The Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA) at Florida International University was established in 2003 in order to address the escalating twin epidemics of substance abuse and HIV/AIDS affecting Latino communities throughout South Florida. This pioneering, nationally and internationally recognized Center currently houses grant awards from several of the prestigious institutes within the National Institutes of Health (NIH).
A National Institute of Minority Health and Health Disparities (NIMHD) P20 Exploratory Center of Excellence grant titled The Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD; P20MD002288; PI: De La Rosa)
A National Institute of Nursing Research (NINR) R01 grant titled The Intergenerational Transmission of Alcohol Use Among Latino Mothers and Daughters (R01NR012150; PI: De La Rosa)
A National Institute on Alcohol Abuse and Alcoholism (NIAAA) R21 grant, collaboratively administered and investigated with Dr. Eduardo Romano, Pacific Institute For Research and Evaluation (PIRE). The grant is titled Drinking and Driving Among Recent Latino Immigrants (R21AA022202; PIs: De La Rosa, Romano)
CRUSADA Administrative Staff execute the following Specific Aims:
Manage the administration of grants and budgets;
Provide scientific and administrative leadership, overseeing activities of each grant
Coordinate and integrate CRUSADA personnel, FIU colleges, schools, and departments, community-based agencies, governmental and non-governmental agencies, and personnel from colleges, schools, and departments outside of FIU; and facilitate collaboration in research projects;
Monitor and evaluate the effectiveness and impact of the Center's activities in achieving its goals and
objectives in a timely and efficient manner;
Enhance the visibility and reach of the Center at the local, state, and national levels; and
Ensure the long term sustainability and expansion of the Center and its community partners in their
pursuit towards reducing and/or eliminating HIV/AIDS and substance abuse health disparities in Latino
populations and Latina women in Miami-Dade County in particular.
The Center for Substance Use and HIV/AIDS Research on Latinos in the United States
CRUSADA houses a National Institute of Minority Health and Health Disparities (NIMHD) P20 Exploratory Center of Excellence grant titled The Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD; P20MD002288; PI: De La Rosa)
The activities of this grant are structured into four different cores:
The Administrative Core is the key liaison with NIH. It has been designed and structured to support the grant management, direction, coordination, integration, and oversight that is essential to carrying out the grant activities of the Center in a timely and efficient manner and in accordance with NIH requirements.
The Research Core provides the long-term infrastructure support that will facilitate and guide community oriented multidisciplinary research initiatives at FIU. This research is directed towards eliminating substance abuse and HIV health disparities among Latinos, particularly those residing in Miami-Dade County.
The Research Education/Training Core is designed to (a) increase the number of researchers and professionals from racial/ethnic minority and medically underserved populations trained in behavioral research and (b) improve the quality of the training provided to behavioral researchers conducting research on health disparities in HIV/AIDS and substance abuse in Latino populations. Its specific objectives are (1) To develop a cadre of doctoral students at Florida International University who will conduct behavioral research on the nature and extent of the HIV/AIDS and substance abuse epidemics among the Latino population in the United States; (2) To support the career development of postdoctoral trainees at FIU conducting behavioral research on health disparities in HIV/AIDS and substance abuse; and (3) To provide training to community leaders on the conduct of research in HIV/AIDS and substance abuse in Latino populations and to develop their general research skills.
The Community Partnership/Engagement Core is designed to continue collaborative relationships between the Center, FIU, community-based agencies, and the community itself. The Core's overall aim is to establish innovative partnerships between FIU and community organizations for the purpose of improving the health status of Latinos, and in particular Latina women, leading to the reduction and/or elimination of HIV and substance abuse health disparities confronting this population.
