1 00:00:05,040 --> 00:00:08,720 >>WELCOME TO TODAY'S 2 00:00:08,720 --> 00:00:11,960 WEBINAR ON REDUCING SIGNATURES 3 00:00:11,960 --> 00:00:15,160 STATE REGULATOR AROUND ALCOHOL 4 00:00:15,160 --> 00:00:17,120 USE DISORDER IN MINORITY 5 00:00:17,120 --> 00:00:19,600 COMMUNITIES. 6 00:00:19,600 --> 00:00:22,040 STIGMA AT HARMFUL LEVELS AS WELL 7 00:00:22,040 --> 00:00:24,560 AS INTERNALIZATION OF STIGMA BY 8 00:00:24,560 --> 00:00:26,240 SUBSTANCE USES IS WIDE SPREAD 9 00:00:26,240 --> 00:00:27,960 AND MAY REPRESENT A SERIOUS 10 00:00:27,960 --> 00:00:29,400 BARRIER TO TREATMENT SEEKING AND 11 00:00:29,400 --> 00:00:30,760 TREATMENT ACCESS. 12 00:00:30,760 --> 00:00:33,560 TODAY'S WEB NAINAR WILL FOCUS ON 13 00:00:33,560 --> 00:00:35,600 A NOVEL INTERVENTION TO REDUCE 14 00:00:35,600 --> 00:00:37,720 THE IMPACT OF STIGMA AMONG LATIN 15 00:00:37,720 --> 00:00:40,760 X IMMIGRANTS AND ITS POTENTIAL 16 00:00:40,760 --> 00:00:41,960 UTILITY IN THE AFRICAN AMERICAN 17 00:00:41,960 --> 00:00:45,000 AND OTHER MINORITY COMMUNITIES. 18 00:00:45,000 --> 00:00:48,200 MY NAME IS DIEDR'S ROACH AND I 19 00:00:48,200 --> 00:00:49,320 SERVE AS A MEDICAL OFFICER IN 20 00:00:49,320 --> 00:00:50,600 THE DIVISION OF TREATMENT AND 21 00:00:50,600 --> 00:00:52,160 RECOVERY RESEARCH AT THE 22 00:00:52,160 --> 00:00:54,760 NATIONAL INSTITUTE ON ALCOHOL 23 00:00:54,760 --> 00:00:55,240 ABUSE AND ALCOHOLISM. 24 00:00:55,240 --> 00:00:57,200 IT'S MY GREAT PLEASURE AND 25 00:00:57,200 --> 00:00:59,120 PRIVILEGE TO INTRODUCE OUR 26 00:00:59,120 --> 00:01:00,160 SPEAKERS FOR TODAY, START 27 00:01:00,160 --> 00:01:02,920 NOTHING ORDER OF PRESENTATION 28 00:01:02,920 --> 00:01:05,560 WITH DR. CHRISTINA LEE. 29 00:01:05,560 --> 00:01:06,760 DR. LEE IS ASSOCIATE PROFESSOR 30 00:01:06,760 --> 00:01:08,760 IN THE SCHOOL OF SOCIAL WORK AT 31 00:01:08,760 --> 00:01:10,360 BOSTON UNIVERSITY SCHOOL OF 32 00:01:10,360 --> 00:01:12,000 SOCIAL WORK. 33 00:01:12,000 --> 00:01:15,680 ADDICTION FACULTY AT BU'S 34 00:01:15,680 --> 00:01:16,640 [INDISCERNIBLE] CENTER, BOOF 35 00:01:16,640 --> 00:01:18,760 THEOLOGY MEDICAL CENTER, 36 00:01:18,760 --> 00:01:19,320 MOTIVATIONAL INTERVIEWING 37 00:01:19,320 --> 00:01:20,120 TRAINING COMMITTEE MEMBER FOR 38 00:01:20,120 --> 00:01:21,040 THE AMERICAN SOCIETY OF 39 00:01:21,040 --> 00:01:24,160 ADDICTION MEDICINE AND A FACULTY 40 00:01:24,160 --> 00:01:26,960 AFFILIATE AT BU'S CENTER FOR 41 00:01:26,960 --> 00:01:27,360 ANTIRACIST RESEARCH. 42 00:01:27,360 --> 00:01:28,800 SHE IS ALSO THE RESEARCH 43 00:01:28,800 --> 00:01:30,960 CORRECTOR AT THE BU SCHOOL OF 44 00:01:30,960 --> 00:01:32,520 SOCIAL WORKS CENTER FOR 45 00:01:32,520 --> 00:01:35,120 INNOVATION AND SOCIAL WORK AND 46 00:01:35,120 --> 00:01:37,400 HEALTH AND MENTOR'S GRADUATE AND 47 00:01:37,400 --> 00:01:39,160 POST DOCTORAL SCHOLARS FROM 48 00:01:39,160 --> 00:01:40,960 DIVERSE, RACIAL AND ETHNIC 49 00:01:40,960 --> 00:01:41,160 GROUPS. 50 00:01:41,160 --> 00:01:44,760 HER RESEARCH BRIDGES THE AREAS 51 00:01:44,760 --> 00:01:46,160 OF INTERVENTION SCIENCE, 52 00:01:46,160 --> 00:01:48,240 ADDICTION PSYCHOLOGY AND HEALTH 53 00:01:48,240 --> 00:01:48,560 INIQUITIES. 54 00:01:48,560 --> 00:01:51,360 TODAY, DR. LEE WILL PROVIDE AN 55 00:01:51,360 --> 00:01:54,560 OVERVIEW OF THE CULTURALLY 56 00:01:54,560 --> 00:01:57,280 ADAPTED STIGMA MITIGATION 57 00:01:57,280 --> 00:01:58,880 INTERVENTION OR CASMI FOR WHOLE 58 00:01:58,880 --> 00:02:04,480 USE AMONG LATIN X IMMIGRANTS. 59 00:02:04,480 --> 00:02:07,800 MR. HUM BERT O [INDISCERNIBLE] 60 00:02:07,800 --> 00:02:11,720 IS A CONSULTANT AT THE NONPROFIT 61 00:02:11,720 --> 00:02:12,960 ORGANIZATION SPECIALIZING IN 62 00:02:12,960 --> 00:02:14,640 INNOVATION POTENTIAL AND 63 00:02:14,640 --> 00:02:16,440 BUILDING CAPACITY IN THE SOCIAL 64 00:02:16,440 --> 00:02:18,240 SECTOR TO GENERATE EQUITABLE 65 00:02:18,240 --> 00:02:18,640 SYSTEMATIC CHANGE. 66 00:02:18,640 --> 00:02:20,440 HE IS A MASTER OF SOCIAL WORK 67 00:02:20,440 --> 00:02:23,280 AND MASTER OF BUSINESS 68 00:02:23,280 --> 00:02:24,560 ADMINISTRATION WITH EXPERIENCE 69 00:02:24,560 --> 00:02:27,720 IN NONPROFITS SPANNING AREAS OF 70 00:02:27,720 --> 00:02:29,960 HOMELESSNESS, MENTAL HEALTH, 71 00:02:29,960 --> 00:02:31,600 EDUCATION, AND ADVOCACY. 72 00:02:31,600 --> 00:02:34,760 AND HE HAS PARTICULAR EXPERTISE 73 00:02:34,760 --> 00:02:38,280 IN SOCIAL INNOVATION. 74 00:02:38,280 --> 00:02:49,840 MR. CAMARANA IS CO AUTHOR OF THE 75 00:02:49,840 --> 00:02:53,840 BOOK--ADAPTIVE MI STUDY LED BY 76 00:02:53,840 --> 00:02:55,800 DR. LEE, TODAY MR. CAMARENA WILL 77 00:02:55,800 --> 00:02:57,520 DISCUSS COMMUNITY RESPONSES TO 78 00:02:57,520 --> 00:02:59,320 THE CULTURALLY ADAPTED MOTIVATE 79 00:02:59,320 --> 00:03:06,160 THE INTERVENTION OR CAMI. 80 00:03:06,160 --> 00:03:08,160 DR. VICTOR FIGUEREO IS A 81 00:03:08,160 --> 00:03:08,960 PROFESSOR THE UNIVERSITY OF 82 00:03:08,960 --> 00:03:10,760 PITTSBURGH SOCIAL WORK. 83 00:03:10,760 --> 00:03:12,560 HIS WORK FOCUSES ON 84 00:03:12,560 --> 00:03:14,880 RACIALIZATION, THE INTERSECTIONS 85 00:03:14,880 --> 00:03:16,600 OF RACE AND ETHNICITY AND ACCESS 86 00:03:16,600 --> 00:03:19,080 TO HEALTH AND MENTAL HEGHT CARE 87 00:03:19,080 --> 00:03:20,880 AS IT PERTAINS TO THE SOAK 88 00:03:20,880 --> 00:03:22,640 LOGICAL WELL BEING AND DISTRESS 89 00:03:22,640 --> 00:03:24,760 OF LATIN X INDIVIDUALS LIVING IN 90 00:03:24,760 --> 00:03:25,240 THE UNITED STATES. 91 00:03:25,240 --> 00:03:27,880 THE PURPOSE OF HIS WORKS IS TO 92 00:03:27,880 --> 00:03:30,760 DEMYSTIFY THE ETHNIC AND RACIAL 93 00:03:30,760 --> 00:03:34,960 HOMOGENEITY OF U.S. LATIN 94 00:03:34,960 --> 00:03:35,360 Xss. 95 00:03:35,360 --> 00:03:38,680 THE LIVED EXPERIENCE OF AFRO AND 96 00:03:38,680 --> 00:03:40,160 BLACK LATIN Xs AND CONTRIBUTE 97 00:03:40,160 --> 00:03:41,840 TO THE ELIMINATION OF LATIN X 98 00:03:41,840 --> 00:03:42,840 HEALTH AND MENTAL HEALTH 99 00:03:42,840 --> 00:03:43,800 DISPARITIES IN THE U.S. 100 00:03:43,800 --> 00:03:46,120 HE IS THE AUTHOR OF 101 00:03:46,120 --> 00:03:48,240 RACIALIZATION AND SOAK LOGICAL 102 00:03:48,240 --> 00:03:55,400 DISTRESS AMONG U.S. LATIN X'S. 103 00:03:55,400 --> 00:03:57,720 TODAY DR. FIGUEREOO WHICH WILL 104 00:03:57,720 --> 00:04:03,840 DISCUSS DRINKING WITH THE CAMI, 105 00:04:03,840 --> 00:04:06,680 MISS ROCIO MORIEL, WORKS WITH 106 00:04:06,680 --> 00:04:07,920 PROVIDENCE HEALTH AND SERVICES 107 00:04:07,920 --> 00:04:09,640 IN SOUTHERN CALIFORNIA, SHE 108 00:04:09,640 --> 00:04:10,560 WORKS PROVIDING APPROPRIATE 109 00:04:10,560 --> 00:04:12,120 HEALTH EEDUCATION AND 110 00:04:12,120 --> 00:04:13,240 COUNSELING, LINKING COMMUNITY 111 00:04:13,240 --> 00:04:15,640 MEMBERS TO APPROPRIATE CARE, AND 112 00:04:15,640 --> 00:04:17,680 ADVOCATING FOR BEST APPROACHES 113 00:04:17,680 --> 00:04:19,000 TO ADDRESSING COMMUNITY HEALTH 114 00:04:19,000 --> 00:04:22,920 AND SOCIAL SERVICES NEEDS. 115 00:04:22,920 --> 00:04:24,880 MISS MORIEL IS CURRENTLY 116 00:04:24,880 --> 00:04:25,960 COLLABORATING WITH A COMMUNITY 117 00:04:25,960 --> 00:04:28,080 SOCIAL WORKER IN A LOCAL 118 00:04:28,080 --> 00:04:28,920 EMERGENCY DEPARTMENT TO ASSIST 119 00:04:28,920 --> 00:04:31,760 PATIENTS WITH CARE MANAGEMENT 120 00:04:31,760 --> 00:04:34,240 AND TO PROVIDE RESOURCES FOR ANY 121 00:04:34,240 --> 00:04:35,760 HEALTHCARE SERVICES THEY MAY 122 00:04:35,760 --> 00:04:36,000 NEED. 123 00:04:36,000 --> 00:04:38,360 SHE RENTLY PARTNER WIDE UCLA ON 124 00:04:38,360 --> 00:04:40,640 THE ALCOHOL RESEARCH STUDY FOR 125 00:04:40,640 --> 00:04:43,320 LATINOS PROVIDING MOTIVATIONAL 126 00:04:43,320 --> 00:04:44,000 INTERVIEWING FOR UNHEALTHY 127 00:04:44,000 --> 00:04:46,000 DRINKING IN THE LATINO 128 00:04:46,000 --> 00:04:47,160 COMMUNITY. 129 00:04:47,160 --> 00:04:49,360 TODAY'S MISS MORIEL WILL DISCUSS 130 00:04:49,360 --> 00:04:51,840 USING THE CAMI TO CONNECT TO A 131 00:04:51,840 --> 00:04:53,000 HIGH RISK UNDOCUMENTED 132 00:04:53,000 --> 00:04:55,480 POPULATION TO REDUCE DRINKING 133 00:04:55,480 --> 00:04:56,160 DURING COVID. 134 00:04:56,160 --> 00:05:02,440 AND FINALLY, WE WILL HEAR FROM 135 00:05:02,440 --> 00:05:07,760 DR. TAMIKA ZAPOLSKI WHO IS A 136 00:05:07,760 --> 00:05:08,560 INDIANA-PURDUE UNIVERSITY 137 00:05:08,560 --> 00:05:09,000 Ph.D. 138 00:05:09,000 --> 00:05:11,560 AND SHE IS ALSO CO DIRECTOR OF 139 00:05:11,560 --> 00:05:13,320 THE ADOLESCENT BEHAVIOR HEALTH 140 00:05:13,320 --> 00:05:14,560 RESEARCH PROGRAM, A 141 00:05:14,560 --> 00:05:16,680 MULTIDISCIPLINARY OF TEAM 142 00:05:16,680 --> 00:05:18,760 RESEARCHERS WITHIN THE INDIANA 143 00:05:18,760 --> 00:05:19,440 UNIVERSITY CREATED TO IMPROVE 144 00:05:19,440 --> 00:05:21,760 THE HEALTH AND WELL BEING OF 145 00:05:21,760 --> 00:05:23,560 TEENAGERS, AND YOUNG ADULTS 146 00:05:23,560 --> 00:05:25,120 THROUGH RESEARCH, EDUCATION AND 147 00:05:25,120 --> 00:05:25,680 INTERVENTION, HER RESEARCH 148 00:05:25,680 --> 00:05:26,960 FOCUSES ON RISK FOR SUBSTANCE 149 00:05:26,960 --> 00:05:30,600 USE AND OTHER HEALTH BEHAVIORS, 150 00:05:30,600 --> 00:05:32,800 AMONG AFRICAN AMERICANS. 151 00:05:32,800 --> 00:05:34,160 GIVEN LIMITED INTEGRATIVE 152 00:05:34,160 --> 00:05:34,960 LITERATURE ON UNDERSTANDING 153 00:05:34,960 --> 00:05:36,360 AFRICAN AMERICAN RISK FOR 154 00:05:36,360 --> 00:05:41,360 ALCOHOL USE AND RELATED 155 00:05:41,360 --> 00:05:43,400 PROBLEMS, DOCTORS ZAPOLSKI 156 00:05:43,400 --> 00:05:44,360 DEVELOPED A MODEL FOR ALCOHOL 157 00:05:44,360 --> 00:05:46,160 USE THAT WAS RECENTLY PUBLISH 158 00:05:46,160 --> 00:05:53,360 INDEED SOAK LOGICAL BULLETIN. 159 00:05:53,360 --> 00:05:55,720 TODAY DR. ZAPOLSKI WILL DISCUSS 160 00:05:55,720 --> 00:05:58,280 DRUG AND ALCOHOL USE AMONG 161 00:05:58,280 --> 00:05:59,080 PLAQUE AMERICANS. 162 00:05:59,080 --> 00:06:00,360 BEFORE WE BEGIN FEEL FREE TO USE 163 00:06:00,360 --> 00:06:02,880 THE ACCEPTED LIVE FEEDBACK 164 00:06:02,880 --> 00:06:05,360 BUTTON LOCATED AT THE TOP OF THE 165 00:06:05,360 --> 00:06:08,960 VIDEOCAST PAGE TO SUBMIT PANELS 166 00:06:08,960 --> 00:06:09,800 FOLLOWING TODAY'S PRESENTATIONS. 167 00:06:09,800 --> 00:06:12,920 ALSO THIS WEBINAR WILL BE 168 00:06:12,920 --> 00:06:14,280 ARCHIVEDOT NIH VIDEOCAST PAGE 169 00:06:14,280 --> 00:06:15,280 FOR FUTURE VIEWING. 170 00:06:15,280 --> 00:06:16,960 AND NOW, PLEASE JOIN ME IN 171 00:06:16,960 --> 00:06:20,200 WELCOMING OUR FIRST SPEAKER FOR 172 00:06:20,200 --> 00:06:21,840 TODAY DR. CHRISTINA LEE. 173 00:06:21,840 --> 00:06:39,400 >>I'M VERY PLEASED TO 174 00:06:39,400 --> 00:06:40,400 PRESENT THE EVIDENCE 175 00:06:40,400 --> 00:06:41,400 BASE INTERVENTION, THE 176 00:06:41,400 --> 00:06:42,200 CULTURALLY ADAPTED STIGMA 177 00:06:42,200 --> 00:06:43,720 MITIGATION FOR ALCOHOL MISUSE 178 00:06:43,720 --> 00:06:44,160 AMONG LATINO A/X IMMIGRANTS. 179 00:06:44,160 --> 00:06:45,440 I WILL EXPLAIN THIS TALK AND 180 00:06:45,440 --> 00:06:47,480 LOOKING AT ALL MY RESOWLTS OVER 181 00:06:47,480 --> 00:06:49,440 THE YEARS, I HAVE REALIZE THAT 182 00:06:49,440 --> 00:06:50,640 WHAT THE INTERVENTION ADDRESSES 183 00:06:50,640 --> 00:06:52,800 ARE THE CONSEQUENCES OF BEING 184 00:06:52,800 --> 00:06:55,120 STIGMATIZED FOR DIFFERENT 185 00:06:55,120 --> 00:06:56,840 REASONS INCLUDING ALCOHOL, 186 00:06:56,840 --> 00:06:58,880 HAVING IMMIGRANT STATUS OR 187 00:06:58,880 --> 00:06:59,720 THROUGH 1'S RAISE. 188 00:06:59,720 --> 00:07:01,360 SO DESCRIBING EARLY WORK, 189 00:07:01,360 --> 00:07:04,360 HOWEVER, I WILL BE USING THE KEY 190 00:07:04,360 --> 00:07:06,320 TERM CAMI, I ALSO FEEL VERY 191 00:07:06,320 --> 00:07:07,760 PRIVATE SECTOR LEMMINGED TO HAVE 192 00:07:07,760 --> 00:07:11,720 MY COLLEAGUES HERE TODAY, HUM 193 00:07:11,720 --> 00:07:16,080 BERT O, DR. FIGUERO, AND 194 00:07:16,080 --> 00:07:16,440 [INDISCERNIBLE]. 195 00:07:16,440 --> 00:07:17,440 THEY HAVE DONE A TON OF WORK AND 196 00:07:17,440 --> 00:07:31,680 THEY WILL SHARE THEIR REALLY 197 00:07:31,680 --> 00:07:32,280 VALUABLE PERSPECTIVES--HEALTH 198 00:07:32,280 --> 00:07:33,320 DISPARITIES EVEN BEFORE IT 199 00:07:33,320 --> 00:07:34,960 BECAME A CENTRAL FOCUS AND FOR 200 00:07:34,960 --> 00:07:35,880 SUPPORTING RESEARCH THAT WAS 201 00:07:35,880 --> 00:07:38,520 OUTSIDE THE BOX WITH THE GOAL OF 202 00:07:38,520 --> 00:07:39,720 MINIMIZING HEALTH INENTIOUS 203 00:07:39,720 --> 00:07:41,640 QUITYS RELATED TO HARMFUL 204 00:07:41,640 --> 00:07:44,480 ALCOHOL USE. 205 00:07:44,480 --> 00:07:46,240 RECENTLY, I THANKED MY STUDY 206 00:07:46,240 --> 00:07:46,920 PARTICIPANTS BY POSTING MY 207 00:07:46,920 --> 00:07:49,160 NOTICE IN A SPANISH LANGUAGE 208 00:07:49,160 --> 00:07:49,600 NEWSPAPER IN BOSTON. 209 00:07:49,600 --> 00:07:50,880 CAN YOU SEE THE LINK HERE IN THE 210 00:07:50,880 --> 00:07:51,960 CENTER AND THE THANK YOU NOTICE 211 00:07:51,960 --> 00:07:54,440 THAT WENT TO A SUMMARY OF THE 212 00:07:54,440 --> 00:07:55,720 STUDY RESULTS EVERY DAY LANGUAGE 213 00:07:55,720 --> 00:08:00,480 THAT WAS TRANSLATED INTO 214 00:08:00,480 --> 00:08:00,840 SPANISH. 215 00:08:00,840 --> 00:08:03,480 SO TO BEGIN IN 2002, I CHOSE TO 216 00:08:03,480 --> 00:08:05,680 FOCUS ON LATIN X'S BECAUSE THE 217 00:08:05,680 --> 00:08:09,080 EVIDENCE SHOWED AND STILL SHOWS 218 00:08:09,080 --> 00:08:10,800 THAT DESPITE DRINKING ALCOHOL AT 219 00:08:10,800 --> 00:08:12,440 RATES THAT ARE COMPARABLE TO 220 00:08:12,440 --> 00:08:15,000 OTHER RACIAL ETHNIC GROUPS, 221 00:08:15,000 --> 00:08:15,920 THERE REMAIN UNEXPLAINED 222 00:08:15,920 --> 00:08:19,720 DISPARITIES IN HEALTH OUTCOMES, 223 00:08:19,720 --> 00:08:22,840 RELATED TO ALCOHOL MISUSE AMONG 224 00:08:22,840 --> 00:08:25,160 LATIN X'S, THESE INCLUDE HIGHER 225 00:08:25,160 --> 00:08:27,560 RATES OF LIVER CIRRHOSIS, HIGHER 226 00:08:27,560 --> 00:08:29,520 RATES EVER MOTE VORVEHICLE 227 00:08:29,520 --> 00:08:31,640 CRASHES INVOLVING ALCOHOL AND 228 00:08:31,640 --> 00:08:37,000 INCREASED ARRESTS DUE TO 229 00:08:37,000 --> 00:08:37,520 DRUNKENNESS. 230 00:08:37,520 --> 00:08:39,280 THESE PHYSICAL CONSEQUENCES SUCH 231 00:08:39,280 --> 00:08:42,040 AS LIVER CIRRHOSIS ARE MOST 232 00:08:42,040 --> 00:08:43,640 ASSOCIATED WITH A SPECIFIC HEAVY 233 00:08:43,640 --> 00:08:44,280 PATTERN OF DRINKING. 234 00:08:44,280 --> 00:08:47,480 THIS IS A RECENT ANALYSIS OF THE 235 00:08:47,480 --> 00:08:48,720 NASDA, IF YOU LOOK AT THE 236 00:08:48,720 --> 00:08:50,840 CENTER, YOU WILL SEE THE 237 00:08:50,840 --> 00:08:51,880 PERCENTILES FOR BINGE DRINK 238 00:08:51,880 --> 00:08:54,120 NOTHING THE PAST 30 DAYS. 239 00:08:54,120 --> 00:08:55,680 WHITE NONLATINOS ARE IN THE 240 00:08:55,680 --> 00:08:58,280 YELLOW, BLACK INDIVIDUALS ARE 241 00:08:58,280 --> 00:09:00,040 REPRESENTED BY MAROON AND LATIN 242 00:09:00,040 --> 00:09:00,960 X'S ARE IN GREEN. 243 00:09:00,960 --> 00:09:05,640 SO YOU CAN SEE HERE THAT AMONG 244 00:09:05,640 --> 00:09:07,160 HISPANIC MALES AND FEMALES IN 245 00:09:07,160 --> 00:09:11,240 GREEN, THEY HAVE HIGHER RATES OF 246 00:09:11,240 --> 00:09:14,280 BENCH DRINKING, 19.3% AMONG 247 00:09:14,280 --> 00:09:22,080 HISPANIC MALES AND 16.2% AMONG 248 00:09:22,080 --> 00:09:23,000 HISPANIC FEMALES. 249 00:09:23,000 --> 00:09:25,440 THIS INFORMATION ON HEALTH 250 00:09:25,440 --> 00:09:27,040 DISPARITIES MOLTIVATED THE 251 00:09:27,040 --> 00:09:29,680 STUDY, AND TRIEWT DEVELOPMENT 252 00:09:29,680 --> 00:09:32,040 AND TESTING, IT WAS--INVOLVEMENT 253 00:09:32,040 --> 00:09:33,360 AND INPUT. 254 00:09:33,360 --> 00:09:34,560 DRINKING OF THE COMMUNITY 255 00:09:34,560 --> 00:09:38,200 ADVISORY BOARD WAS NEEDED AND 256 00:09:38,200 --> 00:09:40,040 THAT REGULARLY CONSISTED OF 257 00:09:40,040 --> 00:09:42,960 SPANISH BILING Y'ALL COMMUNITY 258 00:09:42,960 --> 00:09:46,720 HEALTH WORKERS, PROVIDERS AND 259 00:09:46,720 --> 00:09:47,480 COMMUNITY LEADERS, GIVING INPUT 260 00:09:47,480 --> 00:09:48,800 TO WHAT THE COMMUNITY NEEDED AND 261 00:09:48,800 --> 00:09:51,440 IN THE BEGINNING OF 2002, THEY 262 00:09:51,440 --> 00:09:53,720 SAID WE NEED NOR TREATMENT SITES 263 00:09:53,720 --> 00:09:55,840 THAT COULD SERVICE US IN 264 00:09:55,840 --> 00:09:56,200 SPANISH. 