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Miller P, Coomber K, Smith J, Livingston M, Stevens M, Guthridge S, Room R, Wright CJC, Rung D, Clifford S, Baldwin R, Das S, Paradies Y, Scott D, Griffiths KE, Farmer C, Mayshak R, Silver B, Moore S, Mack J, Mithen V, Dyall D, Ward J, Boffa J, Chikritzhs T. Learning from alcohol (policy) reforms in the Northern Territory (LEARNT): protocol for a mixed-methods study examining the impacts of the banned drinker register. BMJ Open 2022; 12:e058614. [PMID: 35365540 PMCID: PMC8977786 DOI: 10.1136/bmjopen-2021-058614] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The Banned Drinker Register (BDR) was reintroduced in the Northern Territory (NT) in September 2017. The BDR is a supply reduction measure and involves placing people who consume alcohol at harmful levels on a register prohibiting the purchase, possession and consumption of alcohol. The current study aims to evaluate the impacts of the reintroduction of the BDR, in the context of other major alcohol policy initiatives introduced across the NT such as Police Auxiliary Liquor Inspectors and a minimum unit price for alcohol of US$1.30 per standard drink. METHODS AND ANALYSES The Learning from Alcohol (policy) Reforms in the Northern Territory project will use a mixed-methods approach and contain four major components: epidemiological analysis of trends over time (outcomes include health, justice and social welfare data); individual-level data linkage including those on the BDR (outcomes include health and justice data); qualitative interviews with key stakeholders in the NT (n≥50); and qualitative interviews among people who are, or were previously, on the BDR, as well as the families and communities connected to those on the BDR (n=150). The impacts of the BDR on epidemiological data will be examined using time series analysis. Linked data will use generalised mixed models to analyse the relationship between outcomes and exposures, utilising appropriate distributions. Qualitative data will be analysed using thematic analysis. ETHICS AND DISSEMINATION Ethics approvals have been obtained from NT Department of Health and Menzies School of Health Research Human Research Ethics Committee (HREC), Central Australia HREC and Deakin University HREC. In addition to peer-reviewed publications, we will report our findings to key organisational, policy, government and community stakeholders via conferences, briefings and lay summaries.
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Affiliation(s)
| | | | - James Smith
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Michael Livingston
- Curtin University, Perth, Western Australian, Australia
- La Trobe University, Melbourne, Victoria, Australia
| | - Matthew Stevens
- Well-being and Preventable Chronic Disease, Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Steven Guthridge
- Child Development, Population Health and Policy, Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Robin Room
- La Trobe University, Melbourne, Victoria, Australia
| | | | - Daile Rung
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Sarah Clifford
- Charles Darwin University, Casuarina, Northern Territory, Australia
| | | | - Sumon Das
- Child Health Division, Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Yin Paradies
- Faculty of Arts and Education, Deakin University, Burwood, Victoria, Australia
| | - Debbie Scott
- Turning Point, Monash University Eastern Health Clinical School, North Richmond, Victoria, Australia
- Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Kalinda E Griffiths
- Charles Darwin University, Casuarina, Northern Territory, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - Bronwyn Silver
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Sam Moore
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Jordan Mack
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Vincent Mithen
- Aboriginal Medical Services Alliance Northern Territory, Darwin, Northern Territory, Australia
| | - Danielle Dyall
- Aboriginal Medical Services Alliance Northern Territory, Darwin, Northern Territory, Australia
| | - J Ward
- University of Queensland, Brisbane, Queensland, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, Australian Capital Territory, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
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Pennay A, Savic M, Seear K, Volpe I, Manning V, Room R. Decriminalising public drunkenness: Accountability and monitoring needed in the ongoing and evolving management of public intoxication. Drug Alcohol Rev 2020; 40:205-209. [PMID: 32974996 DOI: 10.1111/dar.13169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
In light of the recent announcement from the Victorian (Australia) state government that they are moving to decriminalise public drunkenness and replace it with a 'health-based response', it is timely to reflect on a number of important considerations identified from the academic literature on this topic. We briefly review a number of models of health-care delivery that have been utilised in other jurisdictions, and suggest there are opportunities at a more principled level to respond more adequately to the decriminalisation of public drunkenness in Victoria (and elsewhere). First, embedding research and evaluation, particularly that draws on the needs, views and experiences of those who are deemed to be drunk in public, is essential from the outset, and must be ongoing to enable the continual refinement of models of care. Second, significant funding and intersectoral support are needed to ensure that the laws are not tokenistic and do not remain the responsibility of police. Third, there are opportunities to put policies and principles in place to ensure that police do not use more coercive powers to address concerns around public drunkenness. Most importantly, state-wide education and training efforts are needed alongside the repeal of the law to ensure that emergency services and health-care workers (as well as the community), have a good understanding of the contexts and needs of people who are considered drunk in public, and consequently treat them with care and respect.
