International Latino Research Partnership
Condition: Substance Use (Drugs, Alcohol)
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      Through a grant funded by the National Institute on Drug Abuse (NIDA) the Center for
      Multicultural Mental Health Research at Cambridge Health Alliance is testing a screening and
      intervention project designed to improve the quality of care for Latino patients with
      comorbid mental health and substance use problems. We will first test a screening of comorbid
      problems with patients identified in mental health as well as primary health care. Building
      on that work, we will test the feasibility, acceptability and efficacy of the "Integrated
      Intervention for Dual Problems and Early Action" (IIDEA) intervention addressing mental
      health, substance use, and prevention of HIV, as well as a smoking cessation supplement. The
      project is being conducted in Massachusetts as well as at two sites in Spain. As such, the
      proposed ILRP multi-site international project is a critical step towards developing models
      of integrated care for the large and diverse Latino migrant population and more broadly
      towards understanding how best to integrate evidence-based assessment and treatments for
      co-occurring substance and mental health problems and HIV risks.
    

Detailed description: 
      Our study aims to conduct behavioral health services research focused on rapid screening and
      referral; as well as testing the feasibility, acceptability and efficacy of integrated
      behavioral health services in primary care clinics for migrant Latinos with co-occurring
      substance use and mental health problems, and increased risk of HIV.

      A key activity for the first phase, the screening project, is administering a screener to at
      least 450 Latino migrant patients across the 3 sites (n=150 each in Boston, Madrid, and
      Barcelona) from primary care and behavioral health (substance abuse and mental health)
      services. We intend to test the referral process for screened participants in need of
      treatment to identify barriers and streamline the process. We will analyze data to optimize
      the screening battery and protocol to use in Phase 2, the IIDEA intervention.

      In Phase 2, we intend to enroll, randomize and collect data on 360 total patients across the
      3 sites - 180 in the intervention condition and 180 in the control condition (120 in each
      site, 60 in the intervention condition and 60 in the control condition). The 10 session IIDEA
      intervention will be offered to Latino patients by trained clinicians with at least a Masters
      level of training. The intervention is designed to help patients to address and prevent
      mental health and substance use problems and will be culturally adapted to Latino populations
      in Boston, Madrid and Barcelona. Usual care - the control group - receives treatment as
      usual, for patients in primary care identified with a mental health or substance use problem.
      5 Research interviews will be conducted to assess outcomes, for patients in both the
      intervention and usual care arms.
    

Intervention name(s): Integrated Intervention for Dual Problems and Early Action
Intervention type(s): Behavioral
Intervention description(s): Integrated Intervention for Dual Problems and Early Action (IIDEA) includes psycho-education, Cognitive Behavioral Therapy and mindfulness; identifies triggers and challenging thoughts; provides motivational techniques for reducing substance use and/or smoking cravings; incorporates cognitive restructuring to identify and correct negative thinking patterns influenced by depression, anxiety and/or trauma; and includes self-monitoring of thoughts and risk behaviors that contribute to substance use, smoking and increased HIV risk.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Dual-diagnosis; Latino; Mental health; Substance use; HIV risk