CAMI for Substance Use

(CAMI-HI Trial)

Recruiting at1 trial location

Overseen by Christina S Lee, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Boston University Charles River Campus

Disqualifiers: Psychotic symptoms, Cognitive impairment, others

No Placebo Group

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

This trial tests a culturally adapted motivational interviewing method to help Latinx heavy drinkers who face immigration-related stress. The study aims to see if this approach reduces alcohol use and improves mental health. It will also explore how well this method can be implemented in real-world clinical settings.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It would be best to discuss this with the trial coordinators or your healthcare provider.

What data supports the effectiveness of the treatment CAMI for Substance Use?

Research shows that Culturally Adapted Motivational Interviewing (CAMI) can be effective in reducing heavy drinking among Latinx adults by addressing cultural stressors. A systematic review found that CAMI performed better than control conditions in several studies, suggesting it can be a helpful approach for substance use issues in diverse populations. ^{1 2 3 4 5}

Is Culturally Adapted Motivational Interviewing (CAMI) safe for humans?

The available research on Culturally Adapted Motivational Interviewing (CAMI) does not report any safety concerns, and participants in studies have reported high satisfaction and engagement with the treatment. ^{1 3 4 6 7}

How is the CAMI treatment different from other treatments for substance use?

CAMI (Culturally Adapted Motivational Interviewing) is unique because it tailors motivational interviewing to address cultural and social factors, making it more effective for specific populations, like Latinx individuals, by considering their unique stressors and cultural contexts. ^{1 3 4 5 7}

Research Team

Christina S Lee, PhD

Principal Investigator

Boston University

Eligibility Criteria

This trial is for Latinx adults who are first or second-generation immigrants and heavy drinkers, defined as having 4/5 or more drinks per occasion at least once a month, or scoring high on alcohol use assessments. It's not for those in current treatment for alcohol disorders, with psychotic symptoms, cognitive impairments, or enrolled in the CCM Program for over 3 months.

Inclusion Criteria

You self-identify as Latinx.

People who have moved to this country recently or whose parents moved here recently.

I am 18 years old or older.

Exclusion Criteria

You are currently experiencing symptoms of psychosis (losing touch with reality).

Currently in psychosocial treatment for alcohol use disorder

I have difficulty with memory or thinking clearly.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a single 75-minute CAMI session focusing on addiction behavior causes, followed by a booster session at 2 months

2 months

1 initial visit (in-person), 1 booster visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, including assessments of drinking and drug use, anxiety, and depression

12 months

Regular follow-up assessments

Treatment Details

Interventions

• CAMI (Behavioural Intervention)

Trial Overview The study tests CAMI (a culturally adapted motivational interviewing) against standard care to see if it reduces alcohol-related harm and improves mental health among Latinx heavy drinkers using drugs and/or alcohol. Participants will be followed up to one year after receiving CAMI from trained Community Wellness Advocates.

Participant Groups

Group I: CAMI/CAMI booster Experimental Treatment 1 Intervention

Culturally Adapted Motivational Interview. Participants will receive a single session, 75 minute addiction counseling discussion that focuses on the causes of addictive behavior. They will receive a CAMI booster session at 2 months and standard care in a primary care setting.

Group II: Control Active Control 1 Intervention

Assessment plus standard care. Participants will complete an assessment, including measures on drinking and drug use. They will also receive standard care in a primary care setting.

Who Is Running the Clinical Trial?

Boston University Charles River Campus

Lead Sponsor

Trials

125

Recruited

14,100+

Dr. Melissa Gilliam

Boston University Charles River Campus

Chief Executive Officer

MD from Yale School of Medicine

Dr. Alastair Bell

Boston University Charles River Campus

Chief Medical Officer since 2023

MD from Harvard Medical School

Brown University

Collaborator

Trials

480

Recruited

724,000+

Mukesh Jain

Brown University

Chief Medical Officer since 2022

MD from Harvard Medical School

Christina H. Paxson

Brown University

Chief Executive Officer since 2012

PhD in Economics from Columbia University

National Institutes of Health (NIH)

Collaborator

Trials

2,896

Recruited

8,053,000+

Dr. Jeanne Marrazzo

National Institutes of Health (NIH)

Chief Medical Officer

MD from University of California, Los Angeles

Dr. Jay Bhattacharya

National Institutes of Health (NIH)

Chief Executive Officer

MD, PhD from Stanford University

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Collaborator

Trials

865

Recruited

1,091,000+

Dr. George F. Koob

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Chief Executive Officer since 2014

PhD in Neurobiology from the Scripps Research Institute

Dr. Patricia Powell

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Chief Medical Officer since 2015

MD from an accredited institution

Findings from Research

Cultural adaptations of motivational interviewing (CAMI) have been shown to enhance effectiveness in treating diverse populations, with 10 out of 17 randomized controlled trials demonstrating significant improvements in primary outcomes compared to control conditions.