265 00:09:56,200 --> 00:09:59,560 AND SADLY IN 2022, THAT IS STILL 266 00:09:59,560 --> 00:10:00,440 THE CASE. 267 00:10:00,440 --> 00:10:02,400 THE CAP ALSO GAVE INPUT TO THE 268 00:10:02,400 --> 00:10:04,880 DEVELOPMENT AND AT THE END OF 269 00:10:04,880 --> 00:10:07,120 THE STUDY, THE GROUP LISTENED TO 270 00:10:07,120 --> 00:10:09,240 THE CAMI AUDIO TAPES AND SPANISH 271 00:10:09,240 --> 00:10:10,400 AND ENGLISH AND GAVE THEIR 272 00:10:10,400 --> 00:10:12,000 FEEDBACK, I ALSO FORMED A 273 00:10:12,000 --> 00:10:14,280 WORKING PARTNERSHIP AT OUR 274 00:10:14,280 --> 00:10:26,000 CLINICAL TRIAL SITE, THIS 275 00:10:26,000 --> 00:10:27,560 COMMUNITY STAGE 1 TREATMENT 276 00:10:27,560 --> 00:10:28,160 DEVELOPMENT GUIDELINES WHICH 277 00:10:28,160 --> 00:10:31,760 LAID OUT THE IMPORTANCE OF 278 00:10:31,760 --> 00:10:34,560 IDENTIFYING UNIQUE RISK FACTORS 279 00:10:34,560 --> 00:10:35,280 BY INFORMING QUALITATIVE 280 00:10:35,280 --> 00:10:36,680 RESEARCH, THE AIMS OF OUR FOCUS 281 00:10:36,680 --> 00:10:40,400 GROUP WERE TO ASK LATIN X'S 282 00:10:40,400 --> 00:10:41,600 UNMET CRITERIA FOR HEAVY 283 00:10:41,600 --> 00:10:43,200 DRINKING TO TELL US ABOUT THEIR 284 00:10:43,200 --> 00:10:44,640 EXPERIENCES LIVING HERE AND IN 285 00:10:44,640 --> 00:10:46,480 THEIR PRIOR COUNTRIES AND WHAT 286 00:10:46,480 --> 00:10:49,440 DRINKING LOOKED LIKE IN BOTH 287 00:10:49,440 --> 00:10:49,680 CONTEXT. 288 00:10:49,680 --> 00:10:52,800 THE IDEA WAS TO CAPTURE WHAT 289 00:10:52,800 --> 00:10:53,320 CHANGED ABOUT ALCOHOL 290 00:10:53,320 --> 00:10:55,000 COMSUMPTION BEHAVIOR IN THE 291 00:10:55,000 --> 00:10:58,520 UNITED STATES AND WHY. 292 00:10:58,520 --> 00:11:00,480 THE KEY FINDING WHICH WAS 293 00:11:00,480 --> 00:11:02,960 PUBLISHED IN 2006 WAS THAT 294 00:11:02,960 --> 00:11:05,120 SOCIAL STRESSORS RELATED TO 295 00:11:05,120 --> 00:11:05,840 INTEGRATION AND ACULTERATION 296 00:11:05,840 --> 00:11:08,240 SUCH AS WORK NOTHING JOBS THAT 297 00:11:08,240 --> 00:11:10,000 WERE NOT COMMENSURATE WITH 1'S 298 00:11:10,000 --> 00:11:12,520 LEVEL OF EDUCATION, BEING 299 00:11:12,520 --> 00:11:13,840 SOCIALLY ISOLATED AND NOT HAVING 300 00:11:13,840 --> 00:11:16,600 EASY ACCESS TO SOCIAL RESOURCES 301 00:11:16,600 --> 00:11:18,680 LIKE TRANSLATORS OR 302 00:11:18,680 --> 00:11:19,840 TRANSPORTATION. 303 00:11:19,840 --> 00:11:23,360 AS WELL AS EXPERIENCES OF 304 00:11:23,360 --> 00:11:25,000 DISCRIMINATION, WERE THE KEY 305 00:11:25,000 --> 00:11:26,520 RISK FACTORS THAT PROMPTED 306 00:11:26,520 --> 00:11:27,960 CHANGES IN DRINKING BEHAVIOR, IN 307 00:11:27,960 --> 00:11:33,400 LATINO MEN AND WOMEN AFTER U.S. 308 00:11:33,400 --> 00:11:33,680 IMMIGRATION. 309 00:11:33,680 --> 00:11:36,920 THE NEXT 2 SLIDES IS TO 310 00:11:36,920 --> 00:11:38,320 EMPHASIZE THAT DISCRIMINATION 311 00:11:38,320 --> 00:11:40,520 AND STIGMA ARE DIFFERENT 312 00:11:40,520 --> 00:11:40,840 PHENOMENON. 313 00:11:40,840 --> 00:11:42,080 THIS IS IMPORTANT TO HELP 314 00:11:42,080 --> 00:11:48,560 UNDERSTAND THE SCOPE OF WHAT WE 315 00:11:48,560 --> 00:11:49,360 TARGETED. 316 00:11:49,360 --> 00:11:52,560 THERE ARE SEVERAL LONG 317 00:11:52,560 --> 00:11:55,360 DEFINITIONS FOR DISCRIMINATION, 318 00:11:55,360 --> 00:11:58,040 HERE I'M USING THIS DEFINITION 319 00:11:58,040 --> 00:11:59,880 WHERE KENDI POINTS OUT THAT 320 00:11:59,880 --> 00:12:00,840 MAKING DISTINCTION BETWEEN 321 00:12:00,840 --> 00:12:02,560 PEOPLE DIFFERENTLY IN FAVOR FOR 322 00:12:02,560 --> 00:12:12,840 OR AGAINST SOMEONE COULD LEAD TO 323 00:12:12,840 --> 00:12:15,600 MORE ISSUES--[AUDIO DISTORTED 324 00:12:15,600 --> 00:12:22,960 ]--PROMPTED THEM TO DRINK 325 00:12:22,960 --> 00:12:23,880 ALCOHOL. 326 00:12:23,880 --> 00:12:25,320 IN CONTRAST, STIGMA IS AN 327 00:12:25,320 --> 00:12:27,320 ATTRIBUTE THAT REDUCES A PERSON 328 00:12:27,320 --> 00:12:30,520 TO A DISCOUNTED 1 AND THIS IS 329 00:12:30,520 --> 00:12:43,560 THE CLASSIC DEFINITION 330 00:12:43,560 --> 00:12:44,280 OF----FROM SOCIAL RESOURCES 331 00:12:44,280 --> 00:12:45,760 WHICH LEADS TO INDIVIDUAL 332 00:12:45,760 --> 00:12:47,760 HEALING NOT DESERVING OF 333 00:12:47,760 --> 00:12:48,680 INCLUSION. 334 00:12:48,680 --> 00:12:50,600 THE IMPORTANT DISTINCTION IS 335 00:12:50,600 --> 00:12:51,880 THAT WHEN PEOPLE FEEL 336 00:12:51,880 --> 00:12:53,960 STIGMATIZED THERE MUST BE SOME 337 00:12:53,960 --> 00:12:55,880 FORM OF POWER IMBALANCE BECAUSE 338 00:12:55,880 --> 00:12:57,080 SOMEBODY NEEDS TO JUDGE SOMEBODY 339 00:12:57,080 --> 00:13:00,560 ELSE AS BEING LESS THAN. 340 00:13:00,560 --> 00:13:02,280 THESE EXPERIENCES ARE OFTEN 341 00:13:02,280 --> 00:13:03,080 CAPTURED IN PARTICIPANT 342 00:13:03,080 --> 00:13:07,480 REACTIONS TO BEING EXCLUDED AND 343 00:13:07,480 --> 00:13:11,120 HERE'S A QUOTE IN RED WHERE A 344 00:13:11,120 --> 00:13:17,280 PARTICIPANT DESCRIBES THESE 345 00:13:17,280 --> 00:13:17,560 BARRIERS. 346 00:13:17,560 --> 00:13:20,480 THIS PAPER IS WHERE I REFLECTED 347 00:13:20,480 --> 00:13:22,600 OR DOCUMENTED THAT WE WERE 348 00:13:22,600 --> 00:13:24,880 REALLY TARGETING IN THE 349 00:13:24,880 --> 00:13:27,240 COMMUNITY NOW REFRAMED AS THE 350 00:13:27,240 --> 00:13:28,840 CULTURALLY ADAPTED STIGMA 351 00:13:28,840 --> 00:13:30,800 MEDICATION, WERE THE EFFECTS OF 352 00:13:30,800 --> 00:13:32,120 STIGMA AND EXCLUSION. 353 00:13:32,120 --> 00:13:34,520 THIS PAPER REPORTED FINDINGS OF 354 00:13:34,520 --> 00:13:35,840 QUALITATIVE STUDY WITH 355 00:13:35,840 --> 00:13:38,160 PARTICIPANTS AFTER THEY 356 00:13:38,160 --> 00:13:40,040 COMPLETED THE CAMI. 357 00:13:40,040 --> 00:13:43,320 THESE PARTICIPANTS ALL REPORTED 358 00:13:43,320 --> 00:13:44,480 SIGNIFICANT DECREASES IN 359 00:13:44,480 --> 00:13:46,000 DEPRESSIVE SYMPTOMS AS WELL AS 360 00:13:46,000 --> 00:13:47,880 DECREASES IN HEAVY DRINKING. 361 00:13:47,880 --> 00:13:49,680 ACCORDING TO MINORITY STRESS 362 00:13:49,680 --> 00:13:51,680 THEORY, SOCIAL EXCLUSION AND 363 00:13:51,680 --> 00:13:53,880 MARGINALIZATION LEADS TO POOR 364 00:13:53,880 --> 00:13:55,440 MENTAL HEALTH WHICH THEN 365 00:13:55,440 --> 00:13:57,160 INCREASES VULNERABILITY TO 366 00:13:57,160 --> 00:13:58,520 UNHEALTHY BEHAVIORS LIKE HEAVY 367 00:13:58,520 --> 00:14:03,000 DRINKING. 368 00:14:03,000 --> 00:14:05,560 IN OUR STUDY, WE DIDN'T ASK OUR 369 00:14:05,560 --> 00:14:06,960 PARTICIPANTS TO MAKE THESE 370 00:14:06,960 --> 00:14:08,240 ASSOCIATIONS WITH US DIRECTLY 371 00:14:08,240 --> 00:14:09,640 BUT HOWEVER, IN THEIR OWN WORDS 372 00:14:09,640 --> 00:14:11,480 THEY TOLD US THAT THEY FELT 373 00:14:11,480 --> 00:14:13,400 EXCLUDED FROM THE MAIN STREAM 374 00:14:13,400 --> 00:14:14,640 AND SECONDLY THAT THIS 375 00:14:14,640 --> 00:14:16,280 EXPERIENCE OF BEING EXCLUDED 376 00:14:16,280 --> 00:14:19,520 CONTRIBUTED TO THEIR FEELINGS OF 377 00:14:19,520 --> 00:14:21,560 LOW SELF-ESTEEM. 378 00:14:21,560 --> 00:14:23,120 LASTLY, THEY REPORTED DRINKING 379 00:14:23,120 --> 00:14:28,120 TO COPE WITH THESE FEELINGS. 380 00:14:28,120 --> 00:14:29,960 SO THIS FINDING, FEELING 381 00:14:29,960 --> 00:14:32,080 MARGINALIZED AND DRINKING TO 382 00:14:32,080 --> 00:14:33,400 MINIMIZE FEELINGS OF STIGMA GET 383 00:14:33,400 --> 00:14:34,800 QUALITATIVE EVIDENCE THAT PEOPLE 384 00:14:34,800 --> 00:14:36,880 INTERNALIZE STIGMA AND THAT IT 385 00:14:36,880 --> 00:14:38,720 MANIFESTS AFTER THE DRINKING. 386 00:14:38,720 --> 00:14:41,720 SO, I BEGAN TO THINK OF THE CAMI 387 00:14:41,720 --> 00:14:45,480 AS A STIGMA LITIGATION WHICH 388 00:14:45,480 --> 00:14:47,000 POSSIBLY WORKS BECAUSE IT 389 00:14:47,000 --> 00:14:49,200 DECOUPLED THE FEELING OF LOW 390 00:14:49,200 --> 00:14:53,640 SELF-ESTEEM FROM BEING 391 00:14:53,640 --> 00:14:55,880 DISCRIMINATED AGAINST. 392 00:14:55,880 --> 00:14:56,800 THERE'S ESTABLISHED EVIDENCE, 393 00:14:56,800 --> 00:14:58,160 DOCUMENT ASSOCIATIONS WITH 394 00:14:58,160 --> 00:15:00,480 RACIAL DISCRIMINATION AND SIGMA 395 00:15:00,480 --> 00:15:02,720 AND SUBSIDIARY STANCE MISUSE 396 00:15:02,720 --> 00:15:03,440 AMONG MARGINALIZED GROUPS, 397 00:15:03,440 --> 00:15:05,400 INCLUDING PEOPLE OF COLOR, THE 398 00:15:05,400 --> 00:15:09,480 REFERENCES ON THE SLIDE ARE 399 00:15:09,480 --> 00:15:11,160 SPECIFIC TO [INDISCERNIBLE], FOR 400 00:15:11,160 --> 00:15:12,440 EXAMPLE, STUDIES HAVE 401 00:15:12,440 --> 00:15:13,600 ESTABLISHED THAT THESE 402 00:15:13,600 --> 00:15:15,320 EXPERIENCES INCREASE THE ODDS OF 403 00:15:15,320 --> 00:15:18,000 ALCOHOL AND DRUG USE DISORDERS. 404 00:15:18,000 --> 00:15:20,400 OTHER STUDIES HAVE DOCUMENTED 405 00:15:20,400 --> 00:15:23,080 THAT THEY CONTRIBUTE TO 406 00:15:23,080 --> 00:15:23,760 INCREASED PSYCHOLOGICAL DISTRESS 407 00:15:23,760 --> 00:15:27,320 AND EVEN TO DEPTHS OF DESPAIR. 408 00:15:27,320 --> 00:15:29,480 THE HYPOTHESIZED MECHANISM IS 409 00:15:29,480 --> 00:15:31,960 THAT EXPERIENCES WITH STIGMA AND 410 00:15:31,960 --> 00:15:34,520 DISCRIMINATION ERODE, PROTECTIVE 411 00:15:34,520 --> 00:15:38,640 RESOURCES SUCH AS A SENSE OF 412 00:15:38,640 --> 00:15:38,960 SELF-EFFICACY. 413 00:15:38,960 --> 00:15:43,280 A STUDY DONE BY DR. COMAS-DIAS 414 00:15:43,280 --> 00:15:45,800 ALSO NOTE THAD INTERNALIZED 415 00:15:45,800 --> 00:15:47,280 OPPRESSION RESULT INDEED A 416 00:15:47,280 --> 00:15:49,520 DECREASED SENSE OF SELF-WORTH 417 00:15:49,520 --> 00:15:51,000 AND DECREASED SENSE OF 418 00:15:51,000 --> 00:15:51,280 MOTIVATION. 419 00:15:51,280 --> 00:15:53,120 SO WHILE WE SET OUT TO ADDRESS 420 00:15:53,120 --> 00:15:54,640 EXPERIENCES RELATED TO 421 00:15:54,640 --> 00:15:55,800 IMMIGRATION AND ACULTERATION AS 422 00:15:55,800 --> 00:15:57,880 RISK FACTORS FOR UNHEALTHY 423 00:15:57,880 --> 00:15:59,960 DRINKING, WE WERE ALSO 424 00:15:59,960 --> 00:16:01,560 ADDRESSING DISCRIMINATION AND 425 00:16:01,560 --> 00:16:04,320 THE EFFECTS BEING STIGMATIZED. 426 00:16:04,320 --> 00:16:06,400 SO THE QUESTION WAS COULD WE 427 00:16:06,400 --> 00:16:08,800 REVERSE THE ASSOCIATION BETWEEN 428 00:16:08,800 --> 00:16:09,720 STIGMA, DISCRIMINATION AND 429 00:16:09,720 --> 00:16:12,880 SUBSTANCE USE AND ALCOHOL USE IN 430 00:16:12,880 --> 00:16:16,480 AIAN CULTURALLY ADAPTED 431 00:16:16,480 --> 00:16:17,640 MOTIVATIONAL INTERVENING? 432 00:16:17,640 --> 00:16:20,520 MANY OF YOU I'M SURE ARE 433 00:16:20,520 --> 00:16:22,400 FAMILIAR WITH MI, SO I WILL 434 00:16:22,400 --> 00:16:23,080 REVIEW THIS QUICKLY. 435 00:16:23,080 --> 00:16:28,080 TO THE LEFT YOU SEE THE KEY MI 436 00:16:28,080 --> 00:16:30,040 ACTIVE TREATMENT INGREDIENTS 437 00:16:30,040 --> 00:16:32,040 THAT INCLUDE AUTONOMY AND 438 00:16:32,040 --> 00:16:36,040 TECHNICAL MI ELEMENTS SUCH AS 439 00:16:36,040 --> 00:16:36,800 ABILITY TO REFLECT. 440 00:16:36,800 --> 00:16:39,920 IF MI IS PERFORMED AS INTENDED, 441 00:16:39,920 --> 00:16:44,080 IT AFFECTS THE MEDIATORS IN THE 442 00:16:44,080 --> 00:16:45,960 SKETCHER BOX, SUCH AS CHANGE 443 00:16:45,960 --> 00:16:48,360 TALK OR STATEMENTS ABOUT CHANGE 444 00:16:48,360 --> 00:16:51,120 WHICH IS A MORE WELL RESEARCH 445 00:16:51,120 --> 00:16:51,800 MEDIATOR THAN SELF-EXPLORATION 446 00:16:51,800 --> 00:16:54,960 WHICH IS A FOCUS OF OUR CURRENT 447 00:16:54,960 --> 00:16:55,200 WORK. 448 00:16:55,200 --> 00:17:00,320 AND THEN THESE ARE ON SUPPOSED 449 00:17:00,320 --> 00:17:01,200 TO IMPACT OUTCOMES. 450 00:17:01,200 --> 00:17:03,120 MI WAS DEVELOPED FOR PEOPLE IN 451 00:17:03,120 --> 00:17:04,960 TREATMENT FOR ALCOHOL USE 452 00:17:04,960 --> 00:17:05,920 DISORDERS SO IT'S NOT SURPRISING 453 00:17:05,920 --> 00:17:08,200 THAT IT HAS A STRONGER EFFECT 454 00:17:08,200 --> 00:17:09,960 SIZE FOR ALCOHOL THAN FOR OTHER 455 00:17:09,960 --> 00:17:11,280 DRUGS TO USE. 456 00:17:11,280 --> 00:17:15,040 MI IS TYPICALLY USED AS ADJUNCT 457 00:17:15,040 --> 00:17:16,800 TREATMENT LIKES CONTINGENCY 458 00:17:16,800 --> 00:17:17,080 MANAGEMENT. 459 00:17:17,080 --> 00:17:20,000 IT'S ALSO BELIEVED THAT IT WORKS 460 00:17:20,000 --> 00:17:21,520 WELL WITH RACIAL ETHNIC 461 00:17:21,520 --> 00:17:22,360 MINORITIZED INDIVIDUALS BECAUSE 462 00:17:22,360 --> 00:17:26,320 OF ITS FOCUS ON AUTONOMY, AND 463 00:17:26,320 --> 00:17:26,920 EVOCATION, IT'S PRESUMED THAT 464 00:17:26,920 --> 00:17:28,800 INDIVIDUAL WHO IS HAVE BEEN 465 00:17:28,800 --> 00:17:34,560 OPPRESSED ARE NOT USINGED TO 466 00:17:34,560 --> 00:17:36,480 HAVING THE OUTPATIENT SETTING TO 467 00:17:36,480 --> 00:17:37,840 EXPRESS THEIR AUTONOMY. 468 00:17:37,840 --> 00:17:39,600 BUT THE FINDINGS FOR MI FOR 469 00:17:39,600 --> 00:17:56,000 PEOPLE OF COLOR ARE NOT AS CLEAR 470 00:17:56,000 --> 00:17:56,240 CUT. 471 00:17:56,240 --> 00:17:58,280 REPORTED INCREASE IN DRUG USES 472 00:17:58,280 --> 00:18:00,280 COMPARED TO TREATMENT AS USUAL. 473 00:18:00,280 --> 00:18:02,000 IN DISCUSSING THE NEGATIVE 474 00:18:02,000 --> 00:18:04,200 EFFECTS OF MI FOR BLACK PEOPLE, 475 00:18:04,200 --> 00:18:05,160 THE AUTHOR SUGGEST THAD 476 00:18:05,160 --> 00:18:07,560 CULTURALLY ASHES DATA 477 00:18:07,560 --> 00:18:08,480 PROTECTIONED MI MIGHT IMPROVE 478 00:18:08,480 --> 00:18:09,120 EFFECTS AND THERE'S SOME 479 00:18:09,120 --> 00:18:11,400 EVIDENCE FOR THIS IN THE 2000 480 00:18:11,400 --> 00:18:17,120 STUDY DONE BY DOUGLAS AND 481 00:18:17,120 --> 00:18:18,680 [INDISCERNIBLE] IN A SECOND 482 00:18:18,680 --> 00:18:20,640 STUDY CHINESE PATIENTS WERE 483 00:18:20,640 --> 00:18:21,480 TREATED WITH CARDIOVASCULAR 484 00:18:21,480 --> 00:18:23,280 DISEASE REPORTED INN CREASES IN 485 00:18:23,280 --> 00:18:24,600 ANXIETY AFTER RECEIVING MI 486 00:18:24,600 --> 00:18:27,080 COMPARED TO TREATMENT AS USUAL 487 00:18:27,080 --> 00:18:32,440 TO HAVE SEEN THOSE POSITIONS. 488 00:18:32,440 --> 00:18:34,760 SO HOW DID THE ADAPT MI, WE 489 00:18:34,760 --> 00:18:37,480 FOLLOWED THE PRINCIPLES OF 490 00:18:37,480 --> 00:18:40,360 ADAPTATION, DESCRIBED BY DR. LAU 491 00:18:40,360 --> 00:18:40,760 IN 2006. 492 00:18:40,760 --> 00:18:45,480 SO THE FIRST PART IS TO IN 493 00:18:45,480 --> 00:18:46,680 ADAPTING TREATMENT TO PRESERVE 494 00:18:46,680 --> 00:18:47,720 THE ACTIVE TREATMENT INGREDIENTS 495 00:18:47,720 --> 00:18:49,720 AND IF NEEDED TO ADD TREATMENT 496 00:18:49,720 --> 00:18:51,480 COMPONENTS THAT ARE SPECIFIC TO 497 00:18:51,480 --> 00:18:55,480 THE UNIQUE RISK FACTORS. 498 00:18:55,480 --> 00:18:57,120 WE ADDED A COMPONENT DISCUSSING 499 00:18:57,120 --> 00:18:59,240 EXPERIENCES OF STIGMA AND 500 00:18:59,240 --> 00:19:00,680 DISCRIMINATION, IN THE 501 00:19:00,680 --> 00:19:02,240 INTERVENTION AND THEY ALSO 502 00:19:02,240 --> 00:19:05,280 INCLUDED INFORMATION ON HEALTH 503 00:19:05,280 --> 00:19:08,040 DISPARITIES, SPECIFIC TO LATIN 504 00:19:08,040 --> 00:19:10,440 Xs, WELL AZIZZ INFORMATION ON 505 00:19:10,440 --> 00:19:12,720 ETHNIC NORMS SPECIFIC TO ALCOHOL 506 00:19:12,720 --> 00:19:14,160 USE OR LATIN X'S. 507 00:19:14,160 --> 00:19:16,040 RESULTS OF THE OPEN SERIES 508 00:19:16,040 --> 00:19:18,440 TRIAL, WHICH WAS REPORTED IN 509 00:19:18,440 --> 00:19:21,160 2011 INDICATED HIGH LEVELS OF 510 00:19:21,160 --> 00:19:23,040 SATISFACTION AND THAT THE 511 00:19:23,040 --> 00:19:24,600 TREATMENT GREETS WERE RETAINED. 512 00:19:24,600 --> 00:19:26,880 WE THEN COMPLETED A SMALL 513 00:19:26,880 --> 00:19:28,440 CLINICAL TRIAL REPORT INDEED 514 00:19:28,440 --> 00:19:34,640 2013, WHICH INDICATED THAT THE 515 00:19:34,640 --> 00:19:37,000 CAMI OUTPERFORM THE MI. 516 00:19:37,000 --> 00:19:38,680 IN 2012, WE WERE FORTUNATE TO 517 00:19:38,680 --> 00:19:42,520 RECEIVE FUNDING TO CONDUCT A 518 00:19:42,520 --> 00:19:43,000 LARGE CLINICAL TRIAL. 519 00:19:43,000 --> 00:19:44,920 A STRENGTH OF THIS STUDY WAS THE 520 00:19:44,920 --> 00:19:46,600 GOLD STANDARD DESIGN, TESTING 521 00:19:46,600 --> 00:19:49,400 THE CULTURALLY ADAPTED MI, 522 00:19:49,400 --> 00:19:50,840 AGAINST MI ITSELF. 523 00:19:50,840 --> 00:19:52,680 SO RANDOMIZATION IS IMPORTANT 524 00:19:52,680 --> 00:19:54,880 BECAUSE THEN IT PERMITS CAUSAL 525 00:19:54,880 --> 00:19:55,800 INFERENCES, MEANING THAT ANY 526 00:19:55,800 --> 00:19:57,240 DIFFERENCES BETWEEN THE GROUPS 527 00:19:57,240 --> 00:20:00,880 ARE DUE TO THE TREATMENT. 528 00:20:00,880 --> 00:20:05,080 THE CAMI WAS 75 MINUTE SESSION, 529 00:20:05,080 --> 00:20:06,600 THE DESCRIPTION OF THE CONTENT 530 00:20:06,600 --> 00:20:08,960 IS HERE AT THE TABLE, AND THIS 531 00:20:08,960 --> 00:20:10,880 SESSION AVERAGED ABOUT 75 532 00:20:10,880 --> 00:20:11,160 MINUTES. 533 00:20:11,160 --> 00:20:13,720 WE USED A THEY--THE KRETERAL 534 00:20:13,720 --> 00:20:15,000 FRAMEWORK FOR ADAPTATION PUBLISH 535 00:20:15,000 --> 00:20:20,360 INDEED 2016 TO UNDERSTAND HOW 536 00:20:20,360 --> 00:20:21,520 THIS TREATMENT MIGHT WORK. 537 00:20:21,520 --> 00:20:24,440 I'M GOING TO FOCUS ON 1 538 00:20:24,440 --> 00:20:26,960 PARTICULAR ADAPTATION TEACHING A 539 00:20:26,960 --> 00:20:30,120 STUDY THERAPIST ABOUT HOW TO 540 00:20:30,120 --> 00:20:33,280 TALK ABOUT SIGMA IN A YAWN 541 00:20:33,280 --> 00:20:34,320 JUDGMENT AND COLLABORATIVE 542 00:20:34,320 --> 00:20:34,880 CONSTRUCTIVE ENVIRONMENT. 