DESCRIPTION (provided by applicant): Annually, there are 1.8 million global deaths due to alcohol. Alcohol use is rapidly increasing in low and middle-income countries, where it is inexpensive, readily available, poorly regulated, and there are few resources devoted to safe alcohol use behavior. Like many other limited resource settings, there are few treatment facilities or addiction practitioners in the Kilimanjaro region of Tanzania. This career development award will allow for the cultural adaptation, validation, and pilot testing of a brief negotiational interview for alcohol use. To do so, the project will 1) describe the current knowledge and perceptions about alcohol use in Tanzania, 2) adapt an evidence-based intervention to the Tanzanian setting and, 3) pilot this intervention in preparation of a large-scae trial. The intervention, a brief negotiational interview, based on a motivational interviewing framework, has proven effective in the US but has not been adapted or implemented in an African context. I am uniquely qualified to lead this project given my 10 years of clinical and research global health experience. I am dedicated to a global health research career, am integrated into the Kilimanjaro Christian Medical Center community, and have conducted the basic alcohol epidemiology research in preparation for this award. To become an independent researcher focusing on addressing alcohol use, I am seeking further skills in mixed methods research, motivational interviewing, global clinical trials, and the responsible conduct of research. This proposal not only provides me with a unique combination of research expertise that are needed in Africa, but also lays a foundation for groundbreaking research to curb the impact of alcohol use in Africa.

PUBLIC HEALTH RELEVANCE: Globally, alcohol causes 1.8 million deaths annually and is the leading disease-attributed risk factor for young adults. Currently, in sub-Saharan Africa, alcohol treatment or alcohol reduction research is limited. This proposal culturally adapts, validates, and pilots a brief negotiational interview for alcohol use reduction amongst a high-risk injury population at Kilimanjaro Christian Medical Center Emergency Department, Tanzania.