1
|
Snijder M, Lees B, Stearne A, Ward J, Garlick Bock S, Newton N, Stapinski L. An ecological model of drug and alcohol use and related harms among Aboriginal and Torres Strait Islander Australians: A systematic review of the literature. Prev Med Rep 2021; 21:101277. [PMID: 33391981 PMCID: PMC7773534 DOI: 10.1016/j.pmedr.2020.101277] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/23/2020] [Accepted: 11/21/2020] [Indexed: 11/17/2022] Open
Abstract
Globally, Indigenous populations experience a disproportionately higher burden of disease related to substance use. Effective prevention of harm related to substance use is a key strategy for improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples in Australia. To inform preventative approaches, this review synthesised the evidence of risk and protective factors of substance use and related harms among Aboriginal and Torres Strait Islander peoples. Eight peer-reviewed and two grey literature databases were systematically searched for quantitative or qualitative studies assessing factors associated with substance use and related harms among Aboriginal and Torres Strait Islander peoples, published between 1 January 1990 and 30 April 2018. Study quality was assessed using validated instruments. Risk or odds ratios were extracted or calculated and factors were summarised in an ecological model into individual, relationship, community, societal or culturally-distinct levels. Thirty-eight relevant studies were identified and reviewed. Individual-level risk factors for substance use were identified including low socio-economic status, high psychological distress, poly drug use and being male. Relationship-level factors were peer pressure and partner/family substance use; protective factors were supportive environments and positive role models. Community-level risk factors included availability of substances. Culturally-distinct factors included cultural connection as a protective factor, but cultural obligations around sharing was a risk factor. Societal risk factors included intergenerational trauma caused by government policies. These findings highlight the importance of tailored preventative approaches for Aboriginal and Torres Strait Islander communities that address identified risk factors and promote protective factors across all ecological levels.
Collapse
Affiliation(s)
- Mieke Snijder
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | | | - James Ward
- The Poche Centre for Indigenous Health, University of Queensland, St Lucia, 4067 Queensland, Australia
| | - Sophia Garlick Bock
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, School of Medicine, Medicine and Health, The University of Sydney, Sydney, 2006 New South Wales, Australia
| |
Collapse
|
2
|
Strong and Deadly Futures: Co-Development of a Web-Based Wellbeing and Substance Use Prevention Program for Aboriginal and Torres Strait Islander and Non-Aboriginal Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042176. [PMID: 33672190 PMCID: PMC7926400 DOI: 10.3390/ijerph18042176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/12/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022]
Abstract
School-based programs can effectively prevent substance use; however, systematic reviews and consultation with stakeholders identified a need for effective, culturally inclusive programs for Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) youth. This paper describes the development of Strong & Deadly Futures, a six-lesson, curriculum-aligned wellbeing and substance use prevention program that was designed for, and with, the Aboriginal youth. Formative reviews and consultation recommended that the program (i) combine effective components of mainstream prevention with cultural elements, highlighting Aboriginal cultural strengths; (ii) avoid stigma and celebrates the cultural diversity by catering to both Aboriginal and non-Aboriginal students; and (iii) use digital technology to enhance engagement, implementation and scalability. Guided by an Appreciative Inquiry approach, the program was developed in partnership with an Indigenous Creative Design Agency, and four schools in New South Wales and Queensland, Australia. Aboriginal (n = 41) and non-Aboriginal students (n = 36) described their role models, positive aspects of their community and reasons to avoid substance use; these formed the basis of an illustrated story which conveyed the key learning outcomes. Feedback from teachers, students and content experts supported the acceptability of the program, which will be evaluated in a subsequent randomised controlled trial.