543 00:20:34,880 --> 00:20:40,680 BECAUSE I THINK THIS IS THE MOST 544 00:20:40,680 --> 00:20:41,280 PERINENT STIGMA INTERVENTION. 545 00:20:41,280 --> 00:20:42,880 JUST A FEW NOTES, SURPRISINGLY 546 00:20:42,880 --> 00:20:45,920 LITTLE IS KNOWN ABOUT HOW TO 547 00:20:45,920 --> 00:20:47,040 DISCUSS DISCRIMINATION IN A 548 00:20:47,040 --> 00:20:47,440 CLINICAL CONTEXT. 549 00:20:47,440 --> 00:20:49,080 I THINK THERE ARE SEVERAL 550 00:20:49,080 --> 00:20:49,760 REASONS FOR THIS. 551 00:20:49,760 --> 00:20:51,280 CLIENTS OR PATIENTS MAY NOT WANT 552 00:20:51,280 --> 00:20:53,680 TO REPORT SOMETHING OUT OF 553 00:20:53,680 --> 00:20:55,920 EMBARRASSMENT, THEY MAY NOT FEEL 554 00:20:55,920 --> 00:20:57,560 COMFORTABLE RAISING THESE ISSUES 555 00:20:57,560 --> 00:21:00,360 WITH THEIR COUNSELOR, THEY MAY 556 00:21:00,360 --> 00:21:01,080 PERCEIVE DISCRIMINATORY AND 557 00:21:01,080 --> 00:21:02,520 PERHAPS TO OTHER PEOPLE BUT NOT 558 00:21:02,520 --> 00:21:03,000 TO THEMSELVES. 559 00:21:03,000 --> 00:21:06,160 THIS IS KNOWN AS PERSONAL GROUP 560 00:21:06,160 --> 00:21:07,680 DISCREPANCY OR THEY MAY NOT 561 00:21:07,680 --> 00:21:11,000 PERCEIVE THEMSELVES AS BEING 562 00:21:11,000 --> 00:21:11,280 RACIALIZED. 563 00:21:11,280 --> 00:21:13,560 THEY CAN ALSO BE MOTIVATIONAL 564 00:21:13,560 --> 00:21:14,760 AMBIGUITY IN OTHER WORDS, PEOPLE 565 00:21:14,760 --> 00:21:19,280 MAY NOT BE ABLE TO SEE A CLEAR 566 00:21:19,280 --> 00:21:21,080 RACE BASED MOTIVES AND THAT'S 567 00:21:21,080 --> 00:21:22,800 HIGHLY LIKELY BECAUSE WE LIVE IN 568 00:21:22,800 --> 00:21:25,440 A RACE NEUTRAL SOCIETY WHERE THE 569 00:21:25,440 --> 00:21:30,120 EFFECTS OF RACES ARE PRESENT BUT 570 00:21:30,120 --> 00:21:33,000 RACE IS RARELY INDICATED. 571 00:21:33,000 --> 00:21:34,440 ALSO LOW MOTIVATION, PEOPLE 572 00:21:34,440 --> 00:21:34,960 REALLY TRIBUTE THAT TO THE 573 00:21:34,960 --> 00:21:36,880 CENTER FOR EXCELLENCE ON AGINGS 574 00:21:36,880 --> 00:21:38,120 OF BEING STIGMATIZED BECAUSE 575 00:21:38,120 --> 00:21:41,000 MAYBE THEY'RE NOT AWARE OR THEY 576 00:21:41,000 --> 00:21:42,280 DON'T MAKE THAT ASSOCIATION 577 00:21:42,280 --> 00:21:42,600 THEMSELVES. 578 00:21:42,600 --> 00:21:45,120 AT THE SAME TIME, SOCIAL 579 00:21:45,120 --> 00:21:46,600 PSYCHOLOGY RESEARCHERS HAS SHOWN 580 00:21:46,600 --> 00:21:50,840 THAT TALKING ABOUT THESE EVENTS 581 00:21:50,840 --> 00:21:51,560 INFERS PSYCHOLOGICAL AND 582 00:21:51,560 --> 00:21:54,080 PHYSICAL PEN FITS SUCH AS 583 00:21:54,080 --> 00:21:56,480 LOWERED BLOOD PRESSURE OR 584 00:21:56,480 --> 00:21:58,240 DECREASED [INDISCERNIBLE] AND 585 00:21:58,240 --> 00:21:59,000 DECREASED REGRET. 586 00:21:59,000 --> 00:22:00,400 FURTHER MORE NOT TALKING ABOUT 587 00:22:00,400 --> 00:22:02,640 THESE THINGS HAS BEEN ASSOCIATE 588 00:22:02,640 --> 00:22:04,880 WIDE INCREASED PSYCHOLOGICAL 589 00:22:04,880 --> 00:22:07,840 DISTRESS AS WELL AS DETRIMENTS 590 00:22:07,840 --> 00:22:08,200 IN PERFORMANCE. 591 00:22:08,200 --> 00:22:10,680 SO WHAT DID THIS LOOK LIKE? 592 00:22:10,680 --> 00:22:13,240 IN THE CAMI, THE PARTICIPANTS 593 00:22:13,240 --> 00:22:14,280 COMPLETED BASE LINE ASSESSMENT 594 00:22:14,280 --> 00:22:15,520 THAT ASKED QUESTIONS THAT 595 00:22:15,520 --> 00:22:17,120 INCLUDED QUESTIONS ABOUT 596 00:22:17,120 --> 00:22:18,120 EXPERIENCES OF DISCRIMINATION, 597 00:22:18,120 --> 00:22:19,680 AND STRESSORS RELATED TO 598 00:22:19,680 --> 00:22:21,560 IMMIGRATION STATUS. 599 00:22:21,560 --> 00:22:24,080 HERE'S AN EXAMPLE OF PEOPLE 600 00:22:24,080 --> 00:22:25,680 DISLIKE ME BECAUSE I'M HISPANIC. 601 00:22:25,680 --> 00:22:28,480 WE THEN ASKED WHETHER THE EVENT 602 00:22:28,480 --> 00:22:29,960 PROMPTED THEIR DRINKING OR IF 603 00:22:29,960 --> 00:22:32,600 THEY HAD A THOUGHT ABOUT HAVING 604 00:22:32,600 --> 00:22:38,000 A DRINK AFTER SUCH AN EVENT. 605 00:22:38,000 --> 00:22:40,400 AND THIS IS HOW THEY ASKED, 606 00:22:40,400 --> 00:22:42,360 PLEASE CLICK THE CENTER BOX 607 00:22:42,360 --> 00:22:44,000 HERE, AGAIN, USING THE ITEM 608 00:22:44,000 --> 00:22:47,200 EXAMPLE FROM THE PRIOR SLIDE, 609 00:22:47,200 --> 00:22:48,920 STUDY THERAPISTS WERE TO SAY, 610 00:22:48,920 --> 00:22:50,000 PEOPLE TRAINED FOR DIFFERENT 611 00:22:50,000 --> 00:23:04,800 REASONS, HAVE YOU TOLD US--AFTER 612 00:23:04,800 --> 00:23:06,080 A DISCUSSION, THE CLIENTS ARE 613 00:23:06,080 --> 00:23:07,800 ASKED TO SHARE WHEN THEY HAD 614 00:23:07,800 --> 00:23:09,720 EXPECTED FROM DRINKING ALCOHOL 615 00:23:09,720 --> 00:23:11,000 OR DRINKING ALCOHOL EXPECTANCYS 616 00:23:11,000 --> 00:23:13,640 AND THEN AFTER GETTING 617 00:23:13,640 --> 00:23:14,600 PERMISSION FROM THE 618 00:23:14,600 --> 00:23:16,000 [INDISCERNIBLE], THE STUDY 619 00:23:16,000 --> 00:23:17,120 THERAPISTS OFFERED INFORMATION 620 00:23:17,120 --> 00:23:19,200 OF THE ACTUAL ALCOHOL FOR 621 00:23:19,200 --> 00:23:20,960 EXAMPLE, THAT DRINKING MAKES 1 622 00:23:20,960 --> 00:23:22,280 FEEL MORE DEPRESSED AND THEN 623 00:23:22,280 --> 00:23:23,480 FREE RADICALS FRAME THE 624 00:23:23,480 --> 00:23:24,720 SITUATION AND THE EMERGENCIES, 625 00:23:24,720 --> 00:23:26,520 BUT TO ME THE MOST IMPORTANT 626 00:23:26,520 --> 00:23:32,080 PART WAS THAT WE WERE TALK ABOUT 627 00:23:32,080 --> 00:23:34,040 EVENTS AND INTRODUCE THE IDEA 628 00:23:34,040 --> 00:23:35,760 THAT THEIR RESPONSE WHICH WAS 629 00:23:35,760 --> 00:23:37,040 HEAVY DRINKING WAS NOT AS 630 00:23:37,040 --> 00:23:40,880 HELPFUL TO THEM AS THEY HAD 631 00:23:40,880 --> 00:23:42,080 ORIGINALLY THOUGHT. 632 00:23:42,080 --> 00:23:44,080 SO TO TO THE RESULTS. 633 00:23:44,080 --> 00:23:45,200 HERE'S A CONSORT AND THE MAIN 634 00:23:45,200 --> 00:23:47,040 STUDY AIMS OF THE LARGER TRIAL, 635 00:23:47,040 --> 00:23:50,960 WE ARE CRUITED ABOUT 296 PEOPLE 636 00:23:50,960 --> 00:24:00,240 AND ABOUT HALF WERE THE CAMI AND 637 00:24:00,240 --> 00:24:01,960 HALF WERE TEST DISCRIMINATION. 638 00:24:01,960 --> 00:24:05,760 YOU CAN SEE THE SECOND AIM WAS 639 00:24:05,760 --> 00:24:07,280 TO TEST DISCRIMINATION AS A 640 00:24:07,280 --> 00:24:08,360 TREATMENT MODERATOR. 641 00:24:08,360 --> 00:24:09,200 THE ENGAGEMENT RESPONSE WAS 642 00:24:09,200 --> 00:24:09,480 POSITIVE. 643 00:24:09,480 --> 00:24:12,240 WE WERE ABLE TO RECRUIT UP TO 644 00:24:12,240 --> 00:24:13,880 20% MORE WITHIN THE SAME STUDY 645 00:24:13,880 --> 00:24:16,920 TIME PERIOD, AND WE HAD UP TO 646 00:24:16,920 --> 00:24:19,640 80% RETENTION RATES, OVER 12 647 00:24:19,640 --> 00:24:23,720 MONTHS AFTER THE INTER INTERVENTION 648 00:24:23,720 --> 00:24:24,920 WAS DELIVERED. 649 00:24:24,920 --> 00:24:28,600 HERE ARE THE PARTICIPANTS. 650 00:24:28,600 --> 00:24:30,280 DESPITE LIVING IN THE UNITED 651 00:24:30,280 --> 00:24:32,880 STATES FOR OVER 20 YEARS ON 652 00:24:32,880 --> 00:24:33,760 AVERAGE, EVIDENCE INDICATES THEY 653 00:24:33,760 --> 00:24:35,200 WERE NOT WELL INTEGRATED INTO 654 00:24:35,200 --> 00:24:36,200 SOCIETY. 655 00:24:36,200 --> 00:24:38,160 FOR EXAMPLE, ABOUT 60% WERE 656 00:24:38,160 --> 00:24:42,200 UNEMPLOYED IN THE AVERAGE INCOME 657 00:24:42,200 --> 00:24:44,120 WAS ABOUT 15,000 A YEAR. 658 00:24:44,120 --> 00:24:45,600 SIXTY% WERE FROM THE CARIBBEAN 659 00:24:45,600 --> 00:24:47,840 AND THIS IS CONSISTENT WITH 660 00:24:47,840 --> 00:24:50,880 DEMOGRAPHIC ESTIMATES YOU KNOW 661 00:24:50,880 --> 00:24:54,040 AT VIEWING NORTHEAST, MOST UP TO 662 00:24:54,040 --> 00:24:54,680 90% EXPERIENCED DISCRIMINATION, 663 00:24:54,680 --> 00:24:56,840 THIS IS A SAMPLE WITH A SERIES 664 00:24:56,840 --> 00:25:02,040 CLINICAL PROFILE AS INDICATED BY 665 00:25:02,040 --> 00:25:04,120 MEAN SPORT FOR ANXIETY AND 666 00:25:04,120 --> 00:25:05,880 DEPRESSION THAT WERE ABOVE THE 667 00:25:05,880 --> 00:25:07,280 CLINICAL CUT POINTS AND ALSO THE 668 00:25:07,280 --> 00:25:08,600 MEAN AUDIT SCORE WAS OVER 16 669 00:25:08,600 --> 00:25:10,600 INDICATING THAT ON AVERAGE OUR 670 00:25:10,600 --> 00:25:18,400 PARTICIPANTS STRUGGLED WITH 671 00:25:18,400 --> 00:25:19,400 ALCOHOL USE DISORDER. 672 00:25:19,400 --> 00:25:21,520 FOR THE SAKE OF TIME I WILL 673 00:25:21,520 --> 00:25:23,320 FOCUS ON ON 1 OUTCOME. 674 00:25:23,320 --> 00:25:25,680 YOU CAN SEE THE TIME POINTS FROM 675 00:25:25,680 --> 00:25:27,320 BASE LINE OF 12 MONTHS READING 676 00:25:27,320 --> 00:25:29,480 LEFT TO RIGHT AND CAMI AND 677 00:25:29,480 --> 00:25:30,880 REPRESENTED IN THE BOLD LINE. 678 00:25:30,880 --> 00:25:34,080 SO AS YOU SEE HERE THERE WAS 679 00:25:34,080 --> 00:25:35,680 SIGNIFICANT DECLINES IN BOTH 680 00:25:35,680 --> 00:25:38,400 CONDITIONS FROM BASE LINE TO 12 681 00:25:38,400 --> 00:25:41,280 MONTHS WITH CAMI TRENDING LOWER 682 00:25:41,280 --> 00:25:42,080 AT EACH TIME POINT. 683 00:25:42,080 --> 00:25:44,400 BUT THERE WERE NO SIGNIFICANT 684 00:25:44,400 --> 00:25:47,160 DIFFERENCES BETWEEN THEM 685 00:25:47,160 --> 00:25:47,560 OVERTIME. 686 00:25:47,560 --> 00:25:50,320 WE THEN LOOKEDDA THE IMPACT OF 687 00:25:50,320 --> 00:25:51,840 THE MODERATOR DISCRIMINATION IN 688 00:25:51,840 --> 00:25:53,480 THE 2 STUDIES IN THIS FIRST 689 00:25:53,480 --> 00:25:54,880 STUDY, WE LOOKED AT THE IMPACT 690 00:25:54,880 --> 00:25:57,480 OF THE MODERATOR ON THE PRIMARY 691 00:25:57,480 --> 00:25:59,520 OUTCOME, AND THE OUTCOME ON THE 692 00:25:59,520 --> 00:26:00,120 NEGATIVE CONSEQUENCES ISSUES 693 00:26:00,120 --> 00:26:02,200 BECAUSE WE ARE INTERESTED TO SEE 694 00:26:02,200 --> 00:26:06,240 IF OUR APPROACH, WE CHECKED 695 00:26:06,240 --> 00:26:07,160 TARGETED DISCRIMINATION STIGMA, 696 00:26:07,160 --> 00:26:07,760 HAD DIFFERENT [INDISCERNIBLE] 697 00:26:07,760 --> 00:26:10,120 FOR PEOPLE AND HIGHER AND LOWER 698 00:26:10,120 --> 00:26:11,880 LEVELS OF DISCRIMINATION AND IN 699 00:26:11,880 --> 00:26:12,680 OUR MODERATION ANALYSIS, WE 700 00:26:12,680 --> 00:26:15,880 FOUND THAT AMONG INDIVIDUALS 701 00:26:15,880 --> 00:26:17,600 WITH HIGHER--WHO REPORTED HIGHER 702 00:26:17,600 --> 00:26:20,000 LEVELS OF DISCRIMINATION AT BASE 703 00:26:20,000 --> 00:26:23,280 LINE, THOSE WHO RECEIVED THE 704 00:26:23,280 --> 00:26:25,680 CAMI INTERVENTION REPORTED 705 00:26:25,680 --> 00:26:26,720 SIGNIFICANTLY FEWER ALCOHOL 706 00:26:26,720 --> 00:26:27,760 CONSEQUENCES AT 3 MONTHS 707 00:26:27,760 --> 00:26:29,880 COMPARED TO THOSE WHO RECEIVED 708 00:26:29,880 --> 00:26:31,120 AN ADAPTIVE MI. 709 00:26:31,120 --> 00:26:33,600 WE DID NOT FIND THESE EFFECTS ON 710 00:26:33,600 --> 00:26:36,680 THESE PURCHASES AS HIGHER OR 711 00:26:36,680 --> 00:26:40,440 LOWER LEVELS OF HAD 712 00:26:40,440 --> 00:26:40,800 DISCRIMINATION. 713 00:26:40,800 --> 00:26:42,480 IN THIS SECOND STUDY, BECAUSE WE 714 00:26:42,480 --> 00:26:44,440 HAD SEEN AN UNEXPECTED 715 00:26:44,440 --> 00:26:46,360 SIGNIFICANT DECLINED IN THE CAMI 716 00:26:46,360 --> 00:26:47,600 GROUP AND DEPRESSIVE SYMPTOMS, 717 00:26:47,600 --> 00:26:51,080 FROM BASE LINE TO 12 MONTHS AND 718 00:26:51,080 --> 00:26:53,000 GUIDED BY THEORETICAL MODELS OF 719 00:26:53,000 --> 00:26:54,920 MINORITY STRESS WHICH POSITED 720 00:26:54,920 --> 00:26:56,920 THAT EXPERIENCE OF STIGMA AND 721 00:26:56,920 --> 00:26:59,360 DISCRIMINATION, ALSO CONTRIBUTED 722 00:26:59,360 --> 00:27:01,560 TO INCREASED PSYCHOLOGICAL 723 00:27:01,560 --> 00:27:02,360 DESTRESS. 724 00:27:02,360 --> 00:27:03,680 WE HYPOTHESIZED THAT 725 00:27:03,680 --> 00:27:04,280 DISCRIMINATION WOULD MODERATE 726 00:27:04,280 --> 00:27:05,560 THE EFFECTS OF TREATMENT ON 727 00:27:05,560 --> 00:27:05,880 DEPRESSION. 728 00:27:05,880 --> 00:27:09,560 SO AS CAN YOU SEE ON THIS GRAPH 729 00:27:09,560 --> 00:27:11,080 BOTH CONDITIONS AGAIN 730 00:27:11,080 --> 00:27:12,080 DEMONSTRATED SIGNIFICANTLY LOWER 731 00:27:12,080 --> 00:27:14,360 LEVELS OF DEPRESSIVE SYMPTOMS, 732 00:27:14,360 --> 00:27:17,640 AT 6 AND 12 MONTHS COMPARED TO 733 00:27:17,640 --> 00:27:19,680 BISE LINE AFTER CONTROLLING THE 734 00:27:19,680 --> 00:27:24,640 GENDER, PLACE OF BIRTH, 735 00:27:24,640 --> 00:27:25,120 HOUSEHOLD INCOME, 736 00:27:25,120 --> 00:27:26,080 DISCRIMINATION, ACULTERATION AND 737 00:27:26,080 --> 00:27:26,680 AGE. 738 00:27:26,680 --> 00:27:29,680 AND THIS REPORTED SIGNIFICANTLY 739 00:27:29,680 --> 00:27:30,960 FEWER DEPRESSIVE SYMPTOMS 740 00:27:30,960 --> 00:27:32,560 COMPARED TO MI PARTICIPANTS AT 741 00:27:32,560 --> 00:27:33,120 12 MONTHS. 742 00:27:33,120 --> 00:27:36,440 SO THE TAKE AWAY FROM THE PAST 2 743 00:27:36,440 --> 00:27:39,200 STUDIES IS THAT FOR THOSE 744 00:27:39,200 --> 00:27:40,120 EXPERIENCING HIGH DISCRIMINATION 745 00:27:40,120 --> 00:27:42,960 WHO RECEIVED THE CAMI, THERE WAS 746 00:27:42,960 --> 00:27:44,040 SIGNIFICANT REDUCTIONS IN 747 00:27:44,040 --> 00:27:45,400 ALCOHOL RELATED PROBLEMS AT 3 748 00:27:45,400 --> 00:27:47,680 MONTHS AND REFRESESSED SYMPTOMS 749 00:27:47,680 --> 00:27:49,520 AT 12 MONTHS. 750 00:27:49,520 --> 00:27:51,160 SO I WILL PAUSE HERE AND REFLECT 751 00:27:51,160 --> 00:27:52,280 ON WHAT THIS MEANS. 752 00:27:52,280 --> 00:27:54,120 FIRST OF ALL WE WERE NOT VERY 753 00:27:54,120 --> 00:27:56,360 SURPRISED AT THE LACK OF 754 00:27:56,360 --> 00:27:58,320 TREATMENT BECAUSE OF THE RIGOR 755 00:27:58,320 --> 00:27:58,960 OF THE CARRIER. 756 00:27:58,960 --> 00:28:14,360 NOT ONLY WAS IT MI ITSELF BUT 757 00:28:14,360 --> 00:28:15,720 THE--ANSWER THE QUESTION FOR 758 00:28:15,720 --> 00:28:17,800 WHOM DOES TREATMENT WORK BEST. 759 00:28:17,800 --> 00:28:19,880 THIRDLY, ANOTHER QUESTION TO ASK 760 00:28:19,880 --> 00:28:22,520 IS WHAT ARE THE MECHANISMS 761 00:28:22,520 --> 00:28:24,960 THROUGH WHICH ADAPTATION WORKS, 762 00:28:24,960 --> 00:28:26,040 CURRENTLY WE'RE INVESTIGATING 763 00:28:26,040 --> 00:28:28,280 SELF-EXPLORATION WHICH IS A KEY 764 00:28:28,280 --> 00:28:28,960 OUTCOME FOR PSYCHOTHERAPY AND 765 00:28:28,960 --> 00:28:31,280 WHICH IS ALSO VIEWED AS A 766 00:28:31,280 --> 00:28:33,800 NECESSARY ANTISEEDENT TO KEEP 767 00:28:33,800 --> 00:28:38,320 THE CHANGE AS A POTENTIAL 768 00:28:38,320 --> 00:28:38,600 MECHANISM. 769 00:28:38,600 --> 00:28:40,520 WITH REGARDS TO WORK TO DATE 770 00:28:40,520 --> 00:28:41,480 CONTRIBUTING TO UNDERSTANDING 771 00:28:41,480 --> 00:28:42,560 HOW INTERVENTIONS MIGHT BE USED 772 00:28:42,560 --> 00:28:44,480 TO MITIGATE THE EFFECTS OF 773 00:28:44,480 --> 00:28:47,120 DISKRIM NATION AND STIGMA, I 774 00:28:47,120 --> 00:28:49,840 THINK THE CAMI AND CASMI SHOWS 775 00:28:49,840 --> 00:28:51,080 THAT WE MUST CREATE THE SPACE 776 00:28:51,080 --> 00:28:52,400 FOR PEOPLE TO TALK ABOUT 777 00:28:52,400 --> 00:28:53,880 EXPERIENCES THAT MAY BE 778 00:28:53,880 --> 00:28:55,280 CHALLENGING FOR THE COMMISSION 779 00:28:55,280 --> 00:28:55,960 AS WELL. 780 00:28:55,960 --> 00:28:57,920 SECOND, OUR STUDY GIVES SOME 781 00:28:57,920 --> 00:29:01,480 INSTRUCTION ON HOW TO HAVE THESE 782 00:29:01,480 --> 00:29:02,880 CONVERSATIONS ABOUT SENSITIVE 783 00:29:02,880 --> 00:29:03,680 TOPICS. 784 00:29:03,680 --> 00:29:04,880 IN OUR EXPECTANCY CHALLENGE WE 785 00:29:04,880 --> 00:29:07,640 SOUGHT TO MITIGATE THE EFFECTS 786 00:29:07,640 --> 00:29:08,880 OF DISCRIMINATION BY DISRUPTING 787 00:29:08,880 --> 00:29:10,080 THE LINK BETWEEN STRESS AND 788 00:29:10,080 --> 00:29:11,360 HEAVY DRINKING AND OTHER PARTS 789 00:29:11,360 --> 00:29:12,360 OF THE INTERVENTION IS THOUGHT 790 00:29:12,360 --> 00:29:14,520 TO PROMOTE SELF-EFFICACY. 791 00:29:14,520 --> 00:29:16,120 SO GOING BACK TO THE 792 00:29:16,120 --> 00:29:21,680 LAST SECOND STUDY, THIS WAS 793 00:29:21,680 --> 00:29:23,880 CULTURALLY ADAPTED MET AND SBCM, 794 00:29:23,880 --> 00:29:26,920 AND THE CONTROL CONDITION WAS 795 00:29:26,920 --> 00:29:28,720 THE NIAAA PASMMENT RETHINKING 796 00:29:28,720 --> 00:29:30,200 DRINKING. 797 00:29:30,200 --> 00:29:32,400 MY COMMENTS ARE KIND OF 798 00:29:32,400 --> 00:29:33,680 RESTRICTED TO THE MET BECAUSE 799 00:29:33,680 --> 00:29:35,240 THAT IS WHAT I SUPERVISED PEOPLE 800 00:29:35,240 --> 00:29:37,000 ON, THIS WAS CONDUCTED DURING 801 00:29:37,000 --> 00:29:39,200 COVID SO WE HAD TO GO FROM 802 00:29:39,200 --> 00:29:40,960 IN-PERSON TO PHONE BASED 803 00:29:40,960 --> 00:29:42,040 DELIVERY BUT WHAT REALLY STRUCK 804 00:29:42,040 --> 00:29:45,680 ME IN LISTENING TO THE COMMUNITY 805 00:29:45,680 --> 00:29:46,960 HEALTH WORKER SYSTEM JUST WHAT A 806 00:29:46,960 --> 00:29:49,280 LIFE LINE THEY WERE TO THE 807 00:29:49,280 --> 00:29:49,920 PARTIC PLAN TO ANALYZE BY AGES, 808 00:29:49,920 --> 00:29:52,160 MANY OF WHOM WERE REALLY HIGH 809 00:29:52,160 --> 00:29:53,600 RISK AND VERY VULNERABLE AND 810 00:29:53,600 --> 00:29:57,320 MANY OF THEM WERE UNDOCUMENTED. 