir las disparidades de salud relacionadas con el consumo de alcohol. Objetivo: El estudio actual investigo si la resiliencia predecía menos motivos para beber, consumo del alcohol y rebajaba el impacto negativo de los motivos para beber en las consecuencias del alcohol entre los estudiantes universitarios Hispanos. Métodos: Se evaluó la resiliencia, los motivos para beber y las consecuencias del alcohol entre 443 estudiantes universitarios en la frontera entre Estados Unidos y México reclutados por correo electrónico (68% mujeres; Medad = 22.6 años, SD = 5.09). Regresión lineales evaluaron si los motivos para beber (es decir, afrontamiento, aprobación, socialización, mejoramiento) y la resiliencia predecían consumo del alcohol. Una regresión lineal también evaluó la resiliencia, los motivos para beber y consumo del alcohol como posibles predictores de las consecuencias del alcohol. Por último, las regresiones lineales probaron los efectos moderadores de la resiliencia entre cada motivo de beber y el consumo del alcohol, así como las consecuencias del alcohol.

Perceived discrimination and alcohol-related problems among Hispanic college students: The protective role of serious harm reduction behaviors.

The present study investigated the use of protective behavioral strategies (PBS) as moderators of the association between perceived discrimination and alcohol-related problems among Hispanic college students. Participants who were between 18 and 24 years of age (n = 379) completed self-report measures. The results showed that greater perceived discrimination was associated with less frequent PBS use, more problematic alcohol use, and more alcohol-related problems, while greater use of PBS types was associated with fewer alcohol-related problems. Furthermore, serious harm-reduction behaviors moderated the association between perceived discrimination and alcohol-related problems. The findings suggest that serious harm-reduction behaviors may protect against the negative effects of perceived discrimination on alcohol-related problems among Hispanic college students.

Measurement Invariance of the Readiness to Change Questionnaire Among Injured Patients Who Received a Brief Intervention for Alcohol Use.

We tested measurement invariance of the Readiness to Change Questionnaire (RCQ) to evaluate its utility in assessing the stages of change in the context of brief intervention for alcohol use in opportunistic settings. Participants (N = 596) were patients admitted from three Level I trauma centers who were randomly assigned to one of three brief alcohol interventions. The RCQ was administered at baseline and 3-month follow-up. The RCQ was scalar invariant across biological sex and partially scalar invariant across race/ethnicity and alcohol use severity. Hispanic participants were higher on contemplation and action and Black participants were higher on action than White participants. Hazardous drinkers were lower in precontemplation and higher in contemplation and action than nonhazardous drinkers. The RCQ was scalar invariant across intervention conditions and time. Brief motivational intervention with a booster increased action from baseline to 3 month. These findings provide further support for the use of the RCQ.