Collapse
|
3
|
Dickerson DL, Parker J, Johnson CL, Brown RA, D'Amico EJ. Recruitment and retention in randomized controlled trials with urban American Indian/Alaska Native adolescents: Challenges and lessons learned. Clin Trials 2021; 18:83-91. [PMID: 33231130 PMCID: PMC7878293 DOI: 10.1177/1740774520971774] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although the majority of American Indians/Alaska Natives reside in urban areas, there are very few randomized controlled trials analyzing culturally centered substance use prevention interventions for this population. METHODS We describe methods employed to recruit and retain urban American Indian/Alaska Native adolescents into a randomized controlled trial, which was focused on testing the potential benefits of a substance use prevention intervention for this population. We also report challenges encountered in recruitment and retention of participants and strategies employed addressing these challenges. Data collection occurred from August 2014 to October 2017. RESULTS We partnered with two community-based organizations in different cities in California. We utilized American Indian/Alaska Native recruiters from communities, placed flyers in community-based organizations, and asked organizations to post flyers on their web and social media sites. We also offered gift cards for participants. Our initial recruitment and retention model was moderately successful; however, we encountered five main challenges: (1) transportation, (2) increasing trust and interest, (3) adding research sites, (4) getting the word out about the project, and (5) getting youth to complete follow-up surveys. Strategies employed to overcome transportation challenges included shortening the number of sessions, offering sessions on both weekends and weekdays, and increasing bus tokens and transportation options. We hired more staff from American Indian/Alaska Native communities, added more research sites from our previously established relationships, and were more proactive in getting the word out on the project in American Indian/Alaska Native communities. We also utilized more field tracking and emailed and mailed survey invitations to reach more participants for their follow-up surveys. Because of our efforts, we were nearly able to reach our initial recruitment and retention goals. CONCLUSION Although our research team had previously established relationships with various urban American Indian/Alaska Native communities, we encountered various recruitment and retention challenges in our study. However, by identifying challenges and employing culturally appropriate strategies, we were able to collect valuable data on the potential effectiveness of a substance use prevention intervention for urban American Indian/Alaska Native adolescents. Findings from this study assist toward the development of potentially successful strategies to successfully recruit and retain urban American Indian/Alaska Native adolescents in randomized controlled trials.
Collapse
Affiliation(s)
- Daniel L Dickerson
- UCLA Integrated Substance Abuse Programs (ISAP), University of California Los Angeles, Los Angeles, CA, USA
| | | | | | | | | |
Collapse
|
4
|
Snijder M, Stapinski L, Lees B, Ward J, Conrod P, Mushquash C, Belone L, Champion K, Chapman C, Teesson M, Newton N. Preventing Substance Use Among Indigenous Adolescents in the USA, Canada, Australia and New Zealand: a Systematic Review of the Literature. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:65-85. [PMID: 31641922 PMCID: PMC6957574 DOI: 10.1007/s11121-019-01038-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This systematic review assessed the current evidence base of substance use prevention programs for Indigenous adolescents in the USA, Canada, Australia and New Zealand. The authors investigated (a) the outcomes, type, setting and context of prevention programs; (b) the common components of beneficial prevention programs; and (c) the methodological quality of evaluations of included prevention programs. The authors searched eight peer-reviewed and 20 grey literature databases for studies published between 1 January 1990 and 31 August 2017. Data extracted included type of program (culturally adapted, culture-based or unadapted), the setting (school, community, family or multi-setting), delivery (computerised or traditional), context (Indigenous-specific or multi-cultural environment) and common components of the programs. Program evaluation methodologies were critically appraised against standardised criteria. This review identified 26 eligible studies. Substance use prevention programs for Indigenous youth led to reductions in substance use frequency and intention to use; improvements in substance-related knowledge, attitudes and resistance strategies; and delay in substance use initiation. Key elements of beneficial programs included substance use education, skills development, cultural knowledge enhancement and community involvement in program development. Five programs were rated as methodologically strong, seven were moderate and fourteen were weak. Prevention programs have the potential to reduce substance use among Indigenous adolescents, especially when they are developed in partnership with Indigenous people. However, more rigorously conducted evaluation trials are required to strengthen the evidence base.
Collapse
Affiliation(s)
- Mieke Snijder
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia.