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Affiliation(s)
- Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Michael Savic
- Eastern Health Clinical School and Monash Addiction Research Centre, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Melbourne, Australia
| | - Kate Seear
- Faculty of Law, Monash University, Melbourne, Australia.,Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Isabelle Volpe
- Eastern Health Clinical School and Monash Addiction Research Centre, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Melbourne, Australia
| | - Victoria Manning
- Eastern Health Clinical School and Monash Addiction Research Centre, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Moore SC, Allen D, Amos Y, Blake J, Brennan A, Buykx P, Goodacre S, Gray L, Irving A, O’Cathain A, Sivarajasingam V, Young T. Evaluating alcohol intoxication management services: the EDARA mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Front-line health-care services are under increased demand when acute alcohol intoxication is most common, which is in night-time environments. Cities have implemented alcohol intoxication management services to divert the intoxicated away from emergency care.
Objectives
To evaluate the effectiveness, cost-effectiveness and acceptability to patients and staff of alcohol intoxication management services and undertake an ethnographic study capturing front-line staff’s views on the impact of acute alcohol intoxication on their professional lives.
Methods
This was a controlled mixed-methods longitudinal observational study with an ethnographic evaluation in parallel. Six cities with alcohol intoxication management services were compared with six matched control cities to determine effects on key performance indicators (e.g. number of patients in the emergency department and ambulance response times). Surveys captured the impact of alcohol intoxication management services on the quality of care for patients in six alcohol intoxication management services, six emergency departments with local alcohol intoxication management services and six emergency departments without local alcohol intoxication management services. The ethnographic study considered front-line staff perceptions in two cities with alcohol intoxication management services and one city without alcohol intoxication management services.
Results
Alcohol intoxication management services typically operated in cities in which the incidence of acute alcohol intoxication was greatest. The per-session average number of attendances across all alcohol intoxication management services was low (mean 7.3, average minimum 2.8, average maximum 11.8) compared with the average number of emergency department attendances per alcohol intoxication management services session (mean 78.8), and the number of patients diverted away from emergency departments, per session, required for services to be considered cost-neutral was 8.7, falling to 3.5 when ambulance costs were included. Alcohol intoxication management services varied, from volunteer-led first aid to more clinically focused nurse practitioner services, with only the latter providing evidence for diversion from emergency departments. Qualitative and ethnographic data indicated that alcohol intoxication management services are acceptable to practitioners and patients and that they address unmet need. There was evidence that alcohol intoxication management services improve ambulance response times and reduce emergency department attendance. Effects are uncertain owing to the variation in service delivery.
Limitations
The evaluation focused on health service outcomes, yet evidence arose suggesting that alcohol intoxication management services provide broader societal benefits. There was no nationally agreed standard operating procedure for alcohol intoxication management services, undermining the evaluation. Routine health data outcomes exhibited considerable variance, undermining opportunities to provide an accurate appraisal of the heterogenous collection of alcohol intoxication management services.
