Substance misuse intervention research in remote Indigenous Australian communities since the NHMRC roadmap.pdf (123.72 kB)
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journal contribution
posted on 2021-06-23, 02:14 authored by VE Graham, Sandra Campbell, C West, AR CloughObjective: 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.
History
Publication Date
2017-01-01Journal
Australian and New Zealand Journal of Public HealthVolume
41Issue
4Pagination
8p. (p. 424-431)Publisher
Wiley-BlackwellISSN
1326-0200Rights Statement
The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.Publisher DOI
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Science & TechnologyLife Sciences & BiomedicinePublic, Environmental & Occupational Healthprogram evaluationsubstance abuseindigenous populationintervention studyRANDOMIZED CONTROLLED-TRIALTORRES STRAIT ISLANDERENVIRONMENTAL TOBACCO-SMOKEREDUCE RESPIRATORY ILLNESSABORIGINAL COMMUNITIESHEALTH RESEARCHCESSATION INTERVENTIONNORTHERN-TERRITORYREALIST EVALUATIONARNHEM-LANDHumansSubstance-Related DisordersOceanic Ancestry GroupRural PopulationHealth Services, IndigenousHealth Services ResearchAustraliaPublic Health