![[ Visit Client Website ]](images/banner.gif)
Young Adults (YA) have the highest prevalence of Alcohol Use Disorder (AUD) in the U.S., while Hispanic YAs face greater alcohol-related health disparities. 12-Step mutual-help fellowships, such as Alcoholics Anonymous (AA), present a promising resource for addressing this public health crisis, given that they are free, widely available, and effective, therefore bypassing many treatment barriers noted among Hispanic YAs. However, misconceptions towards 12-Step language or content may hinder engagement for Hispanic YAs. The present study examines Hispanic YAs’ step-by-step perceptions of the 12 Steps and reports findings from a qualitative study examining community-informed recommendations for adaptation.
Methods
Semi-structured in-depth interviews were conducted with 34 Hispanic YAs (ages 18-29) who met the DSM-5 criteria for moderate-to-severe AUD and reported at least minimal motivation to change drinking behaviors. Data were analyzed using rapid qualitative matrix analysis by three coders, with within-case and cross-case comparisons to identify recurrent patterns. Member checking was conducted to strengthen credibility.
Results
Participants reported varying familiarity with AA/12 Steps, with most knowledge rooted in indirect contact rather than sustained participation. Concerns regarding the 12 Steps centered around two issues: (1) heavy reliance on religious language (“God,” “His will”), and (2) whether steps support personal agency versus passive surrender/powerlessness. On the other hand, participants valued accountability, relationship repair, and self-driven actions in later steps. Improvement suggestions included spirituality/religion flexibility (21%), strengthening community context (15%), and wording refinements (12%). Offering both original and adapted versions and tailoring them to individual religious/cultural preferences, rather than a single fixed version, was favored by most (59%).
Conclusions and Implications
Findings reveal that religious language and powerlessness framing create barriers to AA engagement for Hispanic YAs, while community/family support and self-driven accountability resonate strongly. These insights have important implications for culturally responsive 12-Step facilitation efforts to reduce health disparities in this population.