Reasons and Obstacles for Changing Risky Drinking Behavior: Comparison of Latinas and Nonlatinas at Risk of an Alcohol-Exposed Pregnancy

Background

Fetal alcohol spectrum disorders (FASDs) are neurodevelopmental disorders associated with substantial personal and social costs. Research to address FASDs indicates the need for early intervention targeting risky alcohol use (>3 drinks/day and or >7 drinks/week) in women of child-bearing age before a potential pregnancy, to prevent alcohol-exposed pregnancies (AEP). Few studies have examined Latina adults’ reasons for and obstacles to changing their risky alcohol behavior. This is important because Latinas experience more negative outcomes related to risky alcohol use and treatment when compared to nonLatinas. A comparison between Latinas and nonLatinas can reveal sociocultural factors potentially involved in the process of changing alcohol behavior. This study examined: (a) reasons for change; (b) obstacles to change; and (c) differences in changing alcohol behavior between Latinas and nonLatinas.

Methods

The study used data (N= 128) from a randomized controlled trial testing the efficacy of CHOICES Plus, an intervention targeting risky alcohol and tobacco use among women at risk of an AEP in primary care settings. The majority of nonLatina (n= 69) intervention participants were African American (n= 57, 83%) and the remaining 12 (17%) were White. On average Latinas (n= 59) were high acculturated (M= 3.31, SD= .73) using the Short Acculturation Scale for Hispanics. The Timeline Followback method was used to assess number of heavy drinking days (>3 drinks consumed 30 days before baseline). Session recordings pertaining to study questions were transcribed and analyzed using thematic analysis, which consisted of comparing codes across and within participant transcripts. A codebook was developed, and memo writing was used throughout the analysis process to document decisions regarding theme development.

Results

Latinas were significantly younger (M= 28, SD= 7.13) than nonLatinas (M= 34, SD= 6.97) (t= 4.23, df = 126, p<.001) and had fewer (M= 5.15, SD= 6.36) heavy drinking days when compared to nonLatinas (M= 8.23, SD= 9.56) (t= 2.17, df = 126, p<.05). Findings revealed that reasons for change were focused on health (“can destroy liver”) and negative social consequences (“crashed three times”). Obstacles focused on drinking to address emotional distress (“calms me down”) and socialization (“brings family together”). Differences were found in reasons for change with Latinas citing parenting as a major reason for change, particularly among low-acculturated (“be there for my son”). In comparison, nonLatinas’ reasons for change were mainly self-focused (“reasons are myself”).

Conclusion and Implications

Learning about important factors and perceived obstacles in the early process of change is critical to addressing treatment disparities. Both Latinas and nonLatinas cited health and negative social consequences as reasons for change. Both experienced challenges in changing their behavior due to emotional distress and socialization. However, important differences in reasons for change between Latinas and nonLatinas were found and may reflect cultural values. Understanding these women’s perspectives and incorporating culturally relevant components based on this knowledge, may help tailor treatment to better address the needs of these and other vulnerable women with risky alcohol use.