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Race and Ethnicity Differences in a MI-Based Brief Intervention Delivered in an ED Setting.

Poster presented at the College on Problems of Drug Dependence (CPDD) annual meeting, San Juan, Puerto Rico, June 14-19, 2014.

Alyssa A. Forcehimes, PhD (Center on Alcoholism, Substance Abuse and Addictions (CASAA), SW Node), Michael P. Bogenschutz, MD (Center on Alcoholism, Substance Abuse and Addictions (CASAA), SW Node), Gaurav Sharma, PhD (EMMES Corporation, CTN Data & Statistics Center), Raul N. Mandler, MD (Center for the Clinical Trials Network, NIDA).

Evidence is accumulating that motivational interviewing (MI) has larger effects in minority populations, yet most MI trials do not have sufficient numbers of minority participants to support this finding. The aim of this study was to examine race and ethnicity effects among participants in the six-site National Drug Abuse Treatment Clinical Trials Network (CTN) Screening, Motivational Assessment, Referral and Treatment in the Emergency Department (SMART-ED). The SMART-ED study contrasted the effects of a MI-based brief intervention plus booster calls (BI-B) to those of screening, assessment and referral (SAR) or minimal screening only (MSO) in patients endorsing problematic drug use during an ED visit. Drug use information was collected at baseline and for the 30-day period preceding the 3-month follow-up to determine changes in days of use of the patient-defined primary problem drug. Analyses adjusted for covariates of baseline use days, DAST score and AUDIT-C score and race or ethnicity as fixed effects and Site as a random effect. Race was categorized as Black, White, or Other race. Ethnicity was categorized as Hispanic/Latino or not. It was hypothesized that minority patients randomized to BI-B would have significantly fewer days of substance use at 3 months than patients in the SAR or MSO conditions. Of the 1285 randomized participants, 50% were White, 34% were Black/African American, and 24% were Hispanic. The most common primary drugs of abuse were cannabis (44%), cocaine (27%), and street opioids (17%). Neither the interaction between treatment and race nor the interaction between treatment and ethnicity were statistically significant (p=.46 and p=.62 respectively).

Conclusions: The lack of an interaction effect between treatment x ethnicity and treatment x race does not support findings of larger effects of MI in minority populations. Perhaps the assumed reasons for MI being a more successful approach with ethnic minority populations are less significant when there is not continuity in the interventionist delivering care. (Poster, PDF, English, 2014)

Keywords: African American | Brief intervention | CTN platform/ancillary study | Emergency departments | Hispanics and Latinos | Minority groups | Motivational interviewing (MI) | Screening, Brief Intervention, Referral to Treatment (SBIRT) | College on Problems of Drug Dependence (CPDD) annual meeting, 2014

Document No: 1079.

Submitted by Alyssa Forcehimes, PhD, SW Node, 7/21/2014.

Bogenschutz, Michael P. search mail
Forcehimes, Alyssa A. search mail
Mandler, Raul N. search mail
Sharma, Gaurav search mail
NIDA-CTN-0047 search www

Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
The materials on this site have neither been created nor reviewed by NIDA.
Updated 7/2014 --