Conclusions
Alcohol intoxication management services are varied, multipartner endeavours and would benefit from agreed national standards. Alcohol intoxication management services are popular with and benefit front-line staff and serve as a hub facilitating partnership working. They are popular with alcohol intoxication management services patients and capture previously unmet need in night-time environments. However, acute alcohol intoxication in emergency departments remains an issue and opportunities for diversion have not been entirely realised. The nurse-led model was the most expensive service evaluated but was also the most likely to divert patients away from emergency departments, suggesting that greater clinical involvement and alignment with emergency departments is necessary. Alcohol intoxication management services should be regarded as fledgling services that require further work to realise benefit.
Future work
Research could be undertaken to determine if a standardised model of alcohol intoxication management services, based on the nurse practitioner model, can be developed and implemented in different settings. Future evaluations should go beyond the health service and consider outcomes more generally, especially for the police. Future work on the management of acute alcohol intoxication in night-time environments could recognise the partnership between health-care, police and ambulance services and third-sector organisations in managing acute alcohol intoxication.
Trial registration
Current Controlled Trials ISRCTN63096364.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 24. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Simon C Moore
- Crime and Security Research Institute, Cardiff University, Cardiff, UK
- Violence Research Group, School of Dentistry, Cardiff University, Cardiff, UK
| | - Davina Allen
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Yvette Amos
- Violence Research Group, School of Dentistry, Cardiff University, Cardiff, UK
| | - Joanne Blake
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Alan Brennan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Penny Buykx
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
- School of Humanities and Social Science, University of Newcastle, Newcastle, NSW, Australia
| | - Steve Goodacre
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Laura Gray
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Andy Irving
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Alicia O’Cathain
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Tracey Young
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Munro A, Shakeshaft A, Breen C, Clare P, Allan J, Henderson N. Understanding remote Aboriginal drug and alcohol residential rehabilitation clients: Who attends, who leaves and who stays? Drug Alcohol Rev 2018; 37 Suppl 1:S404-S414. [PMID: 29349855 PMCID: PMC5969080 DOI: 10.1111/dar.12656] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/18/2017] [Accepted: 12/10/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND AIMS Aboriginal residential rehabilitation services provide healing for Aboriginal people who misuse substances. There is limited available research that empirically describes client characteristics of these services. This study examined 5 years of data of a remote Aboriginal residential rehabilitation service. DESIGN AND METHODS Retrospective analysis of 329 client admissions to Orana Haven Drug and Alcohol Rehabilitation Centre from 2011 to 2016. Multinomial and binary logistic regressions were conducted to identify trends in the data. RESULTS There were 66 admissions recorded annually, of which most identified as Aboriginal (85%). Mean length of stay was 56 days, with one in three (36%) discharging within the first month. A third (32%) completed, 47% self-discharged and 20% house-discharged from the program. Client age significantly increased over time (P = 0.03), with most aged from 26 to 35. Older clients were significantly more likely to readmit (P < 0.002) and stay longer than 90 days (P = 0.02). Most clients were referred from the criminal justice system, significantly increasing from 79% (2011-2012) to 96% (2015-2016) (P < 0.001) and these clients were more likely to self-discharge (P < 0.01). Among a subset of clients, most (69%) reported concerns with polysubstance use and half (51%) reported mental illness. DISCUSSION AND CONCLUSIONS The current study makes a unique contribution to the literature by empirically describing the characteristics of clients of a remote Aboriginal residential rehabilitation service to more accurately tailor the service to the client's needs. Key recommendations include integrating these empirical observations with staff and client perceptions to co-design a model of care, standardise data collection, and routinely following-up clients to monitor treatment effectiveness.
