In last week’s post I laid out some alarming trends on substance use disorders (SUD) among Latino/Hispanic youth, as well as the latest programs and policy changes that can assist healthcare system and providers in addressing those, and a few examples of specific culturally targeted interventions aimed at prevention, supports, and treatment.
Our current healthcare system needs to embrace a more holistic approach to engage Latino/Hispanic youth and their families/caregivers regarding SUD and overdose prevention. We must develop and implement strategies and interventions that are tailored to meet the unique cultural, linguistic, and social needs of the Latino/Hispanic population by intentionally focusing on cultural sensitivity, education and language accessibility, community engagement and specific models of care.
CULTURAL SENSITIVITY
Healthcare providers should be offered [online training modules can provide greater flexibility] training in cultural sensitivity to better understand the specific cultural, social, and economic backgrounds of the Latino/Hispanic community. These should include understanding cultural attitudes towards substance use, language-related needs, stigma as a barrier to care, which are ultimately crucial for building trust and ensuring more effective communication and engagement. A core component of these training and educational modules should focus on the importance of family (familismo) in the Latino/Hispanic culture, including the role of extended family members and the impact of family dynamics on healthcare decision making.
Additionally, there are training programs that focus on enhancing language skills for non-Spanish speaking healthcare providers, including medical Spanish courses, as well as training in culturally appropriate communication techniques. Many institutions, including hospitals, universities, and colleges—some even provide certification programs—offer medical Spanish classes specifically designed for healthcare professionals. There are also online platforms, for example: Canopy Learn Medical Spanish, that offer medical Spanish courses that healthcare providers can complete at their own pace.
Healthcare providers should receive training on how to reduce stigma around substance use disorders and address misconceptions or biases about SUD and overdose prevention. It is imperative that providers recognize and address their own preconceptions and stereotypes about substance use, in order to avoid prejudiced judgments and perpetuate care disparities among the individuals they are treating.
By incorporating cultural sensitivity training programs, healthcare organizations can significantly enhance the cultural competence of their staff, leading to improved healthcare outcomes, higher satisfaction, and create a more inclusive healthcare environment.
EDUCATION AND LANGUAGE ACCESSIBILITY
Culturally attuned educational materials and programs in Spanish can significantly improve understanding and awareness of SUD and overdose prevention among Latinos/Hispanics. It is critical that these educational materials not only be translated into Spanish but also adapted to reflect the cultural values and norms, social, and economic realities of the Latino/Hispanic community; ensuring better engagement and effectiveness in promoting understanding and awareness of SUDs and overdose prevention.
Here are some examples:
SAMHSA's Spanish-Language Resources including brochures, pamphlets, and booklets on substance use disorders, treatment options, and prevention strategies. 988 Lifeline recently launched the addition of Spanish text and chat services.
Centers for Disease Control and Prevention (CDC) Spanish Materials that cover a range of topics, including opioid overdose prevention, safe medication practices, and understanding addiction.
National Institute on Drug Abuse (NIDA) for Teens offers resources tailored for adolescents, including NIDA for Teens website in Spanish, which provides information about the effects of drugs and how to resist peer pressure.
Whenever possible, offering services in Spanish or the patient's preferred language, is critical and this can be achieved through bilingual staff or professional interpretation services. Clear communication is essential for discussing sensitive issues like substance use, harm reduction, and overdose prevention.
COMMUNITY-BASED APPROACHES
There are several community-based programs and initiatives dedicated to addressing substance use education and focused on incorporating cultural sensitivity and awareness to effectively engage with the Latino/Hispanic community.
National Alliance on Mental Illness - Hispanic/Latinx Community Programs provides various resources and strategies for wellness, including family support and other resources tailored to the Latino/Hispanic community.
NAMI Compartiendo Esperanza focuses on mental wellness in the Latino/Hispanic community and aims to change cultural perceptions and help community members by discussing mental health openly and providing support.
Healthcare organizations must actively engage and create meaningful partnerships with local service organizations, schools, sports clubs, labor unions, churches, and community leaders who can help outreach and facilitate trust-building with Latino/Hispanic individuals. Developing and engaging in community outreach programs to educate about SUD, overdose prevention, harm reduction, and treatment options can greatly reduce stigma and enhance access to care.
Extensive research had demonstrated that school-based prevention programs are one of the most effective strategies for reducing substance use among youth people. While many schools adapt existing substance use prevention programs to be culturally sensitive for their Latino/Hispanic students, there are a several programs that are culturally targeted for the Latino/Hispanic youth.