811 00:29:57,320 --> 00:29:58,440 SO GETTING RIGHT TO THE RESULTS 812 00:29:58,440 --> 00:30:04,880 OF HERE IS A PICTURE OF THE 813 00:30:04,880 --> 00:30:06,400 OKAY--I DON'T KNOW IT'S 814 00:30:06,400 --> 00:30:07,240 NOT--OKAY, GREAT. 815 00:30:07,240 --> 00:30:09,200 OF THE INTENT TO TREAT ANALYSIS. 816 00:30:09,200 --> 00:30:13,280 YOU CAN SEE SIGNIFICANT DECLINES 817 00:30:13,280 --> 00:30:13,880 FAVORING THE INTERVENTION 818 00:30:13,880 --> 00:30:15,760 CONDITION IN RED, ON THE 819 00:30:15,760 --> 00:30:17,720 OUTCOMES, AVERAGE DRINKS PER 820 00:30:17,720 --> 00:30:20,760 WEEK, PERCENT HEAVY DRINKING 821 00:30:20,760 --> 00:30:24,160 DAYS AND AMOUNT OF CONSEQUENCES 822 00:30:24,160 --> 00:30:24,440 AT WEEK 26. 823 00:30:24,440 --> 00:30:27,040 AND THIS IS ADJUSTED FOR AGE, 824 00:30:27,040 --> 00:30:30,680 GENDER, EMPLOYMENT STATUS AND 825 00:30:30,680 --> 00:30:31,280 DEPRESSION, CO-MORBIDITIES, 826 00:30:31,280 --> 00:30:32,120 SELF-REPORTED ALCOHOL PROBLEMS 827 00:30:32,120 --> 00:30:35,160 AT BASE LINE AUDIT SCORES. 828 00:30:35,160 --> 00:30:36,160 HERE'S ANOTHER INTERESTING 829 00:30:36,160 --> 00:30:37,960 FINDING, WE THEN LOOKED AT 830 00:30:37,960 --> 00:30:39,400 DIFFERENCES IN TREATMENT 831 00:30:39,400 --> 00:30:45,680 OUTCOMES BY DELIVERY TYPE. 832 00:30:45,680 --> 00:30:46,800 THIS SLIDE SHOWS--DIDN'T SEEM TO 833 00:30:46,800 --> 00:30:47,040 MATTER. 834 00:30:47,040 --> 00:30:49,560 YOU CAN SEE AGAIN THE IN-PERSON 835 00:30:49,560 --> 00:30:51,800 MET, THE GREEN IS PHONE 836 00:30:51,800 --> 00:30:53,680 DELIVERED MET, BOTH OUTPERFORMED 837 00:30:53,680 --> 00:30:54,640 THE CONTROL CONDITION. 838 00:30:54,640 --> 00:30:56,440 SECONDLY, THE PHONE SEEMED TO 839 00:30:56,440 --> 00:30:57,840 HAVE EVEN GREATER IMPACT 840 00:30:57,840 --> 00:31:02,000 ALTHOUGH, THIS COMPARISON IS NOT 841 00:31:02,000 --> 00:31:02,320 SIGNIFICANT. 842 00:31:02,320 --> 00:31:05,400 IN TALKING ABOUT THE IMPACT ON 843 00:31:05,400 --> 00:31:07,280 THE STUDY, AFTER IT ENDED ON 844 00:31:07,280 --> 00:31:09,640 PARTICIPANTS AFTER THE STUDY 845 00:31:09,640 --> 00:31:11,600 ENDED, THE COMMUNITY HEALTH 846 00:31:11,600 --> 00:31:12,800 WORKERS NOTED THAT PARTICIPANTS 847 00:31:12,800 --> 00:31:14,800 HAD A VERY POSITIVE RESPONSE AS 848 00:31:14,800 --> 00:31:17,640 YOU SEE IN THIS QUOTE. 849 00:31:17,640 --> 00:31:20,480 WE ALSO TALKED A LOT ABOUT HOW 850 00:31:20,480 --> 00:31:23,400 THE COMMUNITY HEALTH WORKERS 851 00:31:23,400 --> 00:31:26,000 WERE CULTURALLY ADAPTED TO 852 00:31:26,000 --> 00:31:26,800 TREATMENT DURING SUPERVISION. 853 00:31:26,800 --> 00:31:28,920 WE TALKED A LOT ABOUT THE 854 00:31:28,920 --> 00:31:30,040 CULTURAL VALUE OF RESILIENCE, 855 00:31:30,040 --> 00:31:32,040 YOU CANY - A SAMPLE REFLECTION 856 00:31:32,040 --> 00:31:33,960 OF THE EXPWM ITED ARES AS THE 857 00:31:33,960 --> 00:31:35,280 TRANSLATION IS, I SEE YOU ARE 858 00:31:35,280 --> 00:31:36,880 VERY STRONG AND HAVE ENDURED A 859 00:31:36,880 --> 00:31:38,560 LOT AND HAVE SURVIVED. 860 00:31:38,560 --> 00:31:42,600 BUT I DO THINK THAT IT OVER 861 00:31:42,600 --> 00:31:44,640 EMPHASIS AND RESILIENCE CAN BE A 862 00:31:44,640 --> 00:31:46,160 DOUBLED EDGED SWORD BECAUSE IT 863 00:31:46,160 --> 00:31:48,680 CAN TURN INTO SELF-BLAME AND THE 864 00:31:48,680 --> 00:31:50,320 REFUSAL TO SEEK HELP. 865 00:31:50,320 --> 00:31:53,200 SO IN OUR SESSIONS WE HAVE TO 866 00:31:53,200 --> 00:31:55,400 BALANCE THAT SELF-A LIAISONNANCE 867 00:31:55,400 --> 00:31:57,480 AGAINST RAISING AWARENESS FOR 868 00:31:57,480 --> 00:32:10,200 OTHER EXTERNAL FACT ORS THAT 869 00:32:10,200 --> 00:32:11,840 COULD INCLUDE--CHWs AND 870 00:32:11,840 --> 00:32:14,600 PREPARE THAT AGAINST CHW 871 00:32:14,600 --> 00:32:16,560 DELIVERY OF INTEGRATED WRAP 872 00:32:16,560 --> 00:32:17,280 AROUND PRIMARY CARE INTERVENTION 873 00:32:17,280 --> 00:32:20,040 AND WE'RE ALSO TRYING TO 874 00:32:20,040 --> 00:32:22,880 UNDERSTAND THE PROCESS OF 875 00:32:22,880 --> 00:32:23,400 IMPLEMENTATION. 876 00:32:23,400 --> 00:32:26,320 SO IN CLOSING, I WOULD SAY THAT 877 00:32:26,320 --> 00:32:28,720 IN A RECENT KEEPER, IT WAS 878 00:32:28,720 --> 00:32:30,320 IDENTIFIED AS 1 OF THE FEW 879 00:32:30,320 --> 00:32:32,400 STUDIES TO INVESTIGATE STIGMA AS 880 00:32:32,400 --> 00:32:35,240 A KEY MODERATOR, WE WOULD 881 00:32:35,240 --> 00:32:36,880 SUGGEST USING A SCREENING 882 00:32:36,880 --> 00:32:39,760 QUESTION ON DISCRIMINATION OR 883 00:32:39,760 --> 00:32:43,760 STIGMA TO BE PART OF THE AUK 884 00:32:43,760 --> 00:32:46,000 INTERVENTION FOR LATIN X'S AND 885 00:32:46,000 --> 00:32:54,480 WE ALSO HOPE THAT THE GROUPS 886 00:32:54,480 --> 00:32:57,880 WERE STUDYING, WILL HAVE RESULTS 887 00:32:57,880 --> 00:32:59,600 FOR THEIR TESTS. 888 00:32:59,600 --> 00:33:02,400 SOME OF THEIR SELECTED QUOTES 889 00:33:02,400 --> 00:33:05,760 LISTED HERE, ECHO SOME THINGS 890 00:33:05,760 --> 00:33:12,520 IDENTIFIED IN THE CASMI. 891 00:33:12,520 --> 00:33:14,040 AND I WANT TO FINALLY CLOSE BY 892 00:33:14,040 --> 00:33:16,880 SAYING THAT I CAN HAVE AN IDEA 893 00:33:16,880 --> 00:33:18,600 BUT IT REALLY TAKES OTHER PEOPLE 894 00:33:18,600 --> 00:33:20,080 WITH THEIR WISDOM TO HELP 895 00:33:20,080 --> 00:33:22,920 UNDERSTAND AND TO HAVE INSIGHTS 896 00:33:22,920 --> 00:33:24,240 ABOUT THIS APPROACH AND I'M 897 00:33:24,240 --> 00:33:26,800 REALLY HAPPY THAT THE CASMI 898 00:33:26,800 --> 00:33:27,720 PROJECTS HAVE GIVEN 899 00:33:27,720 --> 00:33:29,440 OPPORTUNITIES TO ENGAGE IN 900 00:33:29,440 --> 00:33:31,720 RESEARCH WHICH HELPED PEOPLE 901 00:33:31,720 --> 00:33:34,040 PROFESSIONALLY AND PERSONALLY 902 00:33:34,040 --> 00:33:34,560 AND ACADEMICALLY. 903 00:33:34,560 --> 00:33:36,120 IT'S MY GREAT PLEASURE TO 904 00:33:36,120 --> 00:33:42,600 INTRODUCE MY FIRST COLLEAGUE, 905 00:33:42,600 --> 00:33:43,800 ROBERTO CAM ARENA, WHO IS I HAD 906 00:33:43,800 --> 00:33:45,200 THE PRIVATE SECTOR EDGE OF 907 00:33:45,200 --> 00:33:47,240 COLLABORATING WITH IN THE STUDY, 908 00:33:47,240 --> 00:33:49,800 I LEARNED SO MUCH IN OUR 909 00:33:49,800 --> 00:33:50,960 SESSIONS AND HIS REFLECTIONS 910 00:33:50,960 --> 00:33:53,160 ABOUT HOW THIS WORK CONNECTS TO 911 00:33:53,160 --> 00:33:57,040 THE BROADER PICTURE WHICH IS TO 912 00:33:57,040 --> 00:33:58,960 IMPROVE IMMIGRANT HEALTH. 913 00:33:58,960 --> 00:33:59,920 THANK YOU. 914 00:33:59,920 --> 00:34:01,560 >> THANK YOU CHRISTINA AND I 915 00:34:01,560 --> 00:34:03,800 WILL SAY THAT, YOU KNOW AS 916 00:34:03,800 --> 00:34:04,760 SOMEBODY WHO PARTICIPATED VERY 917 00:34:04,760 --> 00:34:08,240 EARLY ON IN THE CAMI 918 00:34:08,240 --> 00:34:08,800 INTERVENTION, IT WAS--IT'S 919 00:34:08,800 --> 00:34:10,880 REALLY NICE TO BE ABLE TO SEE 920 00:34:10,880 --> 00:34:12,920 HOW A LOT OF THE THINGS THAT 921 00:34:12,920 --> 00:34:15,120 FELT INTUITIVE OR THAT I WAS 922 00:34:15,120 --> 00:34:18,200 SEEING IN MY REP WITH THE FOLKS 923 00:34:18,200 --> 00:34:23,000 THAT I WAS ENGAGING WITH, ARE 924 00:34:23,000 --> 00:34:24,200 REALLY NOW EVIDENCE-BASED AND I 925 00:34:24,200 --> 00:34:26,760 SEE IT IN A CONCRETE WAY THAT 926 00:34:26,760 --> 00:34:28,240 REALLY SUPPORTS THESE FEELINGS 927 00:34:28,240 --> 00:34:29,680 THAT WE HAVE, THAT I THINK A LOT 928 00:34:29,680 --> 00:34:31,800 OF TIMES WHEN WE'RE IMPLEMENTING 929 00:34:31,800 --> 00:34:34,000 THESE KINDS OF STRATEGIES IN A 930 00:34:34,000 --> 00:34:34,840 COMMUNITY BASED SETTING WE HAVE 931 00:34:34,840 --> 00:34:36,240 AN IDEA THAT THINGS ARE MOVING 932 00:34:36,240 --> 00:34:37,560 FORWARD AND WE KIND OF GET A 933 00:34:37,560 --> 00:34:39,400 SENSE OF WHAT WORKS AND WHAT 934 00:34:39,400 --> 00:34:40,680 DOESN'T WORK, BUT IT'S REALLY 935 00:34:40,680 --> 00:34:42,600 NICE TO SEE THIS BEING NOW IN 936 00:34:42,600 --> 00:34:43,640 THE EVIDENCE-BASED APPROACH THAT 937 00:34:43,640 --> 00:34:44,760 KIND OF CONFIRMS AND WE CAN FIND 938 00:34:44,760 --> 00:34:47,240 OF TAKE IT ON WITH A BIT MORE 939 00:34:47,240 --> 00:34:47,560 CONFIDENCE. 940 00:34:47,560 --> 00:34:49,320 I WOULD LIKE TO TALK A BIT ABOUT 941 00:34:49,320 --> 00:34:50,840 WHAT CHRISTINA WAS MENTIONING IN 942 00:34:50,840 --> 00:34:53,520 TERMS OF THE ISOLATION WHICH WAS 943 00:34:53,520 --> 00:34:56,000 REALLY 1 OF THE KEY THINGS THAT 944 00:34:56,000 --> 00:34:59,080 I SAW WHEN WORKING WITH PEOPLE 945 00:34:59,080 --> 00:35:01,000 IS HOW THEIR EXPERIENCE AS THE 946 00:35:01,000 --> 00:35:03,120 LATIN X PERSON AND 947 00:35:03,120 --> 00:35:05,320 ERESPONSIBLELY AS AN IMMIGRANT 948 00:35:05,320 --> 00:35:06,800 REALLY DROVE DISCONNECTION AND 949 00:35:06,800 --> 00:35:11,000 THE ISOLATION FROM A LOT OF 950 00:35:11,000 --> 00:35:12,040 THEIR SUPPORTS AND HOW THE 951 00:35:12,040 --> 00:35:14,600 ABILITY TO HAVE THE CAMI STUDY 952 00:35:14,600 --> 00:35:16,000 TO PUT THAT FRONT AND STUDY SO 953 00:35:16,000 --> 00:35:18,120 THAT PEOPLE CAN MAKE CONNECTIONS 954 00:35:18,120 --> 00:35:20,720 WAS REALLY INSTRUMENTAL IN 955 00:35:20,720 --> 00:35:23,560 MAKING THE INTERVENTION 956 00:35:23,560 --> 00:35:24,240 EFFECTIVE. 957 00:35:24,240 --> 00:35:26,560 WHAT PEOPLE WERE--THE STUDY WAS 958 00:35:26,560 --> 00:35:33,240 IN BOSTON AND SO FOR EXAMPLE, 959 00:35:33,240 --> 00:35:33,920 DURING THE SNOWPOCOLYSE, THERE 960 00:35:33,920 --> 00:35:36,520 WAS A LOT OF ISOLATION WHERE YOU 961 00:35:36,520 --> 00:35:37,720 WOULDN'T HAVE CONTACT WITH 962 00:35:37,720 --> 00:35:39,000 PEOPLE IN YOUR SURROUNDINGS AND 963 00:35:39,000 --> 00:35:40,160 WE SEE THAT IN THE WINTER 964 00:35:40,160 --> 00:35:41,440 WEATHER OR TIME WHEN PEOPLE 965 00:35:41,440 --> 00:35:42,640 COULDN'T ENGAGE IN SOCCER 966 00:35:42,640 --> 00:35:44,040 PRACTICE OR DO THINK THEY WOULD 967 00:35:44,040 --> 00:35:46,280 NORMALLY BE OUT IN A PARK, A LOT 968 00:35:46,280 --> 00:35:49,680 OF TIMES THEY TURN TO ALCOHOL TO 969 00:35:49,680 --> 00:35:51,480 BE ABLE SUPPLEMENT WHAT WAS A 970 00:35:51,480 --> 00:35:51,920 LACK OF CONNECTION. 971 00:35:51,920 --> 00:35:53,440 SO THE STUDY WAS AN ABILITY FOR 972 00:35:53,440 --> 00:35:55,080 UTION TO BE ABLE TO PUT THAT ON 973 00:35:55,080 --> 00:35:56,720 THE TABLE AND EXPLORE THAT WITH 974 00:35:56,720 --> 00:35:57,800 PEOPLE GIVEN THE OPPORTUNITY TO 975 00:35:57,800 --> 00:36:01,640 SEE IF THERE IS OR ISN'T 976 00:36:01,640 --> 00:36:04,040 CONNECTIONS IN A VERY WELCOMING 977 00:36:04,040 --> 00:36:06,440 WAY THAT WASN'T JUDGMENTAL AND 978 00:36:06,440 --> 00:36:07,560 THAT REALLY WAS JUST ALLOWED 979 00:36:07,560 --> 00:36:09,400 PEOPLE TO UNDERSTAND WHAT THAT 980 00:36:09,400 --> 00:36:14,120 WAS LIKE, PARTICULARLY FOR THE 981 00:36:14,120 --> 00:36:15,200 IMMIGRANT PERSON WHO WAS SEVERE 982 00:36:15,200 --> 00:36:16,720 MITRALLERRING OR AT THE VERY 983 00:36:16,720 --> 00:36:18,680 LEAST REALLY MORPHING THEIR 984 00:36:18,680 --> 00:36:21,960 CONNECTIONS FROM THEIR COUNTRY 985 00:36:21,960 --> 00:36:23,360 OF ORIGIN, WHAT IS IT LIKE FOR 986 00:36:23,360 --> 00:36:26,240 THEM TO NOT BE ABLE TO HAVE THE 987 00:36:26,240 --> 00:36:28,000 SAME ACCESS OR SAME RELATIONSHIP 988 00:36:28,000 --> 00:36:29,120 WITH NEIGHBORS OR FRIENDS AND 989 00:36:29,120 --> 00:36:32,000 THE INSTITUTIONS THEY WERE 990 00:36:32,000 --> 00:36:32,560 PREVIOUSLY CONNECT WIDE? 991 00:36:32,560 --> 00:36:34,000 WHAT'S IT LIKE TO HAVE THIS 992 00:36:34,000 --> 00:36:37,800 ISOLATION IN TERMS OF CULTURAL 993 00:36:37,800 --> 00:36:40,120 AND LANGUAGE KIND OF DISTANCES 994 00:36:40,120 --> 00:36:43,240 AND GAPS WHERE IT'S NOT REALLY 995 00:36:43,240 --> 00:36:43,920 POSSIBLE TO NAVIGATE THE WORLD 996 00:36:43,920 --> 00:36:45,640 IN THE SAME WAY AND DOES THAT 997 00:36:45,640 --> 00:36:47,320 MEAN FOR YOU AND HOW YOU'RE 998 00:36:47,320 --> 00:36:48,640 PERCEIVED AND WHAT YOU FEEL, A 999 00:36:48,640 --> 00:36:53,480 LOT OF TIMES WHAT WE WOULD TALK 1000 00:36:53,480 --> 00:36:57,600 ABOUT WAS THIS GAP WOULD EXIST 1001 00:36:57,600 --> 00:36:59,120 AND HOW ALCOHOL WAS REALLY 1002 00:36:59,120 --> 00:37:01,240 SOMETHING TO HELP PEOPLE COPE 1003 00:37:01,240 --> 00:37:02,320 WITH THIS DISCONNECTION, WITH 1004 00:37:02,320 --> 00:37:06,560 THE ISOLATION THAT THEY WERE 1005 00:37:06,560 --> 00:37:19,320 FEELING AND IMPLEMENTING BOTH 1006 00:37:19,320 --> 00:37:20,400 THE CULTURALLY--ELEMENT OF THE 1007 00:37:20,400 --> 00:37:21,240 INTERVENTION WAS A REALLY 1008 00:37:21,240 --> 00:37:22,480 EFFECTIVE WAY OF HAVING PEOPLE 1009 00:37:22,480 --> 00:37:25,840 BE ABLE TO BRING IT UP TO BE 1010 00:37:25,840 --> 00:37:30,640 ABLE TO ADDRESS THINGS, MAKE 1011 00:37:30,640 --> 00:37:31,440 CONNECTIONS THAT WEREN'T REALLY 1012 00:37:31,440 --> 00:37:32,840 THERE FOR THEM BUT MAYBE 1013 00:37:32,840 --> 00:37:34,720 SOMETHING THAT WAS MORE OF A GUT 1014 00:37:34,720 --> 00:37:36,160 FEELING WAS NOT EXPLICITLY 1015 00:37:36,160 --> 00:37:39,680 STATED SO THE DESIGN OF THE 1016 00:37:39,680 --> 00:37:44,000 STUDY WHICH INCORPORATED 1017 00:37:44,000 --> 00:37:44,720 CULTURAL ELEMENTS PURPOSEFULLY 1018 00:37:44,720 --> 00:37:45,360 THROUGHOUT THE CONVERSATION WAS 1019 00:37:45,360 --> 00:37:48,520 A VERY NICE WAY TO WELCOME 1020 00:37:48,520 --> 00:37:50,680 PEOPLE INTO EXPLORING HOW THEIR 1021 00:37:50,680 --> 00:37:51,960 ALCOHOL BEHAVIOR DOES OR DOES 1022 00:37:51,960 --> 00:37:56,920 NOT DRIVE SOME OF THE ALCOHOL 1023 00:37:56,920 --> 00:37:57,440 COMSUMPTION WHEN CHRISTINA 1024 00:37:57,440 --> 00:38:00,280 POINTED OUT IN THE STUDY OF, YOU 1025 00:38:00,280 --> 00:38:03,800 KNOW THIS EVENT LED YOU TO 1026 00:38:03,800 --> 00:38:06,640 DRINK, WELL, LET'S EXPLORE THAT. 1027 00:38:06,640 --> 00:38:08,280 LET'S TALK ABOUT THAT. 1028 00:38:08,280 --> 00:38:09,320 THOSE WERE HELPFUL DESIGN 1029 00:38:09,320 --> 00:38:10,920 CHOICES THAT ALLOWED PEOPLE TO 1030 00:38:10,920 --> 00:38:12,000 FEEL MORE COMFORTABLE IN THE 1031 00:38:12,000 --> 00:38:15,280 SESSION, FEEL LIKE THERE'S A 1032 00:38:15,280 --> 00:38:16,680 CONCERN FOR YOUR CULTURAL 1033 00:38:16,680 --> 00:38:22,200 IDENTITY AND HOW THAT INFORMS 1034 00:38:22,200 --> 00:38:26,000 WHO YOU ARE AND IF REALLY HELPED 1035 00:38:26,000 --> 00:38:29,400 PEOPLE BY SAYING, I KNOW THAT, 1036 00:38:29,400 --> 00:38:31,800 YOU KNOW LIFE IS FAR MORE 1037 00:38:31,800 --> 00:38:33,120 COMPLEX THAN IT MIGHT SEEM AND 1038 00:38:33,120 --> 00:38:36,440 SO LET'S KIND OF LEAN INTO THOSE 1039 00:38:36,440 --> 00:38:37,840 COMPLEXITIES PLUS, EXPLORE THEM 1040 00:38:37,840 --> 00:38:39,240 TOGETHER, BE ABLE TO HAVE A 1041 00:38:39,240 --> 00:38:41,760 CONVERSATION ABOUT HOW THAT 1042 00:38:41,760 --> 00:38:43,040 RELATES TO YOUR LIFE GOALS AND 1043 00:38:43,040 --> 00:38:45,520 HOW THAT RELATES TO ALCOHOL 1044 00:38:45,520 --> 00:38:45,920 COMSUMPTION. 1045 00:38:45,920 --> 00:38:47,920 THOSE THINGS WERE REALLY HELPFUL 1046 00:38:47,920 --> 00:38:49,560 PART OF THE DESIGN INTERVENTION 1047 00:38:49,560 --> 00:38:53,000 AND I'M DPLAD TO SEE THAT IT'S 1048 00:38:53,000 --> 00:38:54,920 SUPPORTED THROUGH THE EVIDENCE. 1049 00:38:54,920 --> 00:38:56,560 WITH THAT, I WILL PASS IT OVER 1050 00:38:56,560 --> 00:38:57,680 TO MY COLLEAGUE VICTOR WHO WILL 1051 00:38:57,680 --> 00:39:00,560 BE SHARING MORE ABOUT HIS 1052 00:39:00,560 --> 00:39:04,080 EXPERIENCE IN THE DESIGN. 1053 00:39:04,080 --> 00:39:08,000 >> GOOD AFTERNOON, EVERYONE 1054 00:39:08,000 --> 00:39:09,400 I'M DR. FIGUEREO, I HAVE THE 1055 00:39:09,400 --> 00:39:12,160 PRIVILEGE OF WORKING WITH 1056 00:39:12,160 --> 00:39:14,520 DR. CHRISTINA LEE WITH THE CASMI 1057 00:39:14,520 --> 00:39:15,800 PROJECT AS A CODER. 1058 00:39:15,800 --> 00:39:18,160 I'VE BEEN LISTENING TO TAPES 1059 00:39:18,160 --> 00:39:20,920 BETWEEN THERAPISTS AND CLIENTS 1060 00:39:20,920 --> 00:39:22,520 CODING THERAPIST CHARACTERISTICS 1061 00:39:22,520 --> 00:39:23,600 AND DIFFERENT DIMENSIONS OF 1062 00:39:23,600 --> 00:39:24,960 CLIENT ENGAGEMENT SO I'M HAPPY 1063 00:39:24,960 --> 00:39:29,080 TO BE HERE IN THIS WEBINAR TO 1064 00:39:29,080 --> 00:39:30,560 BRIEFLY SHARE MY OBSERVATIONS AS 1065 00:39:30,560 --> 00:39:31,840 A CODER. 