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Affiliation(s)
- Alice Munro
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | - Courtney Breen
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | - Philip Clare
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | | | - Norm Henderson
- Orana Haven Drug and Alcohol Rehabilitation CentreGongolgonAustralia
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Munro A, Allan J, Shakeshaft A, Breen C. "I just feel comfortable out here, there's something about the place": staff and client perceptions of a remote Australian Aboriginal drug and alcohol rehabilitation service. Subst Abuse Treat Prev Policy 2017; 12:49. [PMID: 29208008 PMCID: PMC5718008 DOI: 10.1186/s13011-017-0135-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 11/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The need for effective, culturally safe residential rehabilitation services for Aboriginal people is widely acknowledged, however the combination of treatment components that is optimally effective, is not well defined. Most existing Aboriginal residential rehabilitation research has focused on describing client characteristics, and largely ignored the impact of treatment and service factors, such as the nature and quality of therapeutic components and relationships with staff. METHODS This qualitative study was undertaken as part of a three-year mixed methods community-based participatory research (CBPR) project that aimed to empirically describe a remote Aboriginal drug and alcohol rehabilitation service. Researchers utilised purposive sampling to conduct 21 in-depth, semi-structured interviews. The interviews used a 'research yarning' approach, a form of culturally appropriate conversation that is relaxed and narrative-based. The interview transcripts were thematically coded using iterative categorization. The emerging themes were then analysed from an Interpretative Phenomenological Analysis, focusing on how participants' lived experiences before and during their admission to the service shaped their perceptions of the program. RESULTS A total of 12 clients (mean age 35 years, SD 9.07, 91% Aboriginal) and 9 staff (2 female, 7 male, mean age 48 years, SD 8.54, 67% Aboriginal) were interviewed. Five themes about specific program components were identified in the interview data: healing through culture and country; emotional safety and relationships; strengthening life skills; improved wellbeing; and perceived areas for improvement. This research found that Aboriginal drug and alcohol residential rehabilitation is not just about length of time in treatment, but also about the culture, activities and relationships that are part of the treatment process. CONCLUSION This study highlights that cultural elements were highly valued by both clients and staff of a remote Aboriginal residential rehabilitation service, with the country or location being fundamental to the daily practice of, and access to, culture. Developing reliable and valid assessments of the program components of culture and treatment alliance would be valuable, given this study has reinforced their perceived importance in achieving positive treatment outcomes. Further, strengthening the aftercare program, as part of an integrated model of care, would likely provide greater support to clients after discharge.
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Affiliation(s)
- Alice Munro
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW Australia
| | | | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW Australia
| | - Courtney Breen
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW Australia
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Irving A, Goodacre S, Blake J, Allen D, Moore SC. Managing alcohol-related attendances in emergency care: can diversion to bespoke services lessen the burden? Emerg Med J 2017; 35:79-82. [PMID: 29183919 PMCID: PMC5868242 DOI: 10.1136/emermed-2016-206451] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 10/27/2017] [Indexed: 11/04/2022]
Abstract
Acute alcohol intoxication (AAI) has a long history of burdening emergency care services. Healthcare systems around the world have explored a variety of different services that divert AAI away from EDs to better manage their condition. Little formal evaluation has been undertaken, particularly in the UK where alcohol misuse is one of the highest in the world. In this article, we outline a brief history of diversionary services, introduce the concept of Alcohol Intoxication Management Services (AIMS) and describe examples of AIMS in the UK. We then describe Evaluating the Diversion of Alcohol-Related Attendances, a natural experiment including six cities with AIMS compared with six cities without, that involves an ethnographic study, records patient experiences in both AIMS and EDs, assesses impact on key performance indicators in healthcare and evaluates the cost-effectiveness of AIMS.