Too Good for Drugs" (TGFD) Program: Offered in Spanish, TGFD is a school-based prevention program designed for various grade levels. It focuses on developing personal and interpersonal skills to resist peer pressures, fostering an understanding of the consequences of substance use, and cultivating a positive attitude towards school and community. The program includes culturally relevant materials and activities that resonate with Latino/Hispanic family values and community norms.
Project ALERT: Designed for middle school students, Project ALERT is a substance abuse prevention program that has been effective in multicultural settings. It can be implemented in Spanish and focuses on teaching students about the negative effects of drug use, resisting peer pressure, and developing refusal skills. The program includes role-playing scenarios and group discussions, often incorporating culturally relevant examples and family-oriented values.
LifeSkills Training (LST) Program: This program targets middle school students and is effective in reducing the use of tobacco, alcohol, and drugs. While it's not exclusively in Spanish, many schools with high Latino/Hispanic populations adapt the curriculum to include Spanish language materials and culturally relevant examples, emphasizing the importance of family and community.
These programs emphasize the importance of culturally sensitive approaches, the need for bilingual communication, and the value of building relationships and trust within the Latino/Hispanic community in addressing substance use among teenagers. By integrating family values, cultural norms, and community involvement, healthcare providers and organizations can create more inclusive and effective programs for Latino/Hispanic youth.
SPECIFIC MODELS OF CARE
Family-Centered Interventions: In many Latino/Hispanic cultures, family plays a central role and must be involved in the recovery process. Involving family members, where appropriate, in treatment and recovery processes can be beneficial. Check out my last post for some examples: Shedding Light on a Growing Concern: Substance Use Challenges Facing Latino/Hispanic* Youth [Part I]
Integrated Care Models: Implementing integrated care models that combine substance use disorder treatment with other health services, including mental health and primary care, can be particularly effective. For example, SAMHSA’s Certified Community Behavioral Health Clinic (CCBHC) model is designed to ensure access to coordinated comprehensive behavioral health care, regardless of ability to pay, place of residence, or age—including developmentally appropriate care for children and youth.
Peer Support and Community Health Workers: Utilizing peer navigators or community health workers (promotores) who share cultural backgrounds can help improve engagement and adherence to treatment. These individuals act as bridges between healthcare providers and the individuals/community, offering support and guidance based on lived experiences.
Telehealth Services: Expanding telehealth services (with flexible scheduling) has been shown to increase access to care, especially for those in remote or underserved areas. Providing telehealth in the patient's preferred language and ensuring accessibility for those with limited technology skills or resources is key to overall engagement.
Screening And Early Intervention: Implementing routine screening for SUD in healthcare settings can help in early identification, accurate assessment, and intervention. There are many screening tools [CAGE-AID Questionnaire; AUDIT (Alcohol Use Disorders Identification Test); DAST (Drug Abuse Screening Test); SBIRT (Screening, Brief Intervention, and Referral to Treatment)] that are adapted to be more culturally relevant for Latino/Hispanic population, taking into account language preferences, cultural norms, and specific risk factors prevalent.
These adapted and specific models of care emphasize the importance of culturally sensitive approaches and the need to better integrate cultural and family values/norms in order to create a more effective and relatable prevention strategy for Latino/Hispanic youth. While these strategies provide a general overview, it is important to keep in mind that specific programs and initiatives may vary by region and healthcare setting, but what is needed is a combination of cultural sensitivity, community engagement, family involvement, integrated care, and personalized approaches to effectively addressing SUD and overdose prevention in the Latino/Hispanic community.
* In this post, and as used in SAMHSA publications, the term Latino/Hispanic is used as an umbrella term to include those who identify as “Hispanic,” “Latino,” and/or “Latinx” in the U.S. This typically includes individuals with ancestral origins from Latin America and/or Spain.
RESOURCES
To improve outreach and treatment for Hispanic and Latino communities, resources and training are available for the healthcare community. Organizations like the National Hispanic and Latino Addiction Technology Transfer Center and the National Latino Behavioral Health Association focus on training healthcare providers to better serve the Hispanic and Latino community needing behavioral health treatment and recovery. SAMHSA’s recently launched Hispanic/Latino Behavioral Health Center of Excellence (H/L CoE) is focused on advancing behavioral health equity of Hispanic/Latino communities. These resources aim to address the cultural and linguistic needs of the community.
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