1066 00:39:31,840 --> 00:39:34,120 SO TO BEGIN, I WILL BE 1067 00:39:34,120 --> 00:39:36,040 CONTEXTUALIZING JUST A BIT OF 1068 00:39:36,040 --> 00:39:39,160 THE IMPORTANCE OF THE ROLE OF 1069 00:39:39,160 --> 00:39:39,720 DISCRIMINATION, FOLLOWED BY 1070 00:39:39,720 --> 00:39:41,880 SHARING AGAIN SOME OF MY 1071 00:39:41,880 --> 00:39:47,280 OBSERVATIONS AS A CODER. 1072 00:39:47,280 --> 00:39:49,600 SO FROM BOTH MY PERSONAL LIFE, 1073 00:39:49,600 --> 00:39:51,160 CLINICAL PRACTICE AND RESEARCH, 1074 00:39:51,160 --> 00:39:52,640 I'VE LEARNED THAT DISCRIMINATION 1075 00:39:52,640 --> 00:39:53,960 IS UNFORTUNATELY PART OF THE 1076 00:39:53,960 --> 00:39:55,480 LIVED EXPERIENCES OF THAT NEXT 1077 00:39:55,480 --> 00:39:57,320 INDIVIDUAL'S IN THE UNITED 1078 00:39:57,320 --> 00:39:57,960 STATES. 1079 00:39:57,960 --> 00:40:00,520 DUE TO SYSTEMIC OPPRESSION SUCH 1080 00:40:00,520 --> 00:40:11,760 AS STRUCTURAL RACISM, COLORSISM, 1081 00:40:11,760 --> 00:40:13,760 ETHNOSENT RISM, XENOPHOBIA, 1082 00:40:13,760 --> 00:40:15,480 HOMOPHOBIA, BASED ON MINORITY 1083 00:40:15,480 --> 00:40:17,880 STRESS THEORY AND 1084 00:40:17,880 --> 00:40:19,280 INTERSECTIONALITY INTERSECTING 1085 00:40:19,280 --> 00:40:21,360 SIGMA WORSENS FOR LATIN X 1086 00:40:21,360 --> 00:40:23,720 INDIVIDUALS LIVINGA THE 1087 00:40:23,720 --> 00:40:24,760 INTERSENSIONS OF STIGMATIZED 1088 00:40:24,760 --> 00:40:25,360 IDENTITIES, AND EXPERIENCING 1089 00:40:25,360 --> 00:40:28,240 THESE IN MANY AREAS OF THE THEIR 1090 00:40:28,240 --> 00:40:30,000 LIVES INCLUDING HEALTHCARE AND 1091 00:40:30,000 --> 00:40:31,360 WORKPLACE SETTINGS. 1092 00:40:31,360 --> 00:40:32,840 IT'S BECAUSE THESE SYSTEMIC 1093 00:40:32,840 --> 00:40:35,760 FORMING OF APREGZ, IT'S BECAUSE 1094 00:40:35,760 --> 00:40:38,480 THEY INTERSECT AND INTERLOCK AND 1095 00:40:38,480 --> 00:40:40,360 WORK TOGETHER THAT THERE IS 1096 00:40:40,360 --> 00:40:41,520 MINORITY STRESS AND 1097 00:40:41,520 --> 00:40:43,120 INTERSECTIONALITY REALLY HELP US 1098 00:40:43,120 --> 00:40:46,240 TO UNDERSTAND THE ADDITIONAL 1099 00:40:46,240 --> 00:40:48,680 BURDENED THAT LATIN X'S WHO LIVE 1100 00:40:48,680 --> 00:40:52,480 AT THE INTERSECTIONS OF MULTIPLE 1101 00:40:52,480 --> 00:40:53,200 STIGMATIZED IDENTITIES, THE 1102 00:40:53,200 --> 00:40:54,840 BURDEN THAT THE ADDITIONAL 1103 00:40:54,840 --> 00:40:59,680 BURDENS THEY BEAR, FOR EXAMPLE, 1104 00:40:59,680 --> 00:41:02,600 AFRO-LATIN Xs, TRANSGENDER 1105 00:41:02,600 --> 00:41:02,960 LATIN X'S. 1106 00:41:02,960 --> 00:41:06,560 AND FOR THOSE OF US WHO 1107 00:41:06,560 --> 00:41:08,600 UNDERSTAND OR FOR THOSE OF US 1108 00:41:08,600 --> 00:41:10,000 WHO ARE FAMILIAR WITH THE 1109 00:41:10,000 --> 00:41:12,280 RESEARCH ON ALCOHOL AND DRINKING 1110 00:41:12,280 --> 00:41:13,760 KNOW THE LINKS BETWEEN STRESS 1111 00:41:13,760 --> 00:41:14,840 AND DRINKING. 1112 00:41:14,840 --> 00:41:15,880 WE KNOW THAT DISCRIMINATION CAN 1113 00:41:15,880 --> 00:41:17,560 LEAD TO STRESS AND THAT DRINKING 1114 00:41:17,560 --> 00:41:19,320 CAN BE A COPING STRATEGY TO DEAL 1115 00:41:19,320 --> 00:41:22,960 WITH THE EFFECTS OF HAD-DEAL 1116 00:41:22,960 --> 00:41:25,160 WITH EVENTS OF DISCRIMINATION 1117 00:41:25,160 --> 00:41:26,800 AND THE BURDENS THEY LEAVE. 1118 00:41:26,800 --> 00:41:29,920 THIS IS WHY ROOTS SO CRUCIAL TO 1119 00:41:29,920 --> 00:41:32,120 AGAIN FOR DISCRIMINATION TO BE 1120 00:41:32,120 --> 00:41:34,000 BE A CENTRAL ASPECT OF THIS 1121 00:41:34,000 --> 00:41:34,360 PROJECT. 1122 00:41:34,360 --> 00:41:39,920 AND SO, AS A CODER, MY 1123 00:41:39,920 --> 00:41:41,920 OBSERVATIONS, I NOTED THAT CASMI 1124 00:41:41,920 --> 00:41:43,960 DOES HAVE THE POTENTIAL TO--DOES 1125 00:41:43,960 --> 00:41:45,760 PROVIDE SPACE FOR LATIN X FOLKS 1126 00:41:45,760 --> 00:42:00,920 TO DISCUSS EXPERIENCES OF 1127 00:42:00,920 --> 00:42:04,160 DISCRIMINATION. 1128 00:42:04,160 --> 00:42:05,680 --I'VE NOTED THAT THAT 1 OTHER 1129 00:42:05,680 --> 00:42:08,680 THING THAT COME UP IS FOR 1130 00:42:08,680 --> 00:42:10,000 PARTICIPANTS, THEM TALK ABOUT 1131 00:42:10,000 --> 00:42:12,240 THE PRESSURE OF BEING 1132 00:42:12,240 --> 00:42:12,560 AMERICANIZED. 1133 00:42:12,560 --> 00:42:15,600 AND SO WHEN ASKED ABOUT GOALS, 1134 00:42:15,600 --> 00:42:17,160 OR STRESSORS, SOME PARTICIPANTS 1135 00:42:17,160 --> 00:42:18,440 REFERRED TO AND TALKED ABOUT 1136 00:42:18,440 --> 00:42:20,760 HAVING TO LEARN ENGLISH OR 1137 00:42:20,760 --> 00:42:22,040 LEARNING ENGLISH THAT BEING 1138 00:42:22,040 --> 00:42:25,720 CRUCIAL IN ORDER TO IMPROVE 1139 00:42:25,720 --> 00:42:26,680 THEIR SOCIOECONOMIC STATUS AND 1140 00:42:26,680 --> 00:42:27,960 POSITIONING, SO THEY DON'T HAVE 1141 00:42:27,960 --> 00:42:32,720 TO WORK MULTIPLE JOBS. 1142 00:42:32,720 --> 00:42:34,640 AND THE PRESSURE TO LEARN 1143 00:42:34,640 --> 00:42:36,760 ENGLISH IS A REFLECTIVE OF THE 1144 00:42:36,760 --> 00:42:40,160 STRUCTURAL BARRIERS THAT SPANISH 1145 00:42:40,160 --> 00:42:41,520 SPEAKING FAMILIES FACE IN ORDER 1146 00:42:41,520 --> 00:42:44,160 TO ACCESS MORE LIFE 1147 00:42:44,160 --> 00:42:44,480 OPPORTUNITIES. 1148 00:42:44,480 --> 00:42:49,360 ANOTHER EXAMPLE, I'VE NOTED FROM 1149 00:42:49,360 --> 00:42:50,400 OBSERVATIONS ARE--WERE WHEN 1150 00:42:50,400 --> 00:42:51,360 PARTICIPANTS WOULD TALK ABOUT, 1151 00:42:51,360 --> 00:42:55,240 THERE'S 1 IN PARTICULAR I WOULD 1152 00:42:55,240 --> 00:42:56,960 SHARE, HAVING TO HIDE THEIR 1153 00:42:56,960 --> 00:42:59,760 HERITAGE WHEN THEY LIVED AROUND 1154 00:42:59,760 --> 00:43:04,360 FEWER LATIN X FOLKS IN FEAR OF 1155 00:43:04,360 --> 00:43:06,720 BEING OTHERRED OR DISCRIMINATED 1156 00:43:06,720 --> 00:43:06,920 AGAIN. 1157 00:43:06,920 --> 00:43:09,960 AND SO FOR THIS, THEY SEE AS A 1158 00:43:09,960 --> 00:43:12,000 MORE INTERNALIZED FORM OF 1159 00:43:12,000 --> 00:43:13,760 OPPRESSION OF DISCRIMINATION TO 1160 00:43:13,760 --> 00:43:17,400 HAVE TO ACTIVELY HIDE AND TO 1161 00:43:17,400 --> 00:43:19,200 FEEL THAT YOUR CULTURE AND 1162 00:43:19,200 --> 00:43:22,720 HERITAGE IS NOT ACCEPTED IN YOUR 1163 00:43:22,720 --> 00:43:25,840 OWN NEIGHBORHOOD OR ENVIRONMENT 1164 00:43:25,840 --> 00:43:26,880 OR COMMUNITY. 1165 00:43:26,880 --> 00:43:29,640 OTHER EXAMPLES FROM OBSERVATIONS 1166 00:43:29,640 --> 00:43:31,120 INCLUDE PARTICIPANTS DISCUSSING 1167 00:43:31,120 --> 00:43:32,360 AND BEING DISCRIMINATED AGAINST 1168 00:43:32,360 --> 00:43:35,280 BY OTHER LATIN X FOLKS FROM 1169 00:43:35,280 --> 00:43:39,400 THESE COMMUNITIES, FOR EXAMPLE, 1170 00:43:39,400 --> 00:43:43,560 YOU PUERTO RICANS ARE TOO LOUD. 1171 00:43:43,560 --> 00:43:44,520 SO THIS MAKES THIS EXAMPLE AND 1172 00:43:44,520 --> 00:43:51,000 THE REST OF THEM CANs LED TO 1173 00:43:51,000 --> 00:43:52,800 AS HUMBERTO AS MENTIONED, LEVELS 1174 00:43:52,800 --> 00:43:55,360 OF ISOLATION AND MORE ISOLATION 1175 00:43:55,360 --> 00:43:57,240 ON TOP OF COMING--MOVING 1176 00:43:57,240 --> 00:43:58,480 NONAPOPTOTIC THE UNITED STATES 1177 00:43:58,480 --> 00:44:01,840 NOT BEING AROUND FAMILY WHO ARE 1178 00:44:01,840 --> 00:44:04,320 STILL IN THEIR HOME COUNTRY. 1179 00:44:04,320 --> 00:44:09,120 AND SO, HIGH LEVELS OF 1180 00:44:09,120 --> 00:44:11,080 ISOLATION, HIGHER LEVELS OF 1181 00:44:11,080 --> 00:44:12,560 STRESS THAT PARTICIPANTS STATED 1182 00:44:12,560 --> 00:44:13,560 ARE REASONS WHY THEY DRINK. 1183 00:44:13,560 --> 00:44:15,840 YOU KNOW I DRINK TO RELAX FOR 1184 00:44:15,840 --> 00:44:18,360 EXAMPLE, I DRINK TO FORGET, I 1185 00:44:18,360 --> 00:44:20,360 DRINK TO FORGET A BAD DAY, I 1186 00:44:20,360 --> 00:44:23,000 DRINK TO DISSTRUCTURALLY MY OWN 1187 00:44:23,000 --> 00:44:28,840 MIND, TO FORGET ABOUT THE PAST. 1188 00:44:28,840 --> 00:44:30,520 AND SO THIS IS JUST A FEW 1189 00:44:30,520 --> 00:44:33,720 EXAMPLES, AGAIN I NOTED CODING 1190 00:44:33,720 --> 00:44:35,800 IS STILL ONGOING FOR THE SPANISH 1191 00:44:35,800 --> 00:44:37,560 LANGUAGE INTERVIEWS BUT THEY 1192 00:44:37,560 --> 00:44:42,440 REALLY--MY OBSERVATIONS TELL ME 1193 00:44:42,440 --> 00:44:43,840 JUST HOW WARRANTED IT IS AND FOR 1194 00:44:43,840 --> 00:44:47,640 THEM TO EXPLORE HOW PARTICIPANTS 1195 00:44:47,640 --> 00:44:49,880 TALK ABOUT DISCRIMINATION IN THE 1196 00:44:49,880 --> 00:44:55,560 INTERVIEWS. 1197 00:44:55,560 --> 00:45:00,480 AND HOW WE CAN DISCUSS 1198 00:45:00,480 --> 00:45:02,560 DISCRIMINATION AND CHANGE TALK, 1199 00:45:02,560 --> 00:45:04,360 CHANGE ENGAGE; CHANGE PLANS 1200 00:45:04,360 --> 00:45:06,160 REGARDING THEIR DRINKING AND SO 1201 00:45:06,160 --> 00:45:07,560 FROM MY EXPERIENCES, IT'S JUST 1202 00:45:07,560 --> 00:45:11,240 BEEN A PRIVILEGE TO BE ABLE TO 1203 00:45:11,240 --> 00:45:13,960 HEAR THE VULNERABILITY IN THOSE 1204 00:45:13,960 --> 00:45:18,760 TAPES FROM THE PARTICIPANTS AND 1205 00:45:18,760 --> 00:45:20,440 THE RESILIENCE THEY'VE SHOWN IN 1206 00:45:20,440 --> 00:45:23,080 THOSE 1 SESSIONS AND SO, YEAH. 1207 00:45:23,080 --> 00:45:25,080 SO I THINK YOU ALL FOR JUST 1208 00:45:25,080 --> 00:45:26,680 ALLOWING ME THIS TIME JUST TO 1209 00:45:26,680 --> 00:45:29,960 SHARE MY PRESENCES AND AT THIS 1210 00:45:29,960 --> 00:45:31,920 POINT, YEAH, I WOULD LIKE TO 1211 00:45:31,920 --> 00:45:39,160 PASS IT OFF TO DR. MORIEL. 1212 00:45:39,160 --> 00:45:42,760 >> HI, GOOD AFTERNOON,IME 1213 00:45:42,760 --> 00:45:48,080 PROFESSOR MORIEL, THANK YOU 1214 00:45:48,080 --> 00:45:49,720 DR. FIGUEROA, I WORK WITH 1215 00:45:49,720 --> 00:45:51,000 PROVEULENCE HEALTH AND SERVICES, 1216 00:45:51,000 --> 00:45:53,320 I AM A COMMUNITY HEALTH WORKER. 1217 00:45:53,320 --> 00:45:55,240 I WAS LUCKY ENOUGH TO WORK WITH 1218 00:45:55,240 --> 00:45:56,880 DR. CHRISTINA LEE ON THIS 1219 00:45:56,880 --> 00:46:01,280 PROJECT AND SO, LITTLE BIT ABOUT 1220 00:46:01,280 --> 00:46:05,160 MY EXPERIENCE WORKING WITH THE 1221 00:46:05,160 --> 00:46:05,840 LATINO COMMUNITY. 1222 00:46:05,840 --> 00:46:07,800 SO AS A COMMUNITY HEALTH WORKER, 1223 00:46:07,800 --> 00:46:09,440 I NOTED THE IMPORTANCE TO HAVE A 1224 00:46:09,440 --> 00:46:12,520 CLOSE UNDERSTANDING OF THE 1225 00:46:12,520 --> 00:46:13,240 COMMUNITY THAT I SERVE. 1226 00:46:13,240 --> 00:46:16,560 SO THIS IS SOMETHING THAT I HAVE 1227 00:46:16,560 --> 00:46:18,240 BEEN DOING FOR QUITE SOMETIME 1228 00:46:18,240 --> 00:46:20,960 AND SO WE DO OUR BEST TO DELIVER 1229 00:46:20,960 --> 00:46:23,600 WHAT THE COMMUNITY NEEDS. 1230 00:46:23,600 --> 00:46:26,760 YOU KNOW I MADE SURE TO CREATE A 1231 00:46:26,760 --> 00:46:30,040 TRUSTING RELATIONSHIP THAT WILL 1232 00:46:30,040 --> 00:46:31,920 ENABLE, YOU KNOW KIND OF LIKE A 1233 00:46:31,920 --> 00:46:34,920 LIAISON BETWEEN OUR SERVICES AND 1234 00:46:34,920 --> 00:46:36,680 THE COMMUNITY, YOU KNOW TO HELP 1235 00:46:36,680 --> 00:46:39,680 FACILITATE ACCESS TO OUR 1236 00:46:39,680 --> 00:46:41,280 SERVICES. 1237 00:46:41,280 --> 00:46:43,720 I DO STRONGLY BELIEVE A ROLE OF 1238 00:46:43,720 --> 00:46:45,000 THE COMMUNITY HEALTH WORKER 1239 00:46:45,000 --> 00:46:48,920 DEPENDS ON THE CULTURAL SETTING 1240 00:46:48,920 --> 00:46:53,720 AND SO WHEN I WAS PRESENTED THIS 1241 00:46:53,720 --> 00:47:00,240 PROJECT OF, YOU KNOW WORKING 1242 00:47:00,240 --> 00:47:15,000 WITH THE LATINO COMMUNITY--THAT 1243 00:47:15,000 --> 00:47:15,520 WERE PARTICIPATING. 1244 00:47:15,520 --> 00:47:17,040 YOU KNOW BESIDES DOING THE 1245 00:47:17,040 --> 00:47:19,360 ASSESSMENTS THAT WE NEEDED TO 1246 00:47:19,360 --> 00:47:25,200 DO, THAT NEEDED TO BE COMPLETED, 1247 00:47:25,200 --> 00:47:28,800 YOU KNOW WITH--I MADE IT TO 1248 00:47:28,800 --> 00:47:35,240 REALLY DO MORE THAN THAT. 1249 00:47:35,240 --> 00:47:37,120 I NEEDED TO TALK TO THE 1250 00:47:37,120 --> 00:47:38,160 PARTICIPANTS AND REALLY EXPLAIN 1251 00:47:38,160 --> 00:47:39,320 WHAT THIS WHOLE EXPERIENCE WAS 1252 00:47:39,320 --> 00:47:41,000 GOING TO BE ABOUT. 1253 00:47:41,000 --> 00:47:42,160 YOU KNOW MORE OFFENSE THAN NOT 1254 00:47:42,160 --> 00:47:45,280 THERE WAS A LOT OF RESISTANCE 1255 00:47:45,280 --> 00:47:46,800 FROM THE PARTICIPANT FROM THE 1256 00:47:46,800 --> 00:47:48,560 COMMUNITIES, YOU KNOW JUST 1257 00:47:48,560 --> 00:47:52,080 BECAUSE AS MENTIONED BEFORE, A 1258 00:47:52,080 --> 00:47:53,960 LOT OF THESE--A LOT OF THESE 1259 00:47:53,960 --> 00:47:56,960 COMMUNITY MEMBERS DID FEEL A 1260 00:47:56,960 --> 00:47:58,760 LITTLE--THEY FEEL A LITTLE 1261 00:47:58,760 --> 00:48:00,520 DISCRIMINATED AND YOU KNOW I GOT 1262 00:48:00,520 --> 00:48:07,760 A LOT OF, IS THIS AA MEETINGS? 1263 00:48:07,760 --> 00:48:09,800 AM I GOING TO AN AA MEETING? 1264 00:48:09,800 --> 00:48:10,840 I DON'T HAVE PROBLEMS. 1265 00:48:10,840 --> 00:48:11,880 I DON'T HAVE ISSUES. 1266 00:48:11,880 --> 00:48:13,720 WHY AM I DOING THIS, YOU KNOW? 1267 00:48:13,720 --> 00:48:15,560 AND I THINK IT WAS IMPORTANT TO 1268 00:48:15,560 --> 00:48:17,240 HIGHLIGHT THE IMPORTANCE EFFECT 1269 00:48:17,240 --> 00:48:23,160 OF JUST OVERALL OUR HEALTH, YOU 1270 00:48:23,160 --> 00:48:24,880 KNOW OVERALL JUST HOW THIS CAN 1271 00:48:24,880 --> 00:48:25,960 AFFECT OUR HEALTH IN THE LONG 1272 00:48:25,960 --> 00:48:26,160 RUN. 1273 00:48:26,160 --> 00:48:27,720 SO YOU KNOW WE STARTED THIS 1274 00:48:27,720 --> 00:48:30,600 BEFORE COVID, SO A LOT OF IT WAS 1275 00:48:30,600 --> 00:48:38,360 PERSON TO--YOU KNOW, IN-PERSON 1276 00:48:38,360 --> 00:48:40,200 AND AND SO IT WAS EASY TO DO 1277 00:48:40,200 --> 00:48:41,160 THESE SESSIONS WITH THEM, YOU 1278 00:48:41,160 --> 00:48:43,240 KNOW ONCE WE HAD TO CONVERT TO 1279 00:48:43,240 --> 00:48:43,480 VIRTUAL. 1280 00:48:43,480 --> 00:48:44,760 YOU KNOW IT WAS A LITTLE 1281 00:48:44,760 --> 00:48:47,720 DIFFERENT NOW, I HAD TO FIND 1282 00:48:47,720 --> 00:48:51,200 WAYS TO REALLY ENGAGE THESE 1283 00:48:51,200 --> 00:48:53,600 PARPII SYSTEMS PANTS IN OUR 1284 00:48:53,600 --> 00:48:53,880 SESSIONS. 1285 00:48:53,880 --> 00:48:58,360 YOU KNOW WHEN I THINK IT WAS 1286 00:48:58,360 --> 00:49:00,000 FACE-TO-FACE, A LOT OF THEM 1287 00:49:00,000 --> 00:49:02,760 WERE--I THINK DEALING MORE 1288 00:49:02,760 --> 00:49:04,280 ISSUES WITH, YOU KNOW I'M 1289 00:49:04,280 --> 00:49:06,920 DRINKING BECAUSE I WORK TOO 1290 00:49:06,920 --> 00:49:08,200 MUCH, I'M DRINKING BECAUSE I 1291 00:49:08,200 --> 00:49:11,000 HAVE, YOU KNOW FAMILY ISSUES. 1292 00:49:11,000 --> 00:49:12,800 I'M DRINKING BECAUSE, YOU KNOW 1293 00:49:12,800 --> 00:49:14,200 I'M UNDOCUMENTED AND THIS IS THE 1294 00:49:14,200 --> 00:49:16,640 ONLY WAY I CAN COPE WITH THIS, 1295 00:49:16,640 --> 00:49:20,080 OR, YOU KNOW JUST DIFFERENT WAYS 1296 00:49:20,080 --> 00:49:21,280 OF COPING WITH WHAT THEY WERE 1297 00:49:21,280 --> 00:49:24,880 GOING THROUGH AT THE MOMENT 1298 00:49:24,880 --> 00:49:30,040 VERSUS WHEN WE TURNED OVER TO 1299 00:49:30,040 --> 00:49:32,000 VIRTUAL AND THE WHOLE WORLD JUST 1300 00:49:32,000 --> 00:49:33,760 SHUT DOWN ON US, A LOT WERE 1301 00:49:33,760 --> 00:49:37,000 COPING WITH THIS IN THE SENSE 1302 00:49:37,000 --> 00:49:38,400 OF, YOU KNOW I'M DRINKING 1303 00:49:38,400 --> 00:49:40,800 BECAUSE I LOST MY JOB, I'M 1304 00:49:40,800 --> 00:49:42,720 DRINKING BECAUSE, YOU KNOW MY 1305 00:49:42,720 --> 00:49:46,960 FAMILY, WE'RE GOING THROUGH SOME 1306 00:49:46,960 --> 00:49:47,320 STUFF. 1307 00:49:47,320 --> 00:49:48,560 I'M DRINKING BECAUSE I'M 1308 00:49:48,560 --> 00:49:49,880 UNDOCUMENTED AND I CAN'T FIND A 1309 00:49:49,880 --> 00:49:50,200 JOB, YOU KNOW? 1310 00:49:50,200 --> 00:49:53,840 AND I THINK THAT WAS VERY, VERY 1311 00:49:53,840 --> 00:49:58,160 HARD ON A LOT OF PEOPLE, YOU 1312 00:49:58,160 --> 00:49:59,920 KNOW AND I THINK WHEN I HAD 1313 00:49:59,920 --> 00:50:01,560 THESE SESSIONS WITH THESE 1314 00:50:01,560 --> 00:50:02,920 PARTICIPANTS, LIKE I MENTIONED 1315 00:50:02,920 --> 00:50:04,880 BEFORE, I TRIED TO CREATE A SAFE 1316 00:50:04,880 --> 00:50:07,200 SPACE AS MUCH FOR THEM. 1317 00:50:07,200 --> 00:50:08,520 YOU KNOW, WE TALKED ABOUT 1318 00:50:08,520 --> 00:50:10,120 EVERYTHING THAT WAS GOING ON 1319 00:50:10,120 --> 00:50:10,720 WITH THEM. 1320 00:50:10,720 --> 00:50:12,360 I MADE SURE THEY FELT 1321 00:50:12,360 --> 00:50:13,560 COMFORTABLE ENOUGH, YOU KNOW? 1322 00:50:13,560 --> 00:50:15,640 AND SO, AT THE END OF OUR 1323 00:50:15,640 --> 00:50:16,960 SESSIONS WE CREATED GOALS FOR 1324 00:50:16,960 --> 00:50:18,240 THEM, SO WHEN THEY WOULD COME 1325 00:50:18,240 --> 00:50:20,680 BACK, WE WOULD TALK ABOUT IT, 1326 00:50:20,680 --> 00:50:27,480 YOU KNOW, AND THE--BUT A LOT OF 1327 00:50:27,480 --> 00:50:28,680 PARTICIPANTS DID FEEL A LITTLE 1328 00:50:28,680 --> 00:50:29,840 BIT UPSET WHEN THEY DIDN'T 1329 00:50:29,840 --> 00:50:30,600 COMPLETE THEIR GOALS BUT I THINK 1330 00:50:30,600 --> 00:50:32,160 IT WAS A TIME FOR THEM TO REALLY 1331 00:50:32,160 --> 00:50:36,000 SIT DOWN AND JUST TALK ABOUT 1332 00:50:36,000 --> 00:50:38,960 EVERYTHING THAT THEY COULD HAVE, 1333 00:50:38,960 --> 00:50:40,280 YOU KNOW--THEY HAD THE SPACE 1334 00:50:40,280 --> 00:50:42,160 WHERE THEY SAID, WELL, LET'S SEE 1335 00:50:42,160 --> 00:50:44,760 HOW WE CAN WORK THIS OUT, YOU 1336 00:50:44,760 --> 00:50:46,360 KNOW WHERE WE WOULD SAY, OKAY, 1337 00:50:46,360 --> 00:50:48,600 WELL, AT LEAST YOU MADE THIS 1338 00:50:48,600 --> 00:50:48,960 CHANGE. 