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Affiliation(s)
- Andy Irving
- Centre for Urgent and Emergency Care Research (CURE), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Steve Goodacre
- Centre for Urgent and Emergency Care Research (CURE), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Joanne Blake
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Davina Allen
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Simon C Moore
- School of Dentistry, Cardiff University, Cardiff, UK
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Clough AR, Margolis SA, Miller A, Shakeshaft A, Doran CM, McDermott R, Sanson-Fisher R, Ypinazar V, Martin D, Robertson JA, Fitts MS, Bird K, Honorato B, Towle S, West C. Alcohol management plans in Aboriginal and Torres Strait Islander (Indigenous) Australian communities in Queensland: community residents have experienced favourable impacts but also suffered unfavourable ones. BMC Public Health 2017; 17:55. [PMID: 28068977 PMCID: PMC5223386 DOI: 10.1186/s12889-016-3995-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/23/2016] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND In Australia, 'Alcohol Management Plans' (AMPs) provide the policy infrastructure for State and Commonwealth Governments to address problematic alcohol use among Aboriginal and Torres Strait Islanders. We report community residents' experiences of AMPs in 10 of Queensland's 15 remote Indigenous communities. METHODS This cross-sectional study used a two-stage sampling strategy: N = 1211; 588 (48%) males, 623 (52%) females aged ≥18 years in 10 communities. Seven propositions about 'favourable' impacts and seven about 'unfavourable' impacts were developed from semi-structured interviews. For each proposition, one-sample tests of proportions examined participant agreement and multivariable binary logistic regressions assessed influences of gender, age (18-24, 25-44, 45-64, ≥65 years), residence (≥6 years), current drinking and Indigenous status. Confirmatory factor analyses estimated scale reliability (ρ), item loadings and covariances. RESULTS Slim majorities agreed that: AMPs reduced violence (53%, p = 0.024); community a better place to live (54%, 0.012); and children were safer (56%, p < 0.001). More agreed that: school attendance improved (66%, p < 0.001); and awareness of alcohol's harms increased (71%, p < 0.001). Participants were equivocal about improved personal safety (53%, p = 0.097) and reduced violence against women (49%, p = 0.362). The seven 'favourable' items reliably summarized participants' experiences of reduced violence and improved community amenity (ρ = 0.90). Stronger agreement was found for six 'unfavourable' items: alcohol availability not reduced (58%, p < 0.001); drinking not reduced (56%, p < 0.001)); cannabis use increased (69%, p < 0.001); more binge drinking (73%, p < 0.001); discrimination experienced (77%, p < 0.001); increased fines, convictions and criminal records for breaching restrictions (90%, p < 0.001). Participants were equivocal (51% agreed, p = 0.365) that police could enforce restrictions effectively. 'Unfavourable' items were not reliably reflected in one group (ρ = 0.48) but in: i) alcohol availability and consumption not reduced and ii) criminalization and discrimination. In logistic regressions, longer-term (≥ 6 years) residents more likely agreed that violence against women had reduced and that personal safety had improved but also that criminalization and binge drinking had increased. Younger people disagreed that their community was a better place to live and strongly agreed about discrimination. Current drinkers' views differed little from the sample overall. CONCLUSIONS The present Government review provides an opportunity to reinforce 'favourable' outcomes while targeting: illicit alcohol, treatment and diversion services and reconciliation of criminalization and discrimination issues.