The successful adaptations focused on three key dimensions—Context, Content, and Concepts—highlighting the importance of tailoring interventions to align with the cultural values and goals of clients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cultural adaptations of motivational interviewing: A systematic review. Self, KJ., Borsari, B., Ladd, BO., et al.[2023]

Collective Motivational Interviewing (CMI) was tested in a pilot study with 20 individuals with drug use problems and their concerned significant others, showing that CMI can effectively reduce drug use and enhance motivation for change with social support.

At the 3-month follow-up, participants demonstrated reduced drug use and strengthened social support, indicating that CMI is a promising intervention for motivating individuals with drug use issues, although the study's small sample size limits the generalizability of the results.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Collective Motivational Interviewing for Individuals with Drug Use Problems: A Pre-Post-Follow-Up, Uncontrolled Pilot Study. Tse, N., Tse, S., Wong, PWC.[2023]

Culturally adapted motivational interviewing (CAMI) significantly reduced immigration and acculturation stress, as well as related drinking behaviors, among 149 Latinx adults over a 12-month period, indicating its efficacy as an intervention.

Participants with lower levels of acculturation and higher perceived discrimination experienced greater reductions in stress and drinking, suggesting that CAMI may be particularly beneficial for those facing more significant cultural challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Culturally adapted motivational interviewing's effects on drinking in response to immigration and acculturation stressors among Latinx adults with heavy drinking problems. Hai, AH., Lee, CS., Zhou, C., et al.[2023]

A pilot study involving 25 participants from a Latino immigrant community showed that a culturally adapted motivational interviewing approach (CAMI) was well-received, with high engagement and satisfaction scores (M = 3.58 on a scale of 1-4).

Participants emphasized the importance of cultural understanding in addressing their drinking behaviors, with 95% agreeing that it was crucial for effective treatment, highlighting the relevance of cultural adaptations in addiction interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A cultural adaptation of motivational interviewing to address heavy drinking among Hispanics. Lee, CS., López, SR., Hernández, L., et al.[2023]

The study evaluated the effectiveness of motivational interviewing (MI) and culturally adapted motivational interviewing (CAMI) for treating Latino heavy drinkers, using the motivational interviewing treatment integrity system (MITI) to assess treatment fidelity.

The MITI showed excellent reliability in coding MI and CAMI sessions, indicating it is a reliable tool for evaluating treatment integrity, although some aspects like complex reflections and empathy ratings need further investigation for cross-cultural applications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessing treatment fidelity in a cultural adaptation of motivational interviewing. Lee, CS., Tavares, T., Popat-Jain, A., et al.[2021]

A clinical trial involving 57 heavy drinking Latinos showed that both culturally adapted and unadapted motivational interviewing significantly reduced heavy drinking days and drinking-related problems over 6 months, with high retention rates of 86% and 84%.

Culturally adapted motivational interviewing was particularly effective, leading to greater reductions in drinking consequences at both 2 months and 6 months, suggesting that cultural adaptation enhances the treatment's efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Culturally adapted motivational interviewing for Latino heavy drinkers: results from a randomized clinical trial. Lee, CS., López, SR., Colby, SM., et al.[2021]

Motivational interviewing (MI) has been culturally adapted for Native American communities, making it more accessible and relevant for treating substance problems among these populations.

Native American treatment providers showed enthusiasm for using the adapted MI in their practices, indicating that community collaboration can enhance the effectiveness of interventions and support future clinical trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Helping Clients Feel Welcome: Principles of Adapting Treatment Cross-Culturally. Venner, KL., Feldstein, SW., Tafoya, N.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Cultural adaptations of motivational interviewing: A systematic review. [2023]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Collective Motivational Interviewing for Individuals with Drug Use Problems: A Pre-Post-Follow-Up, Uncontrolled Pilot Study. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Culturally adapted motivational interviewing's effects on drinking in response to immigration and acculturation stressors among Latinx adults with heavy drinking problems. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

A cultural adaptation of motivational interviewing to address heavy drinking among Hispanics. [2023]

5. England pubmed.ncbi.nlm.nih.gov

Assessing treatment fidelity in a cultural adaptation of motivational interviewing. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Culturally adapted motivational interviewing for Latino heavy drinkers: results from a randomized clinical trial. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Helping Clients Feel Welcome: Principles of Adapting Treatment Cross-Culturally. [2023]