1339 00:50:48,960 --> 00:50:50,600 I USED TO ALWAYS TELL MY 1340 00:50:50,600 --> 00:50:52,440 PARTICIPANTS IF YOU MADE A 1341 00:50:52,440 --> 00:50:54,600 LITTLE CHANGE, YOU MADE A 1342 00:50:54,600 --> 00:50:57,440 CHANGE, YOU MADE SOMETHING AND 1343 00:50:57,440 --> 00:50:58,560 SO MORE OFTEN THAN NOTHING WE'RE 1344 00:50:58,560 --> 00:51:00,720 GRATEFUL FOR THAT AND I WANTED 1345 00:51:00,720 --> 00:51:03,120 THEM TO REALLY HAVE THAT VISION 1346 00:51:03,120 --> 00:51:05,360 AND REALLY SEE THAT AND SO, YOU 1347 00:51:05,360 --> 00:51:06,840 KNOW, I THINK THAT REALLY 1348 00:51:06,840 --> 00:51:09,280 MOTIVATED THEM TO KEEP GOING. 1349 00:51:09,280 --> 00:51:11,880 AND SO EVERY TIME THAT YOU KNOW 1350 00:51:11,880 --> 00:51:13,360 WE WOULD JUST TALK ABOUT HOW WE 1351 00:51:13,360 --> 00:51:16,560 CAN DO THINGS BETTER, YOU KNOW 1352 00:51:16,560 --> 00:51:19,440 AND OKAY, WHAT ARE WE GOING TO 1353 00:51:19,440 --> 00:51:19,760 DO NEXT TIME? 1354 00:51:19,760 --> 00:51:21,600 AND SO I THINK A LOT OF TIMES, 1355 00:51:21,600 --> 00:51:22,800 YOU KNOW, ALTHOUGH THERE WERE A 1356 00:51:22,800 --> 00:51:25,760 FEW TIMES WHERE, YOU KNOW THEY 1357 00:51:25,760 --> 00:51:27,520 FELT THE NEED TO TALK TO ME AND 1358 00:51:27,520 --> 00:51:29,880 SAY THIS IS WHAT'S GOING ON, YOU 1359 00:51:29,880 --> 00:51:31,680 KNOW I DID--YOU KNOW LISTEN TO A 1360 00:51:31,680 --> 00:51:33,720 LOT OF PARTICIPANTS THAT WERE 1361 00:51:33,720 --> 00:51:37,000 JUST GOING THROUGH VERY, VERY 1362 00:51:37,000 --> 00:51:41,200 HEAVY ISSUES AND SO, I WANTED 1363 00:51:41,200 --> 00:51:43,160 THEM TO FEEL LIKE THEY CAN JUST 1364 00:51:43,160 --> 00:51:44,720 TALK TO ME ABOUT ANYTHING, YOU 1365 00:51:44,720 --> 00:51:44,920 KNOW? 1366 00:51:44,920 --> 00:51:48,880 AND I THINK AT THE END OF OUR 1367 00:51:48,880 --> 00:51:50,720 SESSIONS, THEY WERE--THEY WERE 1368 00:51:50,720 --> 00:51:51,560 VERY, VERY APPRECIATIVE OF 1369 00:51:51,560 --> 00:51:54,520 EVERYTHING WE WOULD DO FOR THEM 1370 00:51:54,520 --> 00:51:57,040 AND YOU KNOW JUST HELPING THEM 1371 00:51:57,040 --> 00:51:59,880 SEE THAT, YOU KNOW? 1372 00:51:59,880 --> 00:52:02,320 AND A LOT OF TIMES, THEY SAID, 1373 00:52:02,320 --> 00:52:04,560 WOW, LIKE, I DIDN'T EXPECT THIS, 1374 00:52:04,560 --> 00:52:05,080 YOU KNOW? 1375 00:52:05,080 --> 00:52:10,960 I DIDN'T EXPECT TO FEEL BETTER 1376 00:52:10,960 --> 00:52:21,920 AFTER TALKING TO YOU. 1377 00:52:21,920 --> 00:52:24,440 YOU KNOW I WRITE DOWN MY GOALS 1378 00:52:24,440 --> 00:52:26,080 AND I PUT THEM ON THE 1379 00:52:26,080 --> 00:52:27,240 REFRIGERATOR ASK EVERY MORNING I 1380 00:52:27,240 --> 00:52:28,720 SEE THAT AND ONCE I COMPLETE A 1381 00:52:28,720 --> 00:52:31,560 GOAL, I'M HAPPY TO DO THAT SO I 1382 00:52:31,560 --> 00:52:35,560 THINK YOU KNOW, CIRCLING BACK TO 1383 00:52:35,560 --> 00:52:36,720 JUST EVERYTHING, WORKING WITH 1384 00:52:36,720 --> 00:52:37,560 THE COMMUNITY, YOU HAVE TO 1385 00:52:37,560 --> 00:52:39,760 REALLY UNDERSTAND IT AND BUILD 1386 00:52:39,760 --> 00:52:43,280 THAT TRUST WITH THEM AND YOU 1387 00:52:43,280 --> 00:52:45,520 KNOW, USING, YOU KNOW 1388 00:52:45,520 --> 00:52:46,480 MOTIVATIONAL INTERVIEWING. 1389 00:52:46,480 --> 00:52:50,000 IT'S--IT WAS A DIFFERENT 1390 00:52:50,000 --> 00:52:53,080 APPROACH TO REALLY HELPING THEM 1391 00:52:53,080 --> 00:52:57,160 SEE AND MOTIVATING THEM TO 1392 00:52:57,160 --> 00:53:00,520 REALLY, YOU KNOW WANT TO MAKE A 1393 00:53:00,520 --> 00:53:03,000 CHANGE IN THEIR DRINKING. 1394 00:53:03,000 --> 00:53:05,960 AND SO, YOU KNOW IT WAS GREAT TO 1395 00:53:05,960 --> 00:53:08,360 SEE A LOT OF PARTICIPANTS JUST 1396 00:53:08,360 --> 00:53:14,440 KIND OF SAY, WELL, YOU KNOW NOW, 1397 00:53:14,440 --> 00:53:19,440 I'M GOING OUT FOR A WALK. 1398 00:53:19,440 --> 00:53:22,040 YOU KNOW, I'M DRINKING THIS NOW, 1399 00:53:22,040 --> 00:53:23,600 I'M DRINKING WATER MORE OR YOU 1400 00:53:23,600 --> 00:53:25,160 KNOW IT'S JUST--I WAS ABLE TO 1401 00:53:25,160 --> 00:53:27,960 JUST TO SEE A LOT OF CHANGE IN 1402 00:53:27,960 --> 00:53:29,760 THE PARTICIPANTS. 1403 00:53:29,760 --> 00:53:31,960 SO, BUT YEAH, OVERALL IT WAS A 1404 00:53:31,960 --> 00:53:37,880 GREAT EXPERIENCE TO REEL 1405 00:53:37,880 --> 00:53:40,080 KEEPSAKESLY LISTEN AND MOTIVATE 1406 00:53:40,080 --> 00:53:40,920 THE PARTICIPANTS IN EVERY WHICH 1407 00:53:40,920 --> 00:53:50,360 WAY THAT WE CAN. 1408 00:53:50,360 --> 00:53:50,600 THANK YOU. 1409 00:53:50,600 --> 00:53:57,400 AND I THINK I WILL PASS IT OVER 1410 00:53:57,400 --> 00:53:59,280 TO DR. ZAPLSKI. 1411 00:53:59,280 --> 00:53:59,840 >> THANK YOU. 1412 00:53:59,840 --> 00:54:05,920 GO AHEAD AND SHARE MY SCREEN. 1413 00:54:05,920 --> 00:54:07,080 ALL RIGHT, THANK YOU SO MUCH SO 1414 00:54:07,080 --> 00:54:10,960 I WILL FOLLOW UP WITH THOSE 1415 00:54:10,960 --> 00:54:11,920 GREAT PRESENTATIONS AND 1416 00:54:11,920 --> 00:54:14,760 DISCUSSION TO TALKING ABOUT 1417 00:54:14,760 --> 00:54:16,360 STIGMA AND RACISM, SPECIFICALLY, 1418 00:54:16,360 --> 00:54:16,840 FOR BLACK AMERICANS. 1419 00:54:16,840 --> 00:54:19,960 AND A LOT OF THE THINGS DO 1420 00:54:19,960 --> 00:54:21,840 PARALLEL WELL WITH THE WORK THAT 1421 00:54:21,840 --> 00:54:24,360 HAS BEEN DESCRIBED FOR THE LATIN 1422 00:54:24,360 --> 00:54:24,800 X COMMUNITY. 1423 00:54:24,800 --> 00:54:28,560 SO, JUST TO GET A LITTLE 1424 00:54:28,560 --> 00:54:29,960 BACKGROUND FOR SUBSTANCE USE 1425 00:54:29,960 --> 00:54:30,960 AMONG BLACK AMERICANS COMPARED 1426 00:54:30,960 --> 00:54:32,000 TO WHITE INDIVIDUALS, BLACK 1427 00:54:32,000 --> 00:54:33,200 INDIVIDUALS TEND TO REPORT LOWER 1428 00:54:33,200 --> 00:54:36,280 RATES OF ALCOHOL AND TOBACCO 1429 00:54:36,280 --> 00:54:37,840 USE, BUT COMPARABLE OR MORE 1430 00:54:37,840 --> 00:54:39,960 RECENTLY HIGHER RATES OF 1431 00:54:39,960 --> 00:54:41,080 MARIJUANA OR CANNABIS USE. 1432 00:54:41,080 --> 00:54:43,800 SO I WANT TO SHOW THE DATA FROM 1433 00:54:43,800 --> 00:54:44,760 THE NATIONAL STUDY OF DRUG USE 1434 00:54:44,760 --> 00:54:46,600 AND HEALTH FOR INDIVIDUALS 12 1435 00:54:46,600 --> 00:54:48,640 AND OLDER WHERE YOU CAN SEE 1436 00:54:48,640 --> 00:54:51,160 PRETTY SIGNIFICANT DECREASE OR 1437 00:54:51,160 --> 00:54:52,760 LOWER PREVALENCE RATE OF ALCOHOL 1438 00:54:52,760 --> 00:54:54,360 USE ARE, SIGHTLY LOWER FOR 1439 00:54:54,360 --> 00:54:59,760 TOBACCO AND SLIGHTLY HIGHER FOR 1440 00:54:59,760 --> 00:55:00,320 MARIJUANA OR CANNABIS. 1441 00:55:00,320 --> 00:55:01,400 AND WHAT'S INTERESTING ABOUT THE 1442 00:55:01,400 --> 00:55:02,560 FINDINGS PARTICULARLY FOR 1443 00:55:02,560 --> 00:55:04,400 ALCOHOL IS ALTHOUGH BLACK 1444 00:55:04,400 --> 00:55:05,960 AMERICANS GENERALLY REPORT LOWER 1445 00:55:05,960 --> 00:55:09,080 USE OF ALCOHOL USE, MORE 1446 00:55:09,080 --> 00:55:10,360 ABSTINENCE, THEY EXPERIENCE MORE 1447 00:55:10,360 --> 00:55:12,320 PROBLEMS ASSOCIATE WIDE ALCOHOL 1448 00:55:12,320 --> 00:55:14,720 USE, THIS INCLUDES MORBIDITY, 1449 00:55:14,720 --> 00:55:16,440 MORTALITY, LIVER CIRRHOSIS, 1450 00:55:16,440 --> 00:55:18,640 ALCOHOL DEPENDENT SYMPTOMS AS 1451 00:55:18,640 --> 00:55:21,160 WELL AS A SLEW OF SOCIAL 1452 00:55:21,160 --> 00:55:22,720 PROBLEMS WHETHER IT'S WITHIN 1453 00:55:22,720 --> 00:55:24,360 ENVIRONMENTS AND THE HOME, 1454 00:55:24,360 --> 00:55:25,960 ACCIDENTS, THINGS IN THE 1455 00:55:25,960 --> 00:55:28,280 WORKPLACE AS WELL AS LEGAL 1456 00:55:28,280 --> 00:55:31,200 CONSEQUENCES FROM ALCOHOL USE. 1457 00:55:31,200 --> 00:55:33,400 YOU SEE SIMILAR FINDINGS FOR 1458 00:55:33,400 --> 00:55:35,120 TOBACCO SO AGAIN, JUST OFFERING 1459 00:55:35,120 --> 00:55:37,880 THE NATIONAL DRUG USE OF HEALTH, 1460 00:55:37,880 --> 00:55:41,400 OVERALL PREVALENCE RATE OF 1461 00:55:41,400 --> 00:55:42,480 SMOKING, ALSO, FEWER QUANTITY 1462 00:55:42,480 --> 00:55:44,400 AND FREQUENCY AS WELL STARTING 1463 00:55:44,400 --> 00:55:49,320 LATER OF A CIGARETTE USE BUT 1464 00:55:49,320 --> 00:55:51,800 IRONICALLY, HAVING HIGHER RATES 1465 00:55:51,800 --> 00:55:55,240 OF DEATH FROM SMOKING RELATED 1466 00:55:55,240 --> 00:55:56,880 DISEASES AMONG BLACK AMERICANS 1467 00:55:56,880 --> 00:55:58,400 AND THEN CANNABIS USE, SEEING 1468 00:55:58,400 --> 00:56:00,360 MORE RECENTLY THERE HAS BEEN 1469 00:56:00,360 --> 00:56:02,120 HIGHER RATES OF CANNABIS USE IN 1470 00:56:02,120 --> 00:56:03,560 THE PAST AND PREVIOUS DECADES IT 1471 00:56:03,560 --> 00:56:05,400 WAS LOWER BUT THERE'S STILL THIS 1472 00:56:05,400 --> 00:56:08,520 HIGHER PROGRESSION FROM USE TO 1473 00:56:08,520 --> 00:56:09,200 DISORDER SYMPTOMS AND THEN 1474 00:56:09,200 --> 00:56:11,360 OUTSIDE OF THAT, YOU KNOW 1475 00:56:11,360 --> 00:56:12,760 THERE'S COMPARABLE LEVELS OF 1476 00:56:12,760 --> 00:56:15,640 CANNABIS USE, THERE IS GREATER 1477 00:56:15,640 --> 00:56:17,040 PROBLEMS, PARTICULARLY LEGAL 1478 00:56:17,040 --> 00:56:18,720 PROBLEMS FROM CANNABIS USE FOR 1479 00:56:18,720 --> 00:56:19,720 BLACK AMERICANS. 1480 00:56:19,720 --> 00:56:22,000 AND SO, WITH ALL THIS BEING 1481 00:56:22,000 --> 00:56:25,280 SAID, YOU CAN UNDERSTAND THE 1482 00:56:25,280 --> 00:56:26,720 NEED TO UNDERSTAND WHY PEOPLE 1483 00:56:26,720 --> 00:56:28,240 ARE ENGAGING IN SUBSTANCE RUES 1484 00:56:28,240 --> 00:56:33,040 BUT PARTICULARLY GIVEN THE 1485 00:56:33,040 --> 00:56:33,880 CONSEQUENCES OF HAVING TREATMENT 1486 00:56:33,880 --> 00:56:35,720 BEING ABLE TO DISCIPLINARY 1487 00:56:35,720 --> 00:56:37,080 CREASE THE SUBSTANCE USE 1488 00:56:37,080 --> 00:56:42,360 PROBLEMS AMONG BLACK AMERICANS. 1489 00:56:42,360 --> 00:56:45,040 AND WE DO FIND FROM LOOKING AT 1490 00:56:45,040 --> 00:56:47,640 DATA FOR SUBSTANCE USE 1491 00:56:47,640 --> 00:56:49,040 SUBSTANCES THAT THEY ARE SEEKING 1492 00:56:49,040 --> 00:56:51,240 OUT OR ENGAGE NOTHING TREATMENT 1493 00:56:51,240 --> 00:56:53,280 AT COMPARABLE RATES TO OTHER 1494 00:56:53,280 --> 00:56:55,520 RACIAL ETHNIC GROUPS AND AT 1495 00:56:55,520 --> 00:56:59,800 TIMES EVEN HIGHER UTILIZATION OF 1496 00:56:59,800 --> 00:57:00,560 SUBSTANCE USE SERVICES. 1497 00:57:00,560 --> 00:57:03,520 HOWEVER, THERE IS LOWER 1498 00:57:03,520 --> 00:57:06,200 TREATMENT SATISFACTION ALMOST 1499 00:57:06,200 --> 00:57:07,000 CONSISTENTLY, LOWER ENGAGEMENT 1500 00:57:07,000 --> 00:57:08,320 ONCE THEY'RE IN SERVICES AND 1501 00:57:08,320 --> 00:57:10,960 PRETTY SIGNIFICANT HIGHER RATES 1502 00:57:10,960 --> 00:57:14,520 OF NOT COMPLETING, SO ENDING 1503 00:57:14,520 --> 00:57:14,960 SERVICES EARLY. 1504 00:57:14,960 --> 00:57:18,240 AND SO THERE'S A LOT OF DATA TO 1505 00:57:18,240 --> 00:57:21,200 SUPPORT THIS, I WANT TO 1506 00:57:21,200 --> 00:57:30,120 HIGHLIGHT A FEW. 1507 00:57:30,120 --> 00:57:31,920 SO USING--IT'S NOT GREAT FOR ANY 1508 00:57:31,920 --> 00:57:34,160 GROUP, SO IT'S ABOUT 50% FOR 1509 00:57:34,160 --> 00:57:37,040 WHITE ADULTS, LATIN X IS 46% AND 1510 00:57:37,040 --> 00:57:39,560 40% FOR BLACK ACULTS AND THESE 1511 00:57:39,560 --> 00:57:40,840 FINDINGS WERE ALSO FOUND FOR 1512 00:57:40,840 --> 00:57:42,800 LOOKING AT HOLD OLDER 1513 00:57:42,800 --> 00:57:43,960 POPULATIONS SO THIS WAS ANOTHER 1514 00:57:43,960 --> 00:57:46,600 STUDY FOR 65 AND UP AND FOUND 1515 00:57:46,600 --> 00:57:48,960 THAT COMPARED TO WHITE OLDER 1516 00:57:48,960 --> 00:57:51,120 ADULTS, THE BLACK OLDER ADULTS 1517 00:57:51,120 --> 00:57:55,760 WERE 37 PERCENT LESS LIKELY THAN 1518 00:57:55,760 --> 00:57:57,240 THE WHITE INDIVIDUALS TO 1519 00:57:57,240 --> 00:57:59,800 COMPLETE SUBSTANCE USE SERVICES. 1520 00:57:59,800 --> 00:58:03,760 SO JUST SHOWING THIS, JUST 1521 00:58:03,760 --> 00:58:04,600 VISUALLY, BASED ON SUBSTANCE 1522 00:58:04,600 --> 00:58:08,600 TYPE, AND YOU FIND THAT 1 OF THE 1523 00:58:08,600 --> 00:58:11,840 WORST RATES OF COMPLETION IS 1524 00:58:11,840 --> 00:58:14,760 ACTUALLY FOR ALCOHOL, ALCOHOL 1525 00:58:14,760 --> 00:58:17,720 TREATMENT, ONLY SECOND TO 1526 00:58:17,720 --> 00:58:18,760 METHAMPHETAMINES, SO AGAIN 1527 00:58:18,760 --> 00:58:20,040 OVERALL LOWER RATES OF 1528 00:58:20,040 --> 00:58:20,640 COMPLETION, BUT PARTICULARLY 1529 00:58:20,640 --> 00:58:29,040 WHEN WE THINK ABOUT ALCOHOL, 1530 00:58:29,040 --> 00:58:35,160 THERE IS CONCERN ABOUT SO WHY IS 1531 00:58:35,160 --> 00:58:37,960 THIS THE CASE, WHAT'S GOING ON, 1532 00:58:37,960 --> 00:58:38,840 WHY--NOT COMPLETING TREATMENT, 1533 00:58:38,840 --> 00:58:39,960 THEY'RE ENGAGE NOTHING 1534 00:58:39,960 --> 00:58:41,960 TREATMENT, STARTING TREATMENT 1535 00:58:41,960 --> 00:58:43,680 BUT NOT FINISHING, NOT SATISFIED 1536 00:58:43,680 --> 00:58:46,160 WITH IT, AND SO, WHAT ARE SOME 1537 00:58:46,160 --> 00:58:47,200 THINGS THAT WE NEED TO CONSIDER 1538 00:58:47,200 --> 00:58:50,680 TO HELP WITH THAT. 1539 00:58:50,680 --> 00:58:52,520 AND THIS REALLY DOES ALIGN WELL 1540 00:58:52,520 --> 00:58:54,280 WITH WHAT HAS BEEN DISCUSSED 1541 00:58:54,280 --> 00:58:56,000 EARLIER WITH ISSUES OF STIGMA 1542 00:58:56,000 --> 00:58:58,560 AND RACISM WHICH HAS ALSO BEEN 1543 00:58:58,560 --> 00:58:59,560 IDENTIFIED FOR BLACK AMERICANS. 1544 00:58:59,560 --> 00:59:02,560 SO JUST TO GIVE A DEFINITION FOR 1545 00:59:02,560 --> 00:59:04,640 STIGMA, THIS IS JUST HEALTH 1546 00:59:04,640 --> 00:59:05,880 RELATED STIGMA FOR SUBSTANCE USE 1547 00:59:05,880 --> 00:59:07,920 DISORDER IS ABOUT THE PROCESS, 1548 00:59:07,920 --> 00:59:10,320 IN WHICH SOCIAL GROUPS ARE 1549 00:59:10,320 --> 00:59:11,720 DEVALUED, REJECTED OR EXCLUDED 1550 00:59:11,720 --> 00:59:13,960 ON THE BASIS OF THAT CONDITION 1551 00:59:13,960 --> 00:59:18,160 AND THIS CAN HELP ACROSS GROUPS, 1552 00:59:18,160 --> 00:59:19,920 IT CAN HAPPEN WITHIN THE 1553 00:59:19,920 --> 00:59:22,520 INDIVIDUAL, CAN HAPPEN ACROSS 1554 00:59:22,520 --> 00:59:24,200 CONTEXT THAT AN INDIVIDUAL 1555 00:59:24,200 --> 00:59:26,120 ENGAGES IN, SO WITHIN 1556 00:59:26,120 --> 00:59:28,160 THEMSELVES, THEY CAN INTERNALIZE 1557 00:59:28,160 --> 00:59:31,040 NEGATIVE MESSAGES ABOUT 1558 00:59:31,040 --> 00:59:31,960 SUBSTANCE USE, PERCEIVED STIGMA 1559 00:59:31,960 --> 00:59:33,240 FROM THEMSELVES AND OTHERS 1560 00:59:33,240 --> 00:59:36,720 AROUND THEM AND POSSIBLY AVOID 1561 00:59:36,720 --> 00:59:37,560 THEM ENGAGING IN TREATMENT, BUT 1562 00:59:37,560 --> 00:59:40,440 WE CAN ALSO THINK ABOUT THE 1563 00:59:40,440 --> 00:59:41,800 PUBLIC AND STEREOTYPES ARE 1564 00:59:41,800 --> 00:59:45,200 PREJUDICE, THEY MIGHT BE ABOUT 1565 00:59:45,200 --> 00:59:46,680 INDIVIDUALS WITH SUBSTANCE USE 1566 00:59:46,680 --> 00:59:47,960 DISORDER THAT IS FOUND WITHIN 1567 00:59:47,960 --> 00:59:49,240 THE HEALTHCARE FIELD WITH THE 1568 00:59:49,240 --> 00:59:50,240 PROFESSIONALS AND THOSE ENGAGED 1569 00:59:50,240 --> 00:59:52,280 IN TREATING AND HELPING ALSO 1570 00:59:52,280 --> 00:59:55,040 HAVING STIGMA RELATED TO 1571 00:59:55,040 --> 00:59:57,160 SUBSTANCE USE DISORDER AND THEN 1572 00:59:57,160 --> 00:59:59,000 STRUCTURALLY, WE AND SEE STIGMA 1573 00:59:59,000 --> 01:00:00,360 AND POLICIES AND DIFFERENT 1574 01:00:00,360 --> 01:00:03,120 PROCEDURES THAT DECREASE 1575 01:00:03,120 --> 01:00:05,200 OPPORTUNITIES FOR PEOPLE TO BE 1576 01:00:05,200 --> 01:00:06,960 ABLE TO RECEIVE SUBSTANCE USE 1577 01:00:06,960 --> 01:00:07,800 DISORDER TREATMENT. 1578 01:00:07,800 --> 01:00:09,280 NOW RACISM, AND CHRISTINA TALKED 1579 01:00:09,280 --> 01:00:12,320 ABOUT THE DIFFERENCE AS WELL, IS 1580 01:00:12,320 --> 01:00:12,560 DIFFERENT. 