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Affiliation(s)
- Alan R. Clough
- Community-based Health Promotion and Prevention Studies Group, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD 4870 Australia
| | | | - Adrian Miller
- Indigenous Research Unit, Griffith University, Nathan, QLD 4111 Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052 Australia
| | | | - Robyn McDermott
- Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD 4870 Australia
| | - Robert Sanson-Fisher
- School of Medicine and Public Health (Public Health), University of Newcastle, Sydney, NSW 2000 Australia
| | - Valmae Ypinazar
- School of Medicine, Griffith University, Nathan, QLD 4111 Australia
| | - David Martin
- College of Arts and Social Sciences, Australian National University, Canberra, Australia
| | - Jan A. Robertson
- Division of Tropical Health and Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Cairns, QLD Australia
| | - Michelle S. Fitts
- Division of Tropical Health and Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Cairns, QLD Australia
| | - Katrina Bird
- Division of Tropical Health and Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Cairns, QLD Australia
| | - Bronwyn Honorato
- Division of Tropical Health and Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Cairns, QLD Australia
| | - Simon Towle
- Division of Tropical Health and Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Cairns, QLD Australia
| | - Caryn West
- Division of Tropical Health and Medicine, College of Healthcare Sciences, James Cook University, Cairns, QLD Australia
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Olsen A, Higgs P, Maher L. A review of qualitative research inDrug and Alcohol Review. Drug Alcohol Rev 2015; 34:474-476. [DOI: 10.1111/dar.12307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Anna Olsen
- National Centre of Epidemiology and Population Health; The Australian National University; Canberra Australia
| | - Peter Higgs
- National Drug Research Institute, Faculty of Health Sciences; Curtin University; Melbourne Australia
| | - Lisa Maher
- The Kirby Institue, Faculty of Medicine; The Universsity of New South Wales; Sydney Australia
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Stevens M, Paradies Y. Changes in exposure to 'life stressors' in the Aboriginal and Torres Strait Islander population, 2002 to 2008. BMC Public Health 2014; 14:144. [PMID: 24512200 PMCID: PMC3923397 DOI: 10.1186/1471-2458-14-144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 02/06/2014] [Indexed: 11/10/2022] Open
Abstract
Background The Negative Life Events Scale (NLES) has been included in nationally representative surveys of the Indigenous and Australian population since 2002 as a measure of exposure to a range of ‘life stressors’. There has been limited reporting or analysis of estimates of the NLES from these surveys. This paper reports changes in exposure to stressors from 2002 to 2008 for the Indigenous population, and examines inter-relationships between eleven NLES items. Data for the 2006 Australian population is also included for comparative purposes. Methods Data from the 2002 and 2008 National Aboriginal and Torres Strait Islander Social Surveys (NATSISS) and the 2006 General Social Survey (GSS) were accessed from the Australia Bureau of Statistics in order to determine significant changes in exposure to stressors for the 2002 and 2008 Indigenous population by remoteness and to compare this with the 2006 Australian population. Factor analysis was used to assess the inter-relationships between stressors for the Indigenous and Australian population by remoteness. Results In remote locations, between 2002 and 2008, exposure to life stressors decreased significantly for the Indigenous population across seven of the eleven stressors. In non-remote locations, exposure to four of the stressors increased significantly. Exposure to stressors in the 2002 and 2008 non-remote Indigenous population were significantly higher than those for the 2006 Australian population for all items, except ‘alcohol and/or drug problems’ and ‘trouble with the police’, which showed no evidence of a difference. The factor analysis of the NLES for the 2002 and 2008 remote and non-remote Indigenous populations and the 2006 Australian population showed a consistent clustering of items into three groups: social transgressions; grief and trauma; and labour market stressors. Conclusions The reduction in exposure to life stressors for the remote Indigenous population may be related to policy and practice changes (e.g. more police, income quarantining, housing construction). The differential change in exposure to life stressors between remote and non-remote locations highlights the importance of presenting data for these geographic locations separately.
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Affiliation(s)
- Matthew Stevens
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, PO Box 41096, Casuarina, NT 0811, Australia.
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Abstract
BACKGROUND Alcohol intoxication is a serious health issue among Taiwan's indigenous Malayo-Polynesian groups. No published studies address the drinking perceptions and behaviors of Bunun women. PURPOSE The purpose of this study was to describe the drinking perceptions and behaviors of Bunun women in Taiwan. METHODS This study used an ethnographic approach to study the residents of one township located in eastern Taiwan. Researchers used semistructured, in-depth interviews to collect data from 10 Bunun women in 2006. RESULTS Researchers identified six key culture themes from the data. These were (a) drinking to help make friends, (b) drinking to help solve emotional problems, (c) interpreting the meaning of drinking, (d) hurting the body due to alcohol abuse, (e) decreasing the bond of convention for drinking, and (f) establishing mechanisms to control drinking. CONCLUSIONS/IMPLICATION FOR PRACTICE: The results of this study may help one to understand the alcohol use behavior and attitudes of indigenous women in Taiwan and contribute to better cross-cultural nursing clinical practice. This study is expected to enhance the quality of nursing care provided to Taiwan's indigenous people.