| | - Lexine Stapinski
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Briana Lees
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - James Ward
- South Australian Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Patricia Conrod
- Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Christopher Mushquash
- Centre for Rural and Northern Health Research, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Canada
| | - Lorenda Belone
- Department of Health, Exercise & Sports Sciences, College of Education, University of New Mexico, Albuquerque, NM, USA
| | - Katrina Champion
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Cath Chapman
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Maree Teesson
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| | - Nicola Newton
- The Matilda Centre, Faculty of Health and Medicine, The University of Sydney, Darlington, Sydney, NSW, 2006, Australia
| |
Collapse
|
5
|
Morris SL, Hospital MM, Wagner EF, Lowe J, Thompson MG, Clarke R, Riggs C. SACRED Connections: A University-Tribal Clinical Research Partnership for School-Based Screening and Brief Intervention for Substance Use Problems among Native American Youth. JOURNAL OF ETHNIC & CULTURAL DIVERSITY IN SOCIAL WORK 2020; 30:149-162. [PMID: 33732098 PMCID: PMC7958493 DOI: 10.1080/15313204.2020.1770654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Native American (NA) youth report higher rates of alcohol, marijuana, and drug use than U.S. adolescents from any other racial/ethnic group. Addressing this health disparity is a significant research priority across public health, minority health, and dissemination and implementation (D&I) sciences, underscoring the need for empirically-based interventions tailored for NA youth. Effective D&I with NA youth incorporates NA cultural values and involves tribal elders and stakeholders. SACRED Connections (NIDA R01DA02977) was a university-tribal research partnership that utilized a culturally derived Native-Reliance theoretical framework and a community-based participatory research (CBPR) approach. A significant objective of this randomized controlled trial was to close D&I gaps utilizing the RE-AIM Model and National Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care Standards (HHS, 2019). Findings of this 5-year RCT revealed a statistically significant protective relationship between Native Reliance and baseline lifetime and past month alcohol and marijuana use; additionally, the likelihood of reporting marijuana use at 3 months post-intervention was significantly lower among the active condition than among the control condition. Implementation of a developmentally and NA culturally tailored brief protocol revealed: partnering with Native Americans and utilizing CBPR facilitated engagement with this hard-to-reach, underserved community; age and culture are associated with substance use severity among NA teens; a culturally adapted Motivational Interviewing (MI) brief intervention may be effective in reducing marijuana use among NA youth; the Native Reliance theory proved useful as a framework for working with this population; and RE-AIM proved helpful in conceptualizing health equity promoting D&I.
Collapse
Affiliation(s)
- Staci L Morris
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
| | - Michelle M Hospital
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
| | - Eric F Wagner
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
| | - John Lowe
- Indigenous Nursing Research for Health Equity, Florida State University, Tallahassee, Florida, USA
| | - Michelle G Thompson
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rachel Clarke
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
| | - Cheryl Riggs
- Indigenous Nursing Research for Health Equity, Florida State University, Tallahassee, Florida, USA
| |
Collapse
|
6
|
Maina G, Phaneuf T, Kennedy M, Mclean M, Gakumo A, Nguemo J, King A, Mcharo SK. School-based interventions for preventing substance use in indigenous children ages 7-13: a scoping review protocol. BMJ Open 2020; 10:e034032. [PMID: 32051315 PMCID: PMC7045254 DOI: 10.1136/bmjopen-2019-034032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Throughout the world, indigenous peoples share traumatic colonial experiences that have caused gross inequalities for them and continue to impact every aspect of their lives. The effect of intergenerational trauma and other health disparities have been remarkable for Indigenous children and adolescents, who are at a greater risk of adverse mental health and addiction outcomes compared with non-indigenous people of the same age. Most indigenous children are exposed to addictive substances at an early age, which often leads to early initiation of substance use and is associated with subsequent physical and mental health issues, poor social and relational functioning, and occupational and legal problems. The aim of this paper is to report the protocol for the scoping review of school-based interventions for substance use prevention in Indigenous children ages 7-13 living in Canada, the USA, Australia and New Zealand. This scoping review seeks to answer the following questions: (1) What is known about indigenous school-based interventions for preventing substance use and (2) What are the characteristics and outcomes of school-based interventions for preventing substance use? METHODS AND ANALYSIS This scoping review will use steps described by Arksey and O'Malley and Levac: (1) identifying the research question(s); (2) identifying relevant studies; (3) selecting the studies; (4) charting the data; (5) collating, summarising and reporting the results and (6) consulting with experts. Our findings will be reported according to the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. ETHICS AND DISSEMINATION Ethics review approval is not required for this project. Findings from this study will be presented to lay public, at scientific conferences and published in a peer-reviewed journal.