1581 01:00:12,560 --> 01:00:14,560 THIS IS THINKING ABOUT A SYSTEM 1582 01:00:14,560 --> 01:00:17,560 IN WHICH WE'RE STRUCTURING AND 1583 01:00:17,560 --> 01:00:19,400 ASSIGNING VALUE BASED ON THE WAY 1584 01:00:19,400 --> 01:00:21,920 SOMEONE LOOKS IN THIS CASE, RACE 1585 01:00:21,920 --> 01:00:22,600 THAT UNFAIRLY ADVANTAGES SOME 1586 01:00:22,600 --> 01:00:24,800 INDIVIDUALS AND COMMUNITIES AND 1587 01:00:24,800 --> 01:00:25,640 UNFAIRLY DISADVANTAGES OTHERS 1588 01:00:25,640 --> 01:00:30,680 AND I'M USING THE DEFINITION BY 1589 01:00:30,680 --> 01:00:31,960 DR. KAMARA JONES FOR RACISM, AND 1590 01:00:31,960 --> 01:00:33,680 RACISM CAN BE SEEN AT DIFFERENT 1591 01:00:33,680 --> 01:00:34,960 LEVELS, 1 LEVEL THAT PARALLELS 1592 01:00:34,960 --> 01:00:37,720 WHEN WE TALK ABOUT STIGMA, WHAT 1593 01:00:37,720 --> 01:00:39,160 THAT OPPORTUNITY IS AT THE 1594 01:00:39,160 --> 01:00:41,640 STRUCTURAL LEVEL, IS STRUCTURAL 1595 01:00:41,640 --> 01:00:43,760 OR INSTITUTIONAL RACISM AND THIS 1596 01:00:43,760 --> 01:00:45,240 IS DIFFERENTIAL ACCESS TO GOODS 1597 01:00:45,240 --> 01:00:47,240 AND SERVICES BASED ON RACE. 1598 01:00:47,240 --> 01:00:49,360 AND SO WE THINK ABOUT THIS FOR 1599 01:00:49,360 --> 01:00:50,800 SUBSTABS USE SERVICES AND 1600 01:00:50,800 --> 01:00:54,080 TREATMENT, WHERE ARE THE 1601 01:00:54,080 --> 01:00:54,640 SERVICES PROVIDED? 1602 01:00:54,640 --> 01:00:56,280 IN WHAT COMMUNITIES ARE THEY 1603 01:00:56,280 --> 01:00:56,560 PROVIDED? 1604 01:00:56,560 --> 01:00:59,080 HOW EASY IS IT TO ACCESS THOSE 1605 01:00:59,080 --> 01:00:59,360 SERVICES? 1606 01:00:59,360 --> 01:01:01,840 WHAT THE DATA SHOWS IS THAT IT'S 1607 01:01:01,840 --> 01:01:03,320 MORE DIFFICULT, ALTHOUGH 1608 01:01:03,320 --> 01:01:04,960 MEASURES ARE ENGAGING IN 1609 01:01:04,960 --> 01:01:06,120 TREATMENT, IT'S HARD TO TO FIND 1610 01:01:06,120 --> 01:01:09,080 TREATMENT, NONAPOPTOTIC THE 1611 01:01:09,080 --> 01:01:12,040 GENERALLY EASILY ACCESSIBLE IN 1612 01:01:12,040 --> 01:01:13,960 HIGH PROPORTION OF RACIAL ETHNIC 1613 01:01:13,960 --> 01:01:15,120 MINORITY COMMUNITIES AND 1614 01:01:15,120 --> 01:01:16,080 TRANSPORTATION TO GET TO THOSE 1615 01:01:16,080 --> 01:01:17,800 SERVESZS AND MORE DIFFICULT, SO 1616 01:01:17,800 --> 01:01:19,360 THERE'S BARRIERS TO JUST 1617 01:01:19,360 --> 01:01:20,640 ACCESSING CARE THERE, WE NEED TO 1618 01:01:20,640 --> 01:01:22,280 LOOK AT OUTSIDE OF WHAT YOU GET 1619 01:01:22,280 --> 01:01:24,760 INTO TREATMENT AND WHAT HAPPENS 1620 01:01:24,760 --> 01:01:25,600 AT THAT STAGE. 1621 01:01:25,600 --> 01:01:30,160 AND SO, WHAT WE NEED TO DO 1622 01:01:30,160 --> 01:01:33,800 AGAIN, TALKING THIS THROUGH IS 1623 01:01:33,800 --> 01:01:35,080 DECREASE STIGMA FOR COMMUNITY 1624 01:01:35,080 --> 01:01:36,800 PERCEPTIONS OF SUBSTANCE USE 1625 01:01:36,800 --> 01:01:38,880 TREME AND SUBSTANCE USE 1626 01:01:38,880 --> 01:01:40,040 DISORDER, DECREASED STIGMA 1627 01:01:40,040 --> 01:01:41,080 WITHIN THE HEALTHCARE 1628 01:01:41,080 --> 01:01:42,760 PROFESSION, RIGHT IF SOMEONE 1629 01:01:42,760 --> 01:01:43,920 DOES COME IN, THE NEXT THING 1630 01:01:43,920 --> 01:01:47,680 THEY MAY NEED IS AN ADDITIONAL 1631 01:01:47,680 --> 01:01:50,240 PAIR BARE, PEOPLE HAVE 1632 01:01:50,240 --> 01:01:51,760 EXPERIENCED DISCRIMINATION, AND 1633 01:01:51,760 --> 01:01:53,520 INDIVIDUALS COMING IN TO GET 1634 01:01:53,520 --> 01:01:55,160 CARE AND STRUCTURALLY HOW DOE WE 1635 01:01:55,160 --> 01:01:57,200 MAKE SERVICES AVAILABLE IN 1636 01:01:57,200 --> 01:01:58,560 ENVIRONMENTS THAT'S EASILY 1637 01:01:58,560 --> 01:02:00,240 ACCESSIBLE IN WHICH PEOPLE FEEL 1638 01:02:00,240 --> 01:02:01,920 SAFE AND SUPPORTED WHICH PAIRS 1639 01:02:01,920 --> 01:02:03,400 NICELY WITH THE OTHER 1640 01:02:03,400 --> 01:02:04,800 PRESENTATIONS ABOUT COMMUNITY 1641 01:02:04,800 --> 01:02:05,960 AND BUILDING SUPPORT AND HAVING 1642 01:02:05,960 --> 01:02:07,320 A SAFE PLACE. 1643 01:02:07,320 --> 01:02:10,600 SO THINKING ABOUT BLACK 1644 01:02:10,600 --> 01:02:12,160 AMERICANS, 1 PLACE THAT HAS BEEN 1645 01:02:12,160 --> 01:02:15,600 LOOKED AT AS A GREAT PLACE TO 1646 01:02:15,600 --> 01:02:17,360 PROVIDE SUBSTANCE USE SERVICE IS 1647 01:02:17,360 --> 01:02:18,960 TD BLACK CHURCH AND I'M NOT 1648 01:02:18,960 --> 01:02:20,640 HIGHLIGHTING MY WORK BUT A WORK 1649 01:02:20,640 --> 01:02:24,000 BY A CLOSE FRIEND AND COLLEAGUES 1650 01:02:24,000 --> 01:02:25,960 DR. JORDAN, AND SO RELIGION AND 1651 01:02:25,960 --> 01:02:27,760 SPIRITUALITY HAS BEEN A CENTER 1652 01:02:27,760 --> 01:02:42,320 STONE FOR MANY BLACK 1653 01:02:42,320 --> 01:02:45,720 COMMUNITIES--TO SHOW THAT 65-80% 1654 01:02:45,720 --> 01:02:47,240 OF BLACK ADULTS ATTEND CHURCH, 1655 01:02:47,240 --> 01:02:49,560 SO THIS IS A PLACE WHERE THEY'RE 1656 01:02:49,560 --> 01:02:50,360 ALREADY GOING AND THEY'RE 1657 01:02:50,360 --> 01:02:53,000 ALREADY GOING TO TALK ABOUT 1658 01:02:53,000 --> 01:02:54,480 SUBSTANCE ABUSE ISSUES WITH THE 1659 01:02:54,480 --> 01:02:55,760 CLERGY FOR SEEKING EXPHELGT 1660 01:02:55,760 --> 01:02:56,240 SUPPORT. 1661 01:02:56,240 --> 01:02:57,960 SO SHE CONDUCTED A PILOT OF 1662 01:02:57,960 --> 01:02:59,000 FEASIBILITY OF PROVIDING 1663 01:02:59,000 --> 01:03:00,440 SUBSTANCE USE TREATMENT IN THE 1664 01:03:00,440 --> 01:03:04,560 BLACK CHURCH AND USING LOCAL 1665 01:03:04,560 --> 01:03:07,360 PEOPLE WITHIN THE COMMUNITY AS 1666 01:03:07,360 --> 01:03:07,960 FACILITATORS FOR PROVIDING THE 1667 01:03:07,960 --> 01:03:10,800 TREATMENT AND DOG IT IN A PLACE 1668 01:03:10,800 --> 01:03:11,960 WHERE INDIVIDUALS ALREADY WERE 1669 01:03:11,960 --> 01:03:16,920 AND SO, THIS IS A--IT WAS AN 8 1670 01:03:16,920 --> 01:03:18,400 WEEK PROGRAM WITH 7 SESSIONS AND 1671 01:03:18,400 --> 01:03:19,920 THIS JUST KIND OF SHOW WHAT IS 1672 01:03:19,920 --> 01:03:23,880 IT LOOKED LIKE, IT WAS CBT, SO 1673 01:03:23,880 --> 01:03:26,440 COMPUTER BASED TRAINING FOR 1674 01:03:26,440 --> 01:03:27,960 COGNITIVE BEHAVIORAL THERAPY, I 1675 01:03:27,960 --> 01:03:29,080 APOLOGIZE FOR MY DOG IN THE 1676 01:03:29,080 --> 01:03:30,320 BACKGROUND BUT IT WAS VERY 1677 01:03:30,320 --> 01:03:31,960 STRUCTURED WHERE THEY DID DO 1678 01:03:31,960 --> 01:03:34,560 URINE SAMPLES AND THEY PROVIDED 1679 01:03:34,560 --> 01:03:37,080 SPIR YITUAL SESSIONS WHERE THEY 1680 01:03:37,080 --> 01:03:39,080 TALKED ABOUT THEY HAD PRAYER, 1681 01:03:39,080 --> 01:03:41,880 INCLUDED SINGING, BUT ALSO HAD A 1682 01:03:41,880 --> 01:03:43,360 SESSION OF CBT DAHLINGER WAS ON 1683 01:03:43,360 --> 01:03:44,760 TASK WITH EACH INDIVIDUAL 1684 01:03:44,760 --> 01:03:46,760 COMPLETED WITH THE WORK LOAD AND 1685 01:03:46,760 --> 01:03:48,240 THEN THEY ENGAGED IN PRAYER 1686 01:03:48,240 --> 01:03:49,240 AFTERWARDS WITHIN A COMMUNITY 1687 01:03:49,240 --> 01:03:52,120 ENVIRONMENT AT THE CHURCH. 1688 01:03:52,120 --> 01:03:54,760 AND AGAIN THIS WAS THE PILOT 1689 01:03:54,760 --> 01:03:57,960 DATA SHE HAD PUBLISHED. 1690 01:03:57,960 --> 01:04:00,360 YOU SEE PEOPLE DID MEET CRITERIA 1691 01:04:00,360 --> 01:04:02,160 FOR SEVERE SUBSTANCE USE 1692 01:04:02,160 --> 01:04:04,440 DISORDER BASED ON DSM 5 AND 1693 01:04:04,440 --> 01:04:05,840 THINKING ABOUT FEASIBILITY BUT 1694 01:04:05,840 --> 01:04:07,000 ACCEPTABLE, ARE THEY COMPLETING 1695 01:04:07,000 --> 01:04:08,920 THE TREATMENT, ARE THEY FEELING 1696 01:04:08,920 --> 01:04:12,000 SUPPORTED, DO THEY CONTINUE TO 1697 01:04:12,000 --> 01:04:12,800 FIND IT EFFECTIVE? 1698 01:04:12,800 --> 01:04:17,480 AND 39 OUT OF 40 PARTICIPANTS, 1699 01:04:17,480 --> 01:04:19,520 AND AND ALSO TO MODULE SO WHICH 1700 01:04:19,520 --> 01:04:21,960 IS AMAZING AND NOT ONLY THAT A 1701 01:04:21,960 --> 01:04:24,040 SCALE OF 4.5 OUT OF 5, THEY WERE 1702 01:04:24,040 --> 01:04:25,320 HIGHLY SATISFIED WITH THE 1703 01:04:25,320 --> 01:04:26,400 TREATMENT THEY RECEIVED. 1704 01:04:26,400 --> 01:04:27,960 AGAIN, SO THIS IS JUST SAYING WE 1705 01:04:27,960 --> 01:04:29,040 CAN DO BETTER, RIGHT? 1706 01:04:29,040 --> 01:04:30,160 WE CAN PROVIDE THE SERVICES IN 1707 01:04:30,160 --> 01:04:34,760 PLACES WHERE PEOPLE ARE, WE CAN 1708 01:04:34,760 --> 01:04:36,280 MAKE SURE THAT IT IS WHERE 1709 01:04:36,280 --> 01:04:37,560 PEOPLE FEEL SAFE, SUPPORTED AND 1710 01:04:37,560 --> 01:04:39,000 ADDRESSING NEEDS THEY HAVE AND 1711 01:04:39,000 --> 01:04:40,840 HAVING PEOPLE AROUND THEM THAT 1712 01:04:40,840 --> 01:04:42,280 ARE ALSO SUPPORTIVE, RIGHT? 1713 01:04:42,280 --> 01:04:43,840 REDUCING THOSE BIASES AND 1714 01:04:43,840 --> 01:04:44,080 STIGMA. 1715 01:04:44,080 --> 01:04:45,680 AND SO SHE'S HAS NOW EXPABDED 1716 01:04:45,680 --> 01:04:49,360 THIS TO AN RO1 AND ADDICTION 1717 01:04:49,360 --> 01:04:50,600 TREATMENT IN THE BLACK COMMUNITY 1718 01:04:50,600 --> 01:04:52,000 WHICH IS REALLY GREAT BECAUSE 1719 01:04:52,000 --> 01:04:53,440 IT'S EXPAND THANKSGIVING IDEA 1720 01:04:53,440 --> 01:04:55,640 WHERE WE HAVE COMMUNITY-BASED 1721 01:04:55,640 --> 01:04:58,200 PARTICIPATORY RESEARCH WHERE THE 1722 01:04:58,200 --> 01:04:58,680 COMMUNITY IS INVOLVED. 1723 01:04:58,680 --> 01:05:00,960 WHERE WE'RE NOT JUST COMING IN 1724 01:05:00,960 --> 01:05:03,080 AND DOING PROGRAMS AND NEEDING 1725 01:05:03,080 --> 01:05:05,720 THE COMMUNITY TO BE IN THAT 1726 01:05:05,720 --> 01:05:06,960 PROCESS, COMPARED TO WHAT 1727 01:05:06,960 --> 01:05:08,400 EVERYBODY HAS BEEN TALKING ABOUT 1728 01:05:08,400 --> 01:05:11,000 WITH THE CASMI PROJECT. 1729 01:05:11,000 --> 01:05:12,920 THIS IS PEOPLE WITH COMMUNITY 1730 01:05:12,920 --> 01:05:14,560 LIVED EXPERIENCE, DECREASING 1731 01:05:14,560 --> 01:05:16,520 STIGMA RELATED TO SUBBANCE USE 1732 01:05:16,520 --> 01:05:17,080 DISEAREDDERS AND HAVING 1733 01:05:17,080 --> 01:05:18,520 FLEXIBILITY BY HAVING THE 1734 01:05:18,520 --> 01:05:19,680 COMMUNITY INVOLVED AND MAKING 1735 01:05:19,680 --> 01:05:22,840 SURE THAT IT'S CULTURALLY, 1736 01:05:22,840 --> 01:05:23,480 RELATED, RIGHT, APPLICABLE TO 1737 01:05:23,480 --> 01:05:26,320 THE EXPERIENCES AND NEEDS OF THE 1738 01:05:26,320 --> 01:05:26,960 COMMUNITY. 1739 01:05:26,960 --> 01:05:29,080 AND LASTLY, MAKING SURE IT'S 1740 01:05:29,080 --> 01:05:30,800 CULTURALLY RELEVANT, ALSO WITHIN 1741 01:05:30,800 --> 01:05:32,920 THIS, IS THE BLACK CHURCH IS A 1742 01:05:32,920 --> 01:05:35,920 CENTRAL COMPONENT TO IT WITH 1743 01:05:35,920 --> 01:05:36,600 SPIRITUALITY BEING HIGHLY 1744 01:05:36,600 --> 01:05:40,040 INTEGRATED AND TO THAT 1745 01:05:40,040 --> 01:05:40,480 INTERVENTION. 1746 01:05:40,480 --> 01:05:42,040 SO THAT'S A LOT ABOUT STIGMA, 1747 01:05:42,040 --> 01:05:43,560 BUT I WANT TO NOW SWITCH A 1748 01:05:43,560 --> 01:05:46,280 LITTLE BIT TO TALK ABOUT OTHER 1749 01:05:46,280 --> 01:05:47,880 THINGS TO CONSIDER WITHIN 1750 01:05:47,880 --> 01:05:49,160 TREATMENT FOR SUBSTANCE USE 1751 01:05:49,160 --> 01:05:50,720 DISORDER THAT CAN AGAIN HELP 1752 01:05:50,720 --> 01:05:53,720 WITH ADDRESSING WHERE THERE'S A 1753 01:05:53,720 --> 01:05:56,000 STRAP FOR BLAD INDIVIDUALEN 1754 01:05:56,000 --> 01:05:57,000 GAUGING BUT NOT COMPLETING AND 1755 01:05:57,000 --> 01:05:59,800 NOT FEELING THE QUALITY OF THE 1756 01:05:59,800 --> 01:06:00,800 SERVICE THAT'S PROVIDED. 1757 01:06:00,800 --> 01:06:04,200 SO THINGS TO CONSIDER HERE IS 1758 01:06:04,200 --> 01:06:05,040 RACISM, DISCRIMINATION, CULTURAL 1759 01:06:05,040 --> 01:06:06,800 FACTORS THAT ARE NOT GENERALLY 1760 01:06:06,800 --> 01:06:07,400 INCORPORATED INTO THE 1761 01:06:07,400 --> 01:06:08,000 INTERVENTIONS AND TREATMENTS 1762 01:06:08,000 --> 01:06:11,360 THAT ARE PROVIDED FOR SUBSTANCE 1763 01:06:11,360 --> 01:06:11,560 USE. 1764 01:06:11,560 --> 01:06:14,760 SO, THIS IS NOW TAKING A BIT 1765 01:06:14,760 --> 01:06:15,960 STEP EARLIER INTO DEVELOPMENT 1766 01:06:15,960 --> 01:06:19,440 SINCE I DO A LOT OF MY WORK WITH 1767 01:06:19,440 --> 01:06:20,960 ADOLESCENCENTS AND YOUNG ADULTS 1768 01:06:20,960 --> 01:06:22,280 WUWITHIN THESE MODELS ARE IF 1769 01:06:22,280 --> 01:06:23,800 EARLY INITIATION AND ENGAGEMENT 1770 01:06:23,800 --> 01:06:25,840 IN SUBSTANCE USE, WE ALSO USE 1771 01:06:25,840 --> 01:06:27,560 ADULTS AS WELL, THERE'S KIND OF 1772 01:06:27,560 --> 01:06:31,520 CORE FACTORS THAT WE THINK ARE 1773 01:06:31,520 --> 01:06:32,800 INVOLVED, SO PERSONALITY, 1774 01:06:32,800 --> 01:06:35,080 SOCIOLOGICAL DEMOGRAPHIC 1775 01:06:35,080 --> 01:06:36,680 VARIABLES, WHAT BEHAVIORAL LIST 1776 01:06:36,680 --> 01:06:41,520 THEY MIGHT HAVE, AGGRESSION, OR 1777 01:06:41,520 --> 01:06:42,680 OTHER EXTERNALIZING DISORDERS 1778 01:06:42,680 --> 01:06:44,760 FOR YOUTH FAMILY COMPOSITION, 1779 01:06:44,760 --> 01:06:45,680 PEER INFLUENCE, COMMUNITY 1780 01:06:45,680 --> 01:06:46,120 FACTORS AND STRESS. 1781 01:06:46,120 --> 01:06:48,880 HOW ARE THOSE THINGS INVOLVED IN 1782 01:06:48,880 --> 01:06:50,960 RISKS FOR SUBSTANCE USE AND WE 1783 01:06:50,960 --> 01:06:51,760 CONSIDER THOSE CROSS CULTURAL, 1784 01:06:51,760 --> 01:06:53,880 THAT WILL BE TRUE FOR ALMOST 1785 01:06:53,880 --> 01:06:54,120 ANYONE. 1786 01:06:54,120 --> 01:06:56,400 HOWEVER WHEN WE LOOK AT MODELS 1787 01:06:56,400 --> 01:06:59,360 THAT HAD USED JUST THOSE TYPE OF 1788 01:06:59,360 --> 01:07:02,560 RISK FACTORS FOR SUBSTANCE USE, 1789 01:07:02,560 --> 01:07:06,800 THEY GENERALLY DON'T DO WELL FOR 1790 01:07:06,800 --> 01:07:07,920 RACIAL ETHNIC MINORITIES, 1791 01:07:07,920 --> 01:07:08,680 PARTICULARLY BLACK YOUTH, SO 1792 01:07:08,680 --> 01:07:11,720 THIS IS THE DATA SHOWING THIS 1793 01:07:11,720 --> 01:07:14,080 FOR PREDICTING BINGE DRINKING 1794 01:07:14,080 --> 01:07:17,720 AND AGAIN PREDICTING 10% OF THE 1795 01:07:17,720 --> 01:07:18,960 VARIANTS IN BINGE DRINKING. 1796 01:07:18,960 --> 01:07:20,240 THAT'S MY DOG AND SO, AGAIN, 1797 01:07:20,240 --> 01:07:22,640 WE'RE SEEING THAT THERE'S THINGS 1798 01:07:22,640 --> 01:07:26,040 THAT ARE MISSING IN 1799 01:07:26,040 --> 01:07:35,840 UNDERSTANDING THE SUBSTANCE USE. 1800 01:07:35,840 --> 01:07:37,160 SO--I'M SORRY--SO, YOU KNOW WHAT 1801 01:07:37,160 --> 01:07:44,600 I HAVE USED IN MY RESEARCH IS 1802 01:07:44,600 --> 01:07:51,760 USING SOCIAL ECOLOGICAL MODEL AS 1803 01:07:51,760 --> 01:07:53,200 WELL AS SOCIETIES NORMS AND 1804 01:07:53,200 --> 01:07:54,280 POLICIES BUT ALSO UNDERSTANDING 1805 01:07:54,280 --> 01:07:55,920 THE IMPORTANCE OF RACISM AS IT 1806 01:07:55,920 --> 01:07:57,560 RELATES TO ALL OF THESE LEVELS, 1807 01:07:57,560 --> 01:07:59,440 WE TALKED A LITTLE BIT ABOUT THE 1808 01:07:59,440 --> 01:08:00,840 STRUCTURAL BUT THE INDIVIDUAL, 1809 01:08:00,840 --> 01:08:03,360 THE INTERACTIONS WITH FAMILY AND 1810 01:08:03,360 --> 01:08:04,160 PEERS, THE COMMUNITY. 1811 01:08:04,160 --> 01:08:05,760 IT HAPPENS IN SO MANY DIFFERENT 1812 01:08:05,760 --> 01:08:08,360 LEVELS THAT WE NEED TO 1813 01:08:08,360 --> 01:08:09,840 UNDERSTAND THE BREATH, THE 1814 01:08:09,840 --> 01:08:11,560 FREQUENCY OF WHICH IT OCCURS AND 1815 01:08:11,560 --> 01:08:13,560 HOW IT CAN IMPACT SUBSTANCE USE 1816 01:08:13,560 --> 01:08:17,880 ON A DAILY, WEEKLY, YEARLY LIFE 1817 01:08:17,880 --> 01:08:20,320 LONG LEVEL FOR RACIAL ETHNIC 1818 01:08:20,320 --> 01:08:20,600 MINORITIES. 1819 01:08:20,600 --> 01:08:22,400 SO I DID A STUDY JUST TO SHOW 1820 01:08:22,400 --> 01:08:23,320 THAT. 1821 01:08:23,320 --> 01:08:25,120 WE HAVE SOME DATA ALREADY THAT 1822 01:08:25,120 --> 01:08:26,920 HAS BEEN PRESENTED SHOWING 1823 01:08:26,920 --> 01:08:27,760 DISCRIMINATION BEING AN 1824 01:08:27,760 --> 01:08:28,720 IMPORTANT RISK FACTOR BUT I WANT 1825 01:08:28,720 --> 01:08:30,400 TO SHOW THAT THIS COULD PREDICT 1826 01:08:30,400 --> 01:08:34,160 ABOVE AND BEYOND THESE OTHER 1827 01:08:34,160 --> 01:08:34,760 CULTURALLY--CROSS CULTURAL 1828 01:08:34,760 --> 01:08:36,160 FACTORS, AGAIN TRYING TO PROVIDE 1829 01:08:36,160 --> 01:08:37,200 IMPERICAL SUPPORT FOR THE NEED 1830 01:08:37,200 --> 01:08:38,840 TO FOCUS ON THESE FACTORS 1831 01:08:38,840 --> 01:08:41,160 BECAUSE THEY ARE VERY RELEVANT 1832 01:08:41,160 --> 01:08:43,360 AT RISK FOR SUBSTANCE USE FOR IN 1833 01:08:43,360 --> 01:08:47,640 THIS CASE, FOR BLACK YOUTH AND 1834 01:08:47,640 --> 01:08:50,440 YOUNG ADULTS. 1835 01:08:50,440 --> 01:08:51,960 SOPHISTICATED ASKED WAS JUST 1836 01:08:51,960 --> 01:08:54,680 CANNABIS AND ALCOHOL USE AMONG 1837 01:08:54,680 --> 01:08:56,760 BLACK ADOLESCENTS, IT IS IN 1838 01:08:56,760 --> 01:08:57,440 COLLABORATION WITH DR. GENE 1839 01:08:57,440 --> 01:09:00,560 BRODY AND A TEAM AT THE 1840 01:09:00,560 --> 01:09:01,000 UNIVERSITY OF GEORGIA. 1841 01:09:01,000 --> 01:09:03,560 AND THIS WAS A STUDY WE HAD TO 1842 01:09:03,560 --> 01:09:06,160 FOLLOW UP, BLACK FAMILIES, BLACK 1843 01:09:06,160 --> 01:09:08,160 CHILDREN, FOR 14 YEARS, STARTING 1844 01:09:08,160 --> 01:09:09,840 WHEN THEY WERE 11, ALL THE WAY 1845 01:09:09,840 --> 01:09:10,880 TO 21. 