Tailoring Substance Abuse Interventions for Minority Groups

    • August 4, 2008

Position: Associate Director
Center for Substance Abuse Prevention's
Northeast Center for the Application of Prevention Technologies
Education Development Center
New York, N.Y.

When Deborah McLean Leow was 15, she and her family moved from Guyana, South America, to the Crown Heights section of Brooklyn, N.Y. There she was confronted daily with drug and alcohol users and sellers as she walked to school. She walked by abandoned buildings where drug selling took place, and had to go past young men and boys working their corners to sell drugs.

Leow wanted to get out but she also wanted to help.

Leow used her Developing Leadership in Reducing Substance Abuse fellowship to create substance abuse interventions tailored to minority communities.

Leow, a social worker, was working as the associate director for the Center for Substance Abuse Prevention's Northeast Center for the Application of Prevention Technologies. There she helped policy-makers in northeastern states seek and use evidence-based interventions in designing their substance abuse policies.

Bridging a Gap in the Addiction Field

"I went after this fellowship to bridge the gap I've felt as a minority, as a black woman and as an immigrant with the work I was doing in the addiction field," she said. "Part of what I observed was that the interventions are often generic and with a mainstream population in mind. There is often a need to customize these services to a minority population. It doesn't happen a lot in our field."

Through the course of her fellowship, Leow's project morphed into research. She originally saw herself interviewing providers, talking to parents and creating a documentary to educate professionals about immigrant cultures with the goal of increasing cultural competency.

But a shift in the U.S. political climate in 2006 towards anti-immigrant sentiments meant it became unsafe for immigrants—especially undocumented immigrants—to speak publicly and be captured on film about their experiences.

Working with her mentor, Felipe Castro Gonzalez, Ph.D., a psychology professor at Arizona State University, Tempe, Ariz., Leow decided to embark on a more rigorous research project.

In partnership with five New Jersey community-based organizations providing substance abuse services to diverse communities, Leow and others working on her project interviewed 96 parents living in seven New Jersey counties to study the relationship between acculturation, parenting and access to substance abuse services.

Supporting Family Success in America and Preserving Family Traditions

"One of the challenges that service providers face is how to engage immigrant parents around alcohol and drugs if it's not their primary concern or their only concern," Leow said. "One suggestion that I often make now is that we have to marry what we see as a priority—alcohol prevention and treatment—to their salient concerns.

"I found that although parents are concerned about alcohol and drugs and related problems such as gangs and violence, and they are interested in utilizing alcohol and drug services, few parents actually participate in such services. This is particularly true for traditional, low acculturated families who are nested in their 'home culture' and very self-conscious about seeking ATOD (alcohol, tobacco and other drug) services."

The study also identified dominant cross-cultural values/traditions that parents want to preserve and see as protective, according to Leow. For instance, moral values such as respect for family and elders, maintaining cultural customs and traditions (language, foods and music), religion and church attendance and the value of education.

"I think that these values and traditions offer cultural themes that can be integrated into services designed for immigrant/ethnic groups from Latin America and the Caribbean," says Leow. "Parents shared a strong desire for child/family to succeed in America, which I think can serve as a motivating force to engage immigrant parents in preventive services," she added.

Leow suggests that for these parents, programs can be made more culturally relevant by:

  • Supporting the preservation of ethnic values from their home country and emphasizing the importance of respect for parents/elders.
  • Facilitating the maintenance of cultural customs and traditions (language, foods, music).
  • Addressing health literacy and marketing the benefits of services for parents who are traditional, low in acculturation to mainstream American culture and who have limited English proficiency.

A take-home message for service providers is that parents want to give their children the greatest opportunity for success in America. Service providers can help parents to become comfortable seeking ATOD and other prevention services by supporting family success while at the same time assist parents to preserve protective traditions.

Leow created a website for the project, called Connecting Across Cultures, which features byproducts of her fellowship, including a synthesis of her research findings, funding resources and links to other organizations doing similar work with immigrant populations.

She said that the results of her research also inform her work at the technical assistance center at the Northeast Center for the Application of Prevention Technologies.

What's more, having a mentor and peers in the fellowship program influenced Leow's career direction. She applied for and is enrolled in a doctoral program at Teachers College, Columbia University.

"[My mentor] was very supportive and encouraging," she said. "I struggled a little bit with doing the research project. I didn't have the level of expertise necessary to do it on my own."

She also said that the other fellows gave her unexpected support personally and professionally. Leow had her first child during the fellowship while another fellow, Kim Bishop Stevens, had two children. She and others helped her explore how to combine parenthood and work.

Further Research on Minority Populations

Her research project in the fellowship has lead to other research work with minority populations. For example, she became co-investigator on a federal Centers for Disease Control and Prevention-funded study regarding HIV intervention for African-American and other Black males from Africa and the Caribbean living in New York City.

"The fellowship enabled me to do passion-driven work," Leow said. "It let me tie into my experience of serving communities that have limited influence and access. The fellowship enabled me to reflect on other tools that I need in my toolkit in order to really make a difference for communities that are marginalized."

BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Reports

Leow DM, Goldstein M and McGlinchy L. A Selective Literature Review: Immigration, Acculturation & Substance Abuse, 2006. Available online.

Grantee Websites

cac.hhd.org. Website for "Connecting Across Cultures," which documents research on immigrant families, acculturation and substance abuse. New York: Education Development Center, 2007.