Prevention Research Report: [PDF: 337KB] - DrugInfo - Australian ...

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Prevention Research Report: [PDF: 337KB] - DrugInfo - Australian ...

Prevention research evaluation reportNumber 10 May 2004Studies is not a compulsory subject. We are theonly people who have to prove who we are byway of Confirmation of Aboriginality forms. All ofthese things, which may seem isolated issues tomany, are just some of the very disempoweringand denigrating ways in which we are notvalued.”Intervention programs and policies:ResearchThe association between economic marginalisationand alcohol and drug problems among IndigenousAustralian people suggests that interventionsthat focus on economic participation will need tobe considered as part of the mix of preventionstrategies. In addition to these broad economictargets, programs will also be required that focus onmore specific issues associated with alcohol and druguse.There have been few formal evaluations ofIndigenous Australian intervention projects. Intheir review Gray et al. (2000) note that treatmentprojects and general primary care interventions arethe most common form of intervention in IndigenousAustralian communities, while primary or secondaryprevention projects have received less funding. Mostprograms are directed towards prevention of alcoholmisuse. Available evidence suggests that theseprojects have had mixed results, although there havebeen some successes. d’Abbs (2001) reported onthe Northern Territory Living with Alcohol program,which provided a good example of a program aimedat addressing alcohol-related harm through anintegrated policy agenda.Tobacco smoking has been identified as a majorcontributor to the high morbidity and mortality ratesof Indigenous Australians. Ivers (2001) has presenteda review of smoking cessation projects deliveredwithin Indigenous Australian communities. Therehave been a limited number of programs specificallytargeting Indigenous Australian people, and of thesenone have been formally evaluated. Briggs (1996)describes the background for developing a courseto help the Aboriginal community of Victoria quitsmoking.There have been some efforts to develop schooldrug education programs focusing specifically onIndigenous children. Programs addressing risk factorssuch as peer pressure to use drugs (Barber, Wash& Bradshaw 1989) may be more promising thanprograms aiming to change attitudes (Sheehan,Schonfeld, Hindson & Ballard 1995).A number of studies have commented on increasingproblems associated with illicit drug use amongyoung Indigenous Australian people. For example,a consultation in Victoria noted that few families inthe community had not been touched in some wayby injecting drug use (Lehmann & Frances 1998).In this context, observers have commented on thelimited number of detoxification facilities available forIndigenous