1846 01:09:10,880 --> 01:09:12,880 AND SO, THE GOAL OF THIS WAS TO 1847 01:09:12,880 --> 01:09:16,200 LOOK AT THOSE FACTORS THAT WE 1848 01:09:16,200 --> 01:09:17,360 CONSIDER CROSS CULTURAL AND ALSO 1849 01:09:17,360 --> 01:09:20,640 HAVE A CULTURAL RISK DOMAIN 1850 01:09:20,640 --> 01:09:21,320 WHICH WAS RACIAL DISCRIMINATION, 1851 01:09:21,320 --> 01:09:23,160 AND AGAIN WHAT WE FOUND ON 1852 01:09:23,160 --> 01:09:24,520 SUPPORTING HYPOTHESIS, THAT WE 1853 01:09:24,520 --> 01:09:26,520 DO SEE THAT SOME OF THESE OTHER 1854 01:09:26,520 --> 01:09:28,720 FACTORS DO PREDICT A 1855 01:09:28,720 --> 01:09:33,200 CONSISTENTLY FROM EACH 1856 01:09:33,200 --> 01:09:34,520 SUBSTANCE, RACIAL DISCRIMINATION 1857 01:09:34,520 --> 01:09:35,760 PREDICTED, CONSISTENTLY FOR EACH 1858 01:09:35,760 --> 01:09:36,960 SUBSTANCE FOR THE BLACK YOUTH, 1859 01:09:36,960 --> 01:09:39,280 WHEN SOME OF THESE OTHER 1S THAT 1860 01:09:39,280 --> 01:09:40,040 WERE CONSIDERED CROSS CULTURAL 1861 01:09:40,040 --> 01:09:41,800 DID NOT, SO WHAT THIS IS REALLY 1862 01:09:41,800 --> 01:09:45,360 HIGHLIGHTS IS THE NEED FOR US TO 1863 01:09:45,360 --> 01:09:50,280 FOCUS AND TO INCLUDE RACISM INTO 1864 01:09:50,280 --> 01:09:51,480 MODELS, INTO SUBSTANCE USE AND 1865 01:09:51,480 --> 01:09:52,960 TO TREATMENTS BECAUSE THIS IS 1 1866 01:09:52,960 --> 01:09:54,840 OF THESE FACTORS THAT IS 1867 01:09:54,840 --> 01:09:56,040 SIGNIFICANT IS CAN HELP US 1868 01:09:56,040 --> 01:09:57,320 PROVIDE BETTER UNDERSTANDING OF 1869 01:09:57,320 --> 01:09:59,720 WHAT'S GOING ON TO HELP THOSE 1870 01:09:59,720 --> 01:10:02,680 THAT WE'RE WORKING WITH, THE 1871 01:10:02,680 --> 01:10:03,200 MOST DIVERSE COMMUNITY 1872 01:10:03,200 --> 01:10:04,960 UNDERSTAND HOW THIS TYPE OF 1873 01:10:04,960 --> 01:10:05,760 STRESSOR CAN IMPACT SUBSTANCE 1874 01:10:05,760 --> 01:10:07,720 USE AS WELL AS PROVIDING COPING 1875 01:10:07,720 --> 01:10:12,720 SKILLS AND HOW TO ADDRESS IT AND 1876 01:10:12,720 --> 01:10:13,440 REDUCE THAT IMPACT. 1877 01:10:13,440 --> 01:10:14,560 CO TRANSACTIVATOR PART I'VE DONE 1878 01:10:14,560 --> 01:10:16,360 IN MY WORK ARE RACIAL 1879 01:10:16,360 --> 01:10:18,640 MICROAGGRESSIONS WHICH ARE BRIEF 1880 01:10:18,640 --> 01:10:20,760 EVERYDAY EXCHANGES, SO THESE ARE 1881 01:10:20,760 --> 01:10:23,160 THE MACROLARGE EVENTS WHICH ARE 1882 01:10:23,160 --> 01:10:24,920 ALSO VERY TRAUMATIZING AND 1883 01:10:24,920 --> 01:10:27,240 STRESSFUL AND THESE RACIAL 1884 01:10:27,240 --> 01:10:28,040 MICROAGGRESSIONS ARE SUSHTLE, 1885 01:10:28,040 --> 01:10:31,360 THEY CAN BE VERBAL, NONVERBAL, 1886 01:10:31,360 --> 01:10:35,040 FEELING WATCH WHD YOU GO TO THE 1887 01:10:35,040 --> 01:10:36,280 STORE, POLICED, PEOPLE SAYING 1888 01:10:36,280 --> 01:10:37,880 THINGS LIKE CAN I TOUCH YOUR 1889 01:10:37,880 --> 01:10:39,600 HAIR OR WHERE ARE YOU FROM? 1890 01:10:39,600 --> 01:10:42,160 OR YOU TALK REALLY GOOD FOR 1891 01:10:42,160 --> 01:10:44,440 BEING BLACK OR X, WHATEVER, YOU 1892 01:10:44,440 --> 01:10:47,440 KNOW WHATEVER IESHES DENTITY SO 1893 01:10:47,440 --> 01:10:51,000 AGAIN, THEY'RE UNINTENTIONAL BUT 1894 01:10:51,000 --> 01:10:53,680 THEY RELEASE UNFEELING, 1895 01:10:53,680 --> 01:10:54,480 ISOLATED, UNSAVE ASK ALIENATED 1896 01:10:54,480 --> 01:10:57,200 AND WE WANT TO SHOW AGAIN THESE 1897 01:10:57,200 --> 01:10:58,520 ARE IMPORTANT STRESSORS FOR 1898 01:10:58,520 --> 01:10:59,600 SUBSTANCE USE FOR OTHER 1899 01:10:59,600 --> 01:11:00,960 STRESSORS THAT PEOPLE USE, SO WE 1900 01:11:00,960 --> 01:11:03,760 DID A STUDY LOOKING AT TRAUMA 1901 01:11:03,760 --> 01:11:06,160 USING TRADITIONAL TRAUMA 1902 01:11:06,160 --> 01:11:07,400 MEASURES, IN MANY DIFFERENT 1903 01:11:07,400 --> 01:11:09,360 STRESSORS THAT PEOPLE EXPERIENCE 1904 01:11:09,360 --> 01:11:11,680 AND THEN SPECIFICALLY RACIAL 1905 01:11:11,680 --> 01:11:12,600 MICROAGGRESSIONS THAT HAPPEN 1906 01:11:12,600 --> 01:11:13,560 ACROSS DIFFERENT SEGMENTS OF 1907 01:11:13,560 --> 01:11:14,520 SOMEONE'S LIFE AND AGAIN WE 1908 01:11:14,520 --> 01:11:16,240 FOUND THAT IN PREDICTING PROBLEM 1909 01:11:16,240 --> 01:11:19,120 ALCOHOL USE THAT THE RACIAL 1910 01:11:19,120 --> 01:11:19,960 MICROAGGRESSIONS PREDICTED ABOVE 1911 01:11:19,960 --> 01:11:22,840 AND BEYOND TRAUMA AND THE TRAUMA 1912 01:11:22,840 --> 01:11:25,720 DID PREDICT CANNABIS USE, 1913 01:11:25,720 --> 01:11:27,280 ALCOHOL AND OTHER 1914 01:11:27,280 --> 01:11:28,240 MICROAGGRESSIONS DID PROMPT 1915 01:11:28,240 --> 01:11:29,840 CANNABIS USE, SO ALL THIS TO SAY 1916 01:11:29,840 --> 01:11:31,840 IT'S IMPORTANT TO INCLUDE THOSE, 1917 01:11:31,840 --> 01:11:34,160 THERE'S ALSO OTHER CULTURALLY 1918 01:11:34,160 --> 01:11:37,000 RELEVANT FACTORS SUCH AS RACIAL 1919 01:11:37,000 --> 01:11:39,760 IDENTITY, AND RACIAL ETHNIC 1920 01:11:39,760 --> 01:11:40,800 SOCIALIZATION, IT CAN BE 1921 01:11:40,800 --> 01:11:44,880 IMPORTANT TO INCLUDE 1922 01:11:44,880 --> 01:11:45,920 INTERVENTIONS AND TREATMENTS TO 1923 01:11:45,920 --> 01:11:48,160 HELP ADDRESS THE ISSUES AND THE 1924 01:11:48,160 --> 01:11:48,760 COMMUNITY AND THE INDIVIDUALS 1925 01:11:48,760 --> 01:11:50,360 FACE SO ALL THIS WILL SAY IF WE 1926 01:11:50,360 --> 01:11:54,240 DO THESE THINGS WE CAN INCREASE 1927 01:11:54,240 --> 01:11:55,480 ACCESS AND SUBSTANCE USE 1928 01:11:55,480 --> 01:11:57,360 TREATMENT, AND WE CAN INCREASE 1929 01:11:57,360 --> 01:12:00,520 ENGAGEMENT OF PARTICULARLY BLACK 1930 01:12:00,520 --> 01:12:02,360 AMERICANS COMPLETION RATES OF 1931 01:12:02,360 --> 01:12:03,800 TREATMENTS AND ULTIMATELY 1932 01:12:03,800 --> 01:12:06,240 DECREASE SUBSTANCE USE AND 1933 01:12:06,240 --> 01:12:08,080 OUTCOMES AND DECREASE 1934 01:12:08,080 --> 01:12:11,880 DISPARITIES IN OUTCOMES ACROSS 1935 01:12:11,880 --> 01:12:15,440 DEVELOPMENT. 1936 01:12:15,440 --> 01:12:17,440 >> THANK YOU, THOSE WERE ALL 1937 01:12:17,440 --> 01:12:18,360 GREAT PRESENTATIONS. 1938 01:12:18,360 --> 01:12:23,280 I KNOW WE PROBABLY ONLY HAVE A 1939 01:12:23,280 --> 01:12:27,600 LITTLE BIT OF TIME FOR QUESTIONS 1940 01:12:27,600 --> 01:12:29,120 IF ANYBODY IN THE AUDIENCE WANTS 1941 01:12:29,120 --> 01:12:32,200 TO SEND ANY OF US A QUESTION, 1942 01:12:32,200 --> 01:12:34,480 PLEASE DO. 1943 01:12:34,480 --> 01:12:35,440 >> I CERTAINLY THINK IT'S SO 1944 01:12:35,440 --> 01:12:39,960 INTERESTING TO SEE ALL OF THE 1945 01:12:39,960 --> 01:12:46,920 EVIDENCE KIND OF POINTING IN 1946 01:12:46,920 --> 01:12:51,800 SUMULAR DIRECTIONS AND WHAT'S 1947 01:12:51,800 --> 01:12:53,760 THE--I JUST WANTED TO THANK 1948 01:12:53,760 --> 01:13:05,680 EVERYBODY FOR PARTICIPATING. 1949 01:13:05,680 --> 01:13:11,840 I--OKAY, SOME QUESTIONS ARE 1950 01:13:11,840 --> 01:14:36,320 COMING IN. 1951 01:14:36,320 --> 01:14:40,320 --SO I THINK THERE IS A NEED, I 1952 01:14:40,320 --> 01:14:41,160 BELIEVE IN ACADEMIA, IT'S HAVING 1953 01:14:41,160 --> 01:14:42,560 MORE BUT I DON'T KNOW HOW MUCH 1954 01:14:42,560 --> 01:14:46,400 IN JUST A GENERAL PUBLIC, IS 1955 01:14:46,400 --> 01:14:47,160 BEING DISCUSSED. 1956 01:14:47,160 --> 01:14:49,560 BUT I THINK HAVING THESE 1957 01:14:49,560 --> 01:14:51,240 DISCUSSIONS DEMYSTIFYS IT AND 1958 01:14:51,240 --> 01:14:53,960 HELPS PEOPLE THAT ARE 1959 01:14:53,960 --> 01:14:54,320 EXPERIENCING 1960 01:14:54,320 --> 01:14:54,920 THIS--NEURNOT--YOU'RE NOT JUST 1961 01:14:54,920 --> 01:14:55,680 THINKING THESE THINGS ARE 1962 01:14:55,680 --> 01:14:56,720 HAPPENING AND THEY'RE NOT, BUT 1963 01:14:56,720 --> 01:15:00,160 THEY ARE AND THEY ARE IMPORTANT 1964 01:15:00,160 --> 01:15:02,320 AND IMPACTFUL: 1965 01:15:02,320 --> 01:15:03,720 >> THAT'S A GREAT POINT, THE 1966 01:15:03,720 --> 01:15:04,760 FACT THAT THERE'S ALWAYS 1967 01:15:04,760 --> 01:15:06,120 DIVISION BETWEEN WHAT WE'RE 1968 01:15:06,120 --> 01:15:08,320 DOING IN RESEARCH VERSUS WHAT 1969 01:15:08,320 --> 01:15:14,520 PEOPLE HERE AND TALK ABOUT IN 1970 01:15:14,520 --> 01:15:15,520 LIKE THE COMMUNITY AND WHEN I 1971 01:15:15,520 --> 01:15:16,760 WAS MEETING WITH SOME PEOPLE, WE 1972 01:15:16,760 --> 01:15:17,960 WERE TALKING AND I PLAYED SOME 1973 01:15:17,960 --> 01:15:22,160 OF THE TAPE, AND THEY SAID, THIS 1974 01:15:22,160 --> 01:15:25,240 GOES ON, THIS IS EVERY DAY LIFE, 1975 01:15:25,240 --> 01:15:26,520 YOU KNOW BEING DISCRIMINATED 1976 01:15:26,520 --> 01:15:27,480 AGAINST, BUT IT'S IMPORTANT TBR 1977 01:15:27,480 --> 01:15:32,920 OTHER PEOPLE TO KNOW AND TO HEAR 1978 01:15:32,920 --> 01:15:33,080 IT. 1979 01:15:33,080 --> 01:15:39,000 AND TO KNOW THAT IT HURTS--THAT 1980 01:15:39,000 --> 01:15:41,160 IT AFFECTS US. 1981 01:15:41,160 --> 01:15:43,640 SO IT'S INTERESTING. 1982 01:15:43,640 --> 01:15:44,040 GO AHEAD HUMBERTO. 1983 01:15:44,040 --> 01:15:45,440 >> I WANT TO HIT SOMETHING 1984 01:15:45,440 --> 01:15:46,640 BECAUSE I COMPLETELY AGREE AND I 1985 01:15:46,640 --> 01:15:48,240 THINK THAT ANOTHER ELEMENT THAT 1986 01:15:48,240 --> 01:15:49,440 IS REALLY HELPFUL IS TO THINK 1987 01:15:49,440 --> 01:15:51,120 ABOUT HOW ARE WE GOING TO BE 1988 01:15:51,120 --> 01:15:53,160 TRAINING THE CLINICIANS TO HAVE 1989 01:15:53,160 --> 01:15:53,760 THESE CONVERSATIONS? 1990 01:15:53,760 --> 01:15:57,720 BECAUSE IT'S SO CLEAR THAT 1991 01:15:57,720 --> 01:16:02,680 RACISM PLAYS SUCH A CRITICAL 1992 01:16:02,680 --> 01:16:10,160 ROLE IN PEOPLE'S EXPERIENCES AND 1993 01:16:10,160 --> 01:16:10,760 PEOPLE'S ALCOHOL COMSUMPTIONS. 1994 01:16:10,760 --> 01:16:12,960 BUT YOU KNOW THROUGH 1 OF THE 1995 01:16:12,960 --> 01:16:15,040 SLIDES THAT TAMIKA HAD SLAIRED 1996 01:16:15,040 --> 01:16:18,720 SAID, THESE ARE THINGS I RESERVE 1997 01:16:18,720 --> 01:16:20,240 FOR MY BLACK CLINICIANS, MAYBE 1998 01:16:20,240 --> 01:16:22,360 IT WAS VICTOR BUT I THINK THAT'S 1999 01:16:22,360 --> 01:16:23,760 REALLY TELLING OF, YOU KNOW 2000 01:16:23,760 --> 01:16:24,960 PEOPLE WANT TO MAKE SURE THAT 2001 01:16:24,960 --> 01:16:26,520 WHEN THEY'RE TALKING TO 2002 01:16:26,520 --> 01:16:28,600 SOMEBODY, THE PERSON GETS IT AND 2003 01:16:28,600 --> 01:16:30,000 YOU'RE NOT HAVING TO EXPLAIN 2004 01:16:30,000 --> 01:16:34,040 KIND OF WHAT YOU MEAN OR THE 2005 01:16:34,040 --> 01:16:35,400 CULTURAL IMPLICATIONS ARE OR 2006 01:16:35,400 --> 01:16:38,160 EVEN THIS KIND OF CONCERN OF 2007 01:16:38,160 --> 01:16:39,120 WILL THIS PERSON UNDERSTAND WHAT 2008 01:16:39,120 --> 01:16:40,560 I'M SAYING OR WILL THEY ALSO 2009 01:16:40,560 --> 01:16:42,400 JUDGE ME AND I THINK THAT WE 2010 01:16:42,400 --> 01:16:45,600 HAVE A LONG WAY TO GO BECAUSE 2011 01:16:45,600 --> 01:16:48,000 THE MAJORITY OF SERVICE 2012 01:16:48,000 --> 01:16:50,720 PROVIDERS ARE WHAT? 2013 01:16:50,720 --> 01:17:02,360 AND SO WE NEED TO MAKE SURE THAT 2014 01:17:02,360 --> 01:17:18,680 PEOPLE ARE THANK YOU, THAT WAS 2015 01:17:18,680 --> 01:18:04,520 THAT'S VERY STRIKING TO PICK UP. 2016 01:18:04,520 --> 01:18:06,000 WELL, AGAIN,--I DON'T KNOW THAT 2017 01:18:06,000 --> 01:18:09,360 THE SPECIFIC INTERVENTIONS WE 2018 01:18:09,360 --> 01:18:10,520 TALKED ABOUT HAVE BEEN REP 2019 01:18:10,520 --> 01:18:12,040 LIAISON KAILTED TO THESE 2020 01:18:12,040 --> 01:18:14,160 COMMUNITIES BUT I KNOW THEY ARE 2021 01:18:14,160 --> 01:18:17,000 DOING IT CULTURALLY ADAPTED AND 2022 01:18:17,000 --> 01:18:18,720 TAILORED PROGRAMMING WITHIN THE 2023 01:18:18,720 --> 01:18:19,720 NATIVE COMMUNITY. 2024 01:18:19,720 --> 01:18:20,160 >> THAT'S GREAT. 2025 01:18:20,160 --> 01:18:20,520 THANK YOU. 2026 01:18:20,520 --> 01:18:21,880 >> I WILL JUST END WITH 1 MORE 2027 01:18:21,880 --> 01:18:23,280 QUESTION, I KNOW PEOPLE ARE 2028 01:18:23,280 --> 01:18:25,160 HANGING ON, BUT THIS IS A 2029 01:18:25,160 --> 01:18:29,200 QUESTION FOR YOU DR. SAPOLSKI, 2030 01:18:29,200 --> 01:18:30,200 CAN WE USE--INSTEAD OF QUESTIONS 2031 01:18:30,200 --> 01:18:31,880 CAN WE USE THE DAILY BASIS THEA 2032 01:18:31,880 --> 01:18:32,760 YOU SHARED AND RECOMMEND 2033 01:18:32,760 --> 01:18:33,720 ANTICIPATIONS TO GENERALIZE TO 2034 01:18:33,720 --> 01:18:34,760 MOST COMMUNITIES THE UNITED 2035 01:18:34,760 --> 01:18:36,400 STATES, I BELIEVE IT'S MAYBE 2036 01:18:36,400 --> 01:18:40,960 MOST BLACK COMMUNITIES, IN THE 2037 01:18:40,960 --> 01:18:42,880 UNITED STATES, HOPING I GOT THE 2038 01:18:42,880 --> 01:18:43,720 QUESTION RIGHT. 2039 01:18:43,720 --> 01:18:44,960 >> I'M NOT SURE WHICH DATA 2040 01:18:44,960 --> 01:18:48,520 YOU'RE REFERRING TO BUT I MEAN, 2041 01:18:48,520 --> 01:18:51,520 YEAH, THE DATA I PROVIDE WORK 2042 01:18:51,520 --> 01:18:53,160 FOR ALMOST EXCLUSIVELY,. 2043 01:18:53,160 --> 01:18:54,440 >> YOU CAN GO-- 2044 01:18:54,440 --> 01:18:55,360 >> RECOMMENDATION, YES, YES. 2045 01:18:55,360 --> 01:18:56,880 >> YEAH, YEAH, THE DATA I 2046 01:18:56,880 --> 01:18:57,960 PROVIDED WERE THERE, BUT THERE 2047 01:18:57,960 --> 01:18:59,280 ARE STUDIES THAT DO REPLICATE 2048 01:18:59,280 --> 01:19:00,440 AND THERE ARE STUDIES WE HAVE 2049 01:19:00,440 --> 01:19:02,120 DONE THAT HAVE INCLUDED RACIAL 2050 01:19:02,120 --> 01:19:03,360 ETHNIC GROUPS AS WELL. 2051 01:19:03,360 --> 01:19:06,520 AND MANY OF THEM DO REPLICATE 2052 01:19:06,520 --> 01:19:08,160 ACROSS GROUPS SO I--I WOULD SAY 2053 01:19:08,160 --> 01:19:09,760 ACROSS THE BOARD, AND FOR ME, 2054 01:19:09,760 --> 01:19:11,880 AND MY WORK AS AN EDUCATOR I DO 2055 01:19:11,880 --> 01:19:15,000 TALK TO MY STUDENTS, ON BEING 2056 01:19:15,000 --> 01:19:16,320 CULTURALLY INFORMED AND HOW TO 2057 01:19:16,320 --> 01:19:17,760 HAVE THESE CONVERSATIONS WITHIN 2058 01:19:17,760 --> 01:19:19,520 OUR WORK AND MAKE IT PART OF THE 2059 01:19:19,520 --> 01:19:20,440 CONVERSATION, EVERYONE HAS A 2060 01:19:20,440 --> 01:19:27,160 CULTURE AND A FACTOR ON THIS AND 2061 01:19:27,160 --> 01:19:27,600 IT'S IMPORTANT FACTORS 2062 01:19:27,600 --> 01:19:29,560 WHENSOEVER THOSE MAY BE, AND 2063 01:19:29,560 --> 01:19:30,400 PEOPLE IDENTIFY THEMSELVES SO I 2064 01:19:30,400 --> 01:19:32,840 WOULD SAY, I USE THIS FOR 2065 01:19:32,840 --> 01:19:35,240 OUTSIDE OF RACE ETHNICITY, TALK 2066 01:19:35,240 --> 01:19:38,080 ABOUT THESE THINGS INVOLVED. 2067 01:19:38,080 --> 01:19:41,160 >> JUST 1 LAST QUESTION, THAT IS 2068 01:19:41,160 --> 01:19:41,920 WERE THERE--WAS COMMUNITY 2069 01:19:41,920 --> 01:19:43,960 SUPPORT GROUPS MENTION INDEED 2070 01:19:43,960 --> 01:19:47,400 THE CONVERSATION WITH CLIENTS OR 2071 01:19:47,400 --> 01:19:48,160 PARTICIPANTS LIKE AA MEETINGS, I 2072 01:19:48,160 --> 01:19:52,600 GUESS THAT COULD BE A QUESTION 2073 01:19:52,600 --> 01:19:58,320 FOR HUMBERTO VICTOR OR RECEDO? 2074 01:19:58,320 --> 01:19:59,520 >> WERE THERE ANY COMMUNITY 2075 01:19:59,520 --> 01:20:02,160 SUPPORT GROUPS, WAS THAT EVER 2076 01:20:02,160 --> 01:20:05,480 MENTIONED IN THERE THAT'S THE 2077 01:20:05,480 --> 01:20:05,760 QUESTION. 2078 01:20:05,760 --> 01:20:07,120 >> I WOULD SAY THOSE ARE 2079 01:20:07,120 --> 01:20:08,960 DEFINITELY THINGS THAT WERE 2080 01:20:08,960 --> 01:20:09,240 SURFACED. 2081 01:20:09,240 --> 01:20:11,960 AND YOU KNOW, IT REALLY, HOW 2082 01:20:11,960 --> 01:20:14,320 PEOPLE IF AT ALL WERE CONNECT 2083 01:20:14,320 --> 01:20:15,520 WITH THESE SERVICES, SOMETIMES, 2084 01:20:15,520 --> 01:20:17,960 YOU KNOW, I GUESS IT WOULD BE 2085 01:20:17,960 --> 01:20:19,520 SUPERINTERESTING TO SEE THE 2086 01:20:19,520 --> 01:20:20,800 LEVEL OF ACULTERATION AND THE 2087 01:20:20,800 --> 01:20:22,360 CONNECTION TO GROUPS 2088 01:20:22,360 --> 01:20:23,920 PARTICULARLY WITH RECENT 2089 01:20:23,920 --> 01:20:25,520 IMMIGRANTS IT WAS CHALLENGING TO 2090 01:20:25,520 --> 01:20:27,280 KNOW WHAT GROUPS EXIST AND HOW 2091 01:20:27,280 --> 01:20:30,280 TO GET CONNECTED BUT, A LOT OF 2092 01:20:30,280 --> 01:20:31,840 FOLKS WERE--WERE MORE CONNECTED 2093 01:20:31,840 --> 01:20:36,200 WITH SOCIAL GROUPS IN 2094 01:20:36,200 --> 01:20:36,520 PARTICULAR. 2095 01:20:36,520 --> 01:20:37,400 >> YEAH, THAT WOULD BE IMPORTANT 2096 01:20:37,400 --> 01:20:41,720 BECAUSE OF WHAT YOU LED WITH 2097 01:20:41,720 --> 01:20:44,960 CONCERNING THE PROFOUNDNESS OF 2098 01:20:44,960 --> 01:20:46,960 THE ISOLATION THAT YOU--THAT 2099 01:20:46,960 --> 01:20:53,040 REALLY PARTICIPANTS SHARED WITH 2100 01:20:53,040 --> 01:20:53,200 YOU. 2101 01:20:53,200 --> 01:20:54,800 >> OKAY, WELL, AGAIN, THANK YOU 2102 01:20:54,800 --> 01:20:56,960 TO EVERYBODY WHO'S ATTENDED AND 2103 01:20:56,960 --> 01:21:07,080 THANK YOU ALL ON THE PANEL 2104 01:21:07,080 --> 01:21:08,200 WHO'VE SHARED YOUR COMMENTS AND 2105 01:21:08,200 --> 00:00:00,000 HAVE BEEN VERY ENLIGHTENING