Substance misuse intervention research in remote Indigenous Australian communities since the NHMRC 'Roadmap'

Graham, Veronica E., Campbell, Sandra, West, Caryn, and Clough, Alan R. (2017) Substance misuse intervention research in remote Indigenous Australian communities since the NHMRC 'Roadmap'. Australian and New Zealand Journal of Public Health, 41 (4). pp. 424-431.

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Objective: Describe program theories of substance misuse interventions with Aboriginal and Torres Strait Islander (Indigenous) Australians funded by the National Health and Medical Research Council (NHMRC) since the 'Roadmap' for Indigenous health.

Methods: Projects funded 2003–2013 were categorised by intervention strategies. Realist concepts informed the program theory: intended resources and responses; influence of context on outcomes; explicit and implicit program assumptions.

Results: Seven interventions were included. Three randomised controlled trials targeted tobacco using psychosocial interventions in primary health centres using the program theory: "Local Indigenous health workers extend and sustain the effects of conventional clinical brief intervention by engendering social and cultural resources". Four pragmatic trials of multiple-component, community-based interventions using controlled, semi-controlled or before-and-after designs used the program theory: "Discrete intervention components targeting locally defined substance misuse issues will activate latent capacities to create an environment that favours cessation." Publications did not report clear effect, implementation fidelity or explicit mechanisms affecting participant thinking.

Conclusions: Rigorous intervention designs built on 'Roadmap' principles neither reduced substance use in the populations studied nor identified transferable mechanisms for behaviour change.

Implications for public health: Substance misuse impacts among Indigenous Australians remain severe. Theoretical mechanisms of behaviour change may improve intervention design.

Item ID: 50112
Item Type: Article (Research - C1)
ISSN: 1753-6405
Keywords: program evaluation, substance abuse, indigenous population, intervention study
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This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Date Deposited: 06 Sep 2017 02:42
FoR Codes: 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450418 Aboriginal and Torres Strait Islander remote health @ 100%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920414 Substance Abuse @ 100%
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