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Hart LM, Bourchier SJ, Jorm AF, Kanowski LG, Kingston AH, Stanley D, Lubman DI. Development of mental health first aid guidelines for Aboriginal and Torres Strait Islander people experiencing problems with substance use: a Delphi study. BMC Psychiatry 2010; 10:78. [PMID: 20932326 PMCID: PMC2964528 DOI: 10.1186/1471-244x-10-78] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 10/08/2010] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Problems with substance use are common in some Aboriginal communities. Although problems with substance use are associated with significant mortality and morbidity, many people who experience them do not seek help. Training in mental health first aid has been shown to be effective in increasing knowledge of symptoms and behaviours associated with seeking help. The current study aimed to develop culturally appropriate guidelines for providing mental health first aid to an Aboriginal or Torres Strait Islander person who is experiencing problem drinking or problem drug use (e.g. abuse or dependence). METHODS Twenty-eight Aboriginal health experts participated in two independent Delphi studies (n = 22 problem drinking study, n = 21 problem drug use; 15 participated in both). Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the content. Statements were accepted for inclusion in the guidelines if they were endorsed by ≥ 90% of panellists as either 'Essential' or 'Important'. At the end of the two Delphi studies, participants were asked to give feedback on the value of the project and their participation experience. RESULTS From a total of 735 statements presented over two studies, 429 were endorsed (223 problem drinking, 206 problem drug use). Statements were grouped into sections based on common themes (n = 7 problem drinking, n = 8 problem drug use), then written into guideline documents. Participants evaluated the Delphi method employed, and the guidelines developed, as useful and appropriate for Aboriginal and Torres Strait Islander people. CONCLUSIONS Aboriginal health experts were able to reach consensus about culturally appropriate first aid for problems with substance use. Many first aid actions endorsed in the current studies were not endorsed in previous international Delphi studies, conducted on problem drinking and problem drug use in non-Indigenous people, highlighting the need for culturally specific first aid strategies to be employed when assisting Aboriginal or Torres Strait Islander people.
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Affiliation(s)
- Laura M Hart
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Sarah J Bourchier
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Leonard G Kanowski
- Aboriginal Mental Health and Drug & Alcohol, Greater Western Area Health Service, New South Wales Department of Health, Orange, New South Wales, Australia
| | - Anna H Kingston
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Donna Stanley
- Aboriginal Mental Health and Drug & Alcohol, Greater Western Area Health Service, New South Wales Department of Health, Orange, New South Wales, Australia
| | - Dan I Lubman
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia,Turning Point Alcohol and Drug Centre, Eastern Health and Monash University, Fitzroy, Victoria, Australia
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Desapriya E, Fujiwara T, Verma P, Babul S, Pike I. Comparison of on-reserve road versus off-reserve road motor vehicle crashes in Saskatchewan, Canada: a case control study. Asia Pac J Public Health 2010; 23:1005-20. [PMID: 20460293 DOI: 10.1177/1010539510361787] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is an overwhelmingly high incidence of severe injuries caused by motor vehicle crashes (MVCs) among Aboriginal Canadians as compared with the general population. METHODS The authors obtained MVC data for a 3-year period, 2003-2005, from Saskatchewan Government Insurance (SGI) for collisions occurring on on-reserve roads (n = 1270) together with a randomly selected sample of MVCs from off-reserve roads (n = 1270) in Saskatchewan. They compared the collision characteristics using bivariate and multiple logistic regressions. RESULTS On-reserve MVCs were more likely to include multiple collisions and result in severe injuries than the off-reserve sample. A number of factors were significantly related to the increased risk of on-reserve collisions as compared with the reference group for each variable. INTERPRETATION Factors from all 3 levels (human, environmental, and vehicle factors) are associated with on-reserve MVCs.
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