Collapse
Affiliation(s)
- Geoffrey Maina
- College of Nursing, University of Saskatchewan, Prince Albert, Saskatchewan, Canada
| | - Taryn Phaneuf
- University of Saskatchewan College of Nursing, Prince Albert, Saskatchewan, Canada
| | - Megan Kennedy
- Library, University of Saskatchewan, Saskatoon, Alberta, Canada
| | - Maeve Mclean
- Public Health, University of Saskatchewan College of Graduate Studies and Research, Saskatoon, Saskatchewan, Canada
| | - Ann Gakumo
- Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Joseph Nguemo
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Alexandra King
- Medicine, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Solomon Kasha Mcharo
- Nursing, University of Saskatchewan College of Nursing, Saskatoon, Saskatchewan, Canada
| |
Collapse
|
7
|
Thomas N, van de Ven K, Mulrooney KJD. The impact of rurality on opioid-related harms: A systematic review of qualitative research. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 85:102607. [PMID: 31864787 DOI: 10.1016/j.drugpo.2019.11.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/02/2019] [Accepted: 11/10/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Over the past decade, there has been mounting recognition that opioid use and related mortality and morbidity is a significant public health problem in rural, non-urban areas across the globe. Taking what has been termed the 'opioid crisis' as a starting off point, this article aims to systematically review the qualitative literature on the ways in which rurality shapes the risk for opioid-related harm. METHODS A systematic review was undertaken using database searches and secondary reference list searches for qualitative literature on rural and non-urban opioid-related harms. A total of 32 qualitative studies met the inclusion criteria. Data extraction was performed in NVivo 12 using a codebook based on the 'risk environment' framework. RESULTS The findings explore how rurality shapes the risk environment for opioid-related harms through four environment influences: (1) economic conditions, including economic transition and deindustrialisation that has occurred in many rural areas, and the high levels of economic distress experienced by rural residents; (2) physical conditions, including a lack of infrastructure and recreation opportunities, larger geographic distances, and limited transportation; (3) social conditions, where social networks could be both protective but also amplify risk through a lack of knowledge about treatment and risk behaviours, a lack of anonymity and stigmatisation of people who use opioids in rural areas; and (4) policy conditions including limited coverage and availability of harm reduction and drug treatment services, and stigmatising service provider practices. CONCLUSIONS The impact of rurality on risk of opioid-related harm is multifaceted. We suggest that future research on rural opioid use would benefit from drawing on the theoretical toolkit of rural criminology to attend to the ways the 'rural crisis', and attendant insecurities, anxieties and strains, impacts upon rural communities and shapes risk, along with how socio-cultural characteristics of the rural 'organise' risks of drug use.
Collapse
Affiliation(s)
- Natalie Thomas
- Centre for Rural Criminology, University of New England, Armidale, New South Wales, Australia; School of Humanities, Arts, and Social Sciences, University of New England, Armidale, New South Wales, Australia.
| | - Katinka van de Ven
- Centre for Rural Criminology, University of New England, Armidale, New South Wales, Australia; Drug Policy Modelling Program, Social Policy Research Centre, UNSW, Sydney, NSW, Australia
| | - Kyle J D Mulrooney
- Centre for Rural Criminology, University of New England, Armidale, New South Wales, Australia; School of Humanities, Arts, and Social Sciences, University of New England, Armidale, New South Wales, Australia
| |
Collapse
|
8
|
Snijder M, Lees B, Ward J, Stearne AE, Newton NC, Stapinski L. Developing an ecological framework of factors associated with substance use and related harms among Aboriginal and Torres Strait Islander people: protocol for a systematic review. BMJ Open 2019; 9:e024418. [PMID: 31061022 PMCID: PMC6502052 DOI: 10.1136/bmjopen-2018-024418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Aboriginal and Torres Strait Islander people experience high rates of substance use and related harms. Previous prevention programmes and policies have met with limited success, particularly among youth, and this may be a result of inadequately targeting the unique risk and protective factors associated with substance use for Aboriginal and Torres Strait Islander people. The purpose of this systematic review is to therefore synthesise the risk and protective factors associated with substance use and related harms among Aboriginal and Torres Strait Islander people, and critically appraise the methodological quality of the included studies. METHODS AND ANALYSIS A total of seven peer-reviewed (Cochrane, Embase, PsychInfo, Medline, ProQuest, Informit, and CINAHL) and two grey literature (Heath InfoNet and Closing the Gap Clearinghouse) databases will be systematically searched using search terms in line with the aims of this review and based on previous relevant reviews. Studies published between 1 January 1990 and 31 April 2018 will be included if they identify risk and/or protective factors for substance use or related harms in a study sample that consists of at least 50% Aboriginal and Torres Strait Islander people. A narrative synthesis will be undertaken where the identified factors will be organised using an ecological approach into individual, relationship, community, societal and cultural levels. A critical appraisal of study quality will be conducted using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data and the qualitative assessment tool by Godfrey and Long. ETHICS AND DISSEMINATION Formal ethics approval is not required as primary data will not be collected. The results will be disseminated through a peer-reviewed publication, conference presentations and social media. PROSPERO REGISTRATION NUMBER CRD42017073734.
Collapse
Affiliation(s)
- Mieke Snijder
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - James Ward
- Infection and Immunity Theme, South Australia Health and Medical Research Centre, Adelaide, South Australia, Australia
- Faculty of Medicine Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Annalee E Stearne
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Nicola Clare Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| |
Collapse
|