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dc.contributor.advisorGarcia, David O.en
dc.contributor.authorValdez, Luis A.
dc.creatorValdez, Luis A.en
dc.date.accessioned2017-09-18T16:36:24Z
dc.date.available2017-09-18T16:36:24Z
dc.date.issued2017
dc.identifier.urihttp://hdl.handle.net/10150/625578
dc.description.abstractBACKGROUND: Maladaptive patterns of alcohol consumption can lead to clinically significant impairment or distress and have been established as a partial cause of a wide variety of health conditions, including neuropsychiatric disorders, cardiovascular diseases, hepatic inflammations, certain cancers, and infectious diseases. In the United States, Hispanic and non-Hispanic white (NHW) men have comparable rates of moderate alcohol consumption, however, Hispanic men are more likely to consume higher volumes of alcohol and with more frequency and experience disproportionate levels of adverse health and social consequences of alcohol abuse when compared to NHW men. Further, Hispanic men face greater barriers than NHW men in accessing, engaging, and completing alcohol abuse treatment services despite the contrasting burden of alcohol-related consequences they face. OBJECTIVES: This dissertation is composed from three studies addressing the following aims to: 1) synthesize the culturally- and gender-responsive components of alcohol and substance abuse and dependence treatment programs designed for Hispanic males in the United States; 2) explore Hispanic male perspectives and opinions regarding alcohol use and abuse patterns that may lead to disparate rates of alcohol abuse in Hispanic males in the United States; and 3) examine U.S. Hispanic male perspectives regarding the barriers to alcohol abuse treatment-seeking related behaviors that lead to disparate treatment engagement and completion rates. METHODS: A systematic literature search was conducted for Aim 1 in which articles reporting on culturally- and/or gender-adapted alcohol and/or substance abuse interventions designed exclusively for Hispanic males were identified. Aim 2 and Aim 3 used semi-structured interviews to elicit Hispanic male perspectives of alcohol abuse and alcohol abuse treatment seeking behaviors. Separate thematic analyses were conducted as per the objectives of Aims 2 and 3. Data analysis was based on a deductive process including a preliminary codebook that was supplemented with inductive codes that surfaced during iterative thematic analyses. RESULTS: Regarding Aim 1, literature searches yielded 2685 titles, resulting in 12 articles that fit the parameters of the review. The most scientifically rigorous findings suggest that cultural adaptations may outperform standard treatment for Hispanic men (n=6). Nevertheless, a fraction of the included interventions (n=4) did not improve outcomes compared to standard treatment. Considering the scarce number of publications, it is difficult to discern how much findings reflect ineffective interventions or methodological limitations. Findings for Aim 2 indicate that there are intersected effects of machismo, a culture of normalized overconsumption, social context stressors, and poor coping strategies that may influence maladaptive relationships with alcohol use. Findings for Aim 3 suggest that treatment seeking behaviors are highly influenced by; a) structural factors related to treatment accessibility, and linguistic and cultural-responsiveness of available treatment, b) sociocultural factors related to difficulties problematizing alcohol abuse due to lack of knowledge and cultural normalization of consumption, and societal stigmatization of alcohol abuse treatment, and c) individual factors related to machismo-bound pride as well as lack of knowledge. CONCLUSIONS: Given the rapid expansion of the Hispanic population in the United States, and the parallel growth of alcohol abuse implications in this population, it is imperative that we learn where these problems may be rooted to better understand how to diminish the existing gaps. Collectively, these findings point to the need for treatment providers to disseminate accurate information about treatment availability and eligibility, and the treatment process. This work also illustrates the need to for consciousness building efforts targeting the Hispanic male community regarding the detrimental effects of alcohol-related problems and treatment, in order to diminish the stigma. Increased or redistributed funding for linguistically and culturally responsive programs is also needed in communities with large Hispanic populations in order to meet the growing demand, particularly for the uninsured. Further research is needed to identify other potential barriers and recovery resources for this population and other Hispanic subgroups in other parts of the United States.
dc.language.isoen_USen
dc.publisherThe University of Arizona.en
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en
dc.subjectAlcohol Abuseen
dc.subjectInterviewsen
dc.subjectLatino Healthen
dc.subjectMasculinityen
dc.subjectMen's Healthen
dc.subjectSubstance Abuseen
dc.titleExploring the Intersected Influences of Sociocultural Norms and the Social Context on Alcohol and Substance Abuse in Hispanic Menen_US
dc.typetexten
dc.typeElectronic Dissertationen
thesis.degree.grantorUniversity of Arizonaen
thesis.degree.leveldoctoralen
dc.contributor.committeememberGarcia, David O.en
dc.contributor.committeememberCarvajal, Scott C.en
dc.contributor.committeememberOren, Eyalen
dc.contributor.committeememberRuiz, Johnen
thesis.degree.disciplineGraduate Collegeen
thesis.degree.disciplinePublic Healthen
thesis.degree.namePh.D.en
refterms.dateFOA2018-08-13T18:42:15Z
html.description.abstractBACKGROUND: Maladaptive patterns of alcohol consumption can lead to clinically significant impairment or distress and have been established as a partial cause of a wide variety of health conditions, including neuropsychiatric disorders, cardiovascular diseases, hepatic inflammations, certain cancers, and infectious diseases. In the United States, Hispanic and non-Hispanic white (NHW) men have comparable rates of moderate alcohol consumption, however, Hispanic men are more likely to consume higher volumes of alcohol and with more frequency and experience disproportionate levels of adverse health and social consequences of alcohol abuse when compared to NHW men. Further, Hispanic men face greater barriers than NHW men in accessing, engaging, and completing alcohol abuse treatment services despite the contrasting burden of alcohol-related consequences they face. OBJECTIVES: This dissertation is composed from three studies addressing the following aims to: 1) synthesize the culturally- and gender-responsive components of alcohol and substance abuse and dependence treatment programs designed for Hispanic males in the United States; 2) explore Hispanic male perspectives and opinions regarding alcohol use and abuse patterns that may lead to disparate rates of alcohol abuse in Hispanic males in the United States; and 3) examine U.S. Hispanic male perspectives regarding the barriers to alcohol abuse treatment-seeking related behaviors that lead to disparate treatment engagement and completion rates. METHODS: A systematic literature search was conducted for Aim 1 in which articles reporting on culturally- and/or gender-adapted alcohol and/or substance abuse interventions designed exclusively for Hispanic males were identified. Aim 2 and Aim 3 used semi-structured interviews to elicit Hispanic male perspectives of alcohol abuse and alcohol abuse treatment seeking behaviors. Separate thematic analyses were conducted as per the objectives of Aims 2 and 3. Data analysis was based on a deductive process including a preliminary codebook that was supplemented with inductive codes that surfaced during iterative thematic analyses. RESULTS: Regarding Aim 1, literature searches yielded 2685 titles, resulting in 12 articles that fit the parameters of the review. The most scientifically rigorous findings suggest that cultural adaptations may outperform standard treatment for Hispanic men (n=6). Nevertheless, a fraction of the included interventions (n=4) did not improve outcomes compared to standard treatment. Considering the scarce number of publications, it is difficult to discern how much findings reflect ineffective interventions or methodological limitations. Findings for Aim 2 indicate that there are intersected effects of machismo, a culture of normalized overconsumption, social context stressors, and poor coping strategies that may influence maladaptive relationships with alcohol use. Findings for Aim 3 suggest that treatment seeking behaviors are highly influenced by; a) structural factors related to treatment accessibility, and linguistic and cultural-responsiveness of available treatment, b) sociocultural factors related to difficulties problematizing alcohol abuse due to lack of knowledge and cultural normalization of consumption, and societal stigmatization of alcohol abuse treatment, and c) individual factors related to machismo-bound pride as well as lack of knowledge. CONCLUSIONS: Given the rapid expansion of the Hispanic population in the United States, and the parallel growth of alcohol abuse implications in this population, it is imperative that we learn where these problems may be rooted to better understand how to diminish the existing gaps. Collectively, these findings point to the need for treatment providers to disseminate accurate information about treatment availability and eligibility, and the treatment process. This work also illustrates the need to for consciousness building efforts targeting the Hispanic male community regarding the detrimental effects of alcohol-related problems and treatment, in order to diminish the stigma. Increased or redistributed funding for linguistically and culturally responsive programs is also needed in communities with large Hispanic populations in order to meet the growing demand, particularly for the uninsured. Further research is needed to identify other potential barriers and recovery resources for this population and other Hispanic subgroups in other parts of the United States.


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