The Intergenerational Transmission of Alcohol Use Among Latino Mothers and Daughters
CRUSADA houses a National Institute of Nursing Research (NINR) R01 grant titled The Intergenerational Transmission of Alcohol Use Among Latino Mothers and Daughters (R01NR012150; PI: De La Rosa)
Synopsis: The objective of this study is to determine how the alcohol and illegal drug use (i.e., illicit drug use and non-medical use of prescription drugs) and HIV risk behavior trajectories of a community-based sample of Latina mothers and daughters are influenced by changes in familial (mother-daughter acoplamiento or attachment) and other socio-cultural determinants of substance abuse and HIV risk behaviors over time. Mother-daughter acoplamiento or attachment refers to the degree of mutual trust, quality of communication, and the extent of anger and alienation between mother and daughter (Armsden & Greenberg, 1987). Social determinants of substance abuse and HIV risk behaviors refers to multilevel and theory-based determinants of Latina substance abuse and HIV risk behaviors [e.g., acculturation, poor socioeconomic conditions, loss of interpersonal supports, less religious involvement, involvement with the criminal justice system, intimate partner violence, chronic stress, mental health, medical conditions]. Findings from this study can then be utilized to develop culturally relevant substance abuse and HIV/AIDS prevention and treatment programs that target Latinas across their adult life span.
This NINR-R01 has the following specific aims:
Aim 1. Determine the influence of social determinants on trajectories of change for substance use and HIV risk behaviors among a community-based sample of Latina mothers and daughters. The working hypothesis is that Latina mothers and daughters who experience (1) more acculturation to U.S. culture; (2) poorer socioeconomic conditions; (3) a loss of interpersonal supports; (4) less religious involvement; (5) involvement with the criminal justice system; (6) intimate partner violence; (7) greater employment, relationship, and/or residential related chronic stress; or (8) declining mental health and medical status since their baseline assessment, will exhibit either an increase in or maintenance of high rates of substance use and HIV risk behaviors over the 7 year time period.
Aim 2. Determine the influence of mother-daughter attachment on trajectories of change for substance use and HIV risk behaviors among a community-based sample of Latina mothers and daughters. We hypothesize that Latina mothers and daughters who either increase their levels of attachment with one another or maintain consistently high levels of attachment will indicate reduced or consistently low levels of substance use and HIV risk behaviors over the 7 year time period.
Aim 3. Determine the moderating role of mother-daughter attachment on associations between experiences of detrimental social determinants and trajectories of change for substance use and HIV risk behaviors among a community-based sample of Latina mothers and daughters. We postulate that the association between detrimental social determinants and trajectories of change for substance use and HIV risk behaviors will be moderated by mother-daughter attachment. Specifically, detrimental social determinants will be positively associated with substance use and HIV risk behavior trajectories only among mothers and daughters with declining or consistently low levels of attachment over time (and not among individuals with increasing or high attachment over time). Thus, mother-daughter attachment will buffer the effects of detrimental social determinants on substance use and HIV risk behaviors over time.
Drinking and Driving Among Recent Latino Immigrants
CRUSADA houses a National Institute on Alcohol Abuse and Alcoholism (NIAAA) R21 grant, collaboratively administered and investigated with Dr. Eduardo Romano, Pacific Institute For Research and Evaluation (PIRE). The grant is titled Drinking and Driving Among Recent Latino Immigrants (R21AA022202; PIs: De La Rosa, Romano)
This NIAAA-R21 Grant has the following Specific Aims:
Aim 1. To examine current (post-immigration) risk perceptions associated with drinking and driving (risk of crash involvement, risk and of being arrested) among recent Latino immigrants ages 21-38; as well as their impact on the awareness and understanding of the designated driver â€“DD- concept. We will examine the impact of immigration status (undocumented vs. documented), acculturation, as well as pre-immigration driving behaviors on both the traffic-related risk perceptions and the knowledge of the DD concept.
Aim2. To examine the relative contribution of pre-immigration factors (cultural, family cohesion and social capital assets, alcohol and substance use, and driving behavior) and post-immigration factors (alcohol and substance use, driving behavior, and acculturation-stress). As with Aim 1, we will examine if prevalence of drinking and driving is affected by immigration status (undocumented vs. documented).
Aim3. To estimate the prevalence of drugged-driving among Latino immigrants ages 21-38 who had lived in the U.S. 36 months or less. Because drugged-driving is a more complex activity that drinking and driving (i.e., many drugs, each of different pharmacokinetic and impairing effects), for which almost no information on the target population is available (i.e., the amount of drugged-driving among recent immigrants is unknown, even if it occurs at all). In this exploratory effort we will limit ourselves to estimate pre- and post-immigration prevalence estimates for illicit drugs in general, and marijuana in particular.
For each aim, we will investigate the influence of demographics factors (age, gender, marital status, education, income, reason for immigrating to the United States ) upon the outcome measures; while adjusting our estimates by the participants' driving experience with and attitudes toward other risk-taking driving behaviors (speeding, red light running, seat belt non-use). The findings of this study will not only be informative per se, but also provide the foundation for more comprehensive future research efforts.
CRUSADA conducts Community Based Participatory Research (CBPR) to address the growing problem of HIV/AIDS and substance use health disparities among Latino populations. The Center focuses on the social and cultural determinants of health that link HIV/AIDS and substance use, a priority area of HIV-related research at NIH (according to Fiscal Year 2010 Trans-NIH Plan [HRSA, 2010]). Specifically, CRUSADA investigates determinants impacting Latina women including socio-economic, language, and cultural, as well as health care barriers. The Center's line of research is based on a conceptual framework influenced by the literature on social and cultural influences on health (e.g., Dean & Fenton, 2010; Freemont & Bird, 1999; House, 2001; Link & Phelan, 1995). This scientific paradigm emphasizes "fundamental social and cultural causes" of health diseases to be at the core of the growing HIV and substance abuse epidemics among U.S. Latinos and African Americans.
CRUSADA addresses one of the major objectives of the Healthy People 2020 initiative, which is to reduce the number of new AIDS cases among adolescents and adults who inject drugs (the majority of which are either of Latino or African American descent; U.S. Department of Health & Human Services, 2009). This will be accomplished by increasing the number of substance abuse treatment facilities that provide services such as HIV/AIDS education, counseling, and support to Latino and African American clients. CRUSADA is the only NIMHD P-20 Center whose primary objective is to document the linkages between substance abuse and HIV risk behaviors exclusively among Latinos, and in particular Latina women, primarily of Caribbean and South and Central American descent in the nation (NIMHD, 2010).
The Center facilitates the transfer of culturally relevant information that can be utilized by CBOs in the development of evidence-based HIV and substance abuse prevention strategies among Latina women. Several current major reports and plans highlight the gap between our knowledge of effective treatments (i.e., theory and science) and the services being received by clients (i.e., practice) (Kaiser Family Foundation, 2010; National HIV/AIDS Strategy for the U.S., 2010; National Institute on Drug Abuse and the International Aids Society, 2010). Taking into consideration that Latinas appear to be at heightened risk for alcohol and illicit drug use and contracting HIV, developing evidence based strategies to ameliorate these health disparities is essential (Lyles et al., 2007; CDC, 2010). As noted in the NIH Fiscal year 2010 Plan (p.79-87), it is imperative to sustain a commitment to HIV prevention by recognizing the interventions that have proven efficacious and scaling them up for widespread implementation, particularly among Latino and African American adolescents and young adults.
CRUSADA continues to enhance trust between researchers and the community by allowing for meaningful involvement of the community in the Center's research, training, and community oriented activities.
The Center continues to produce a cadre of scientists conducting research on health disparities that focus on HIV and substance abuse among Latino populations. As fellow stakeholders, these scientists are likely to be highly motivated and have a significant, long-term interest in understanding the social determinants that influence the increased rates of HIV and substance abuse affecting Latino communities. By cultivating scientific interest in this area, the Center aspires to significantly enhance the development of effective culturally-relevant HIV and substance abuse prevention/treatment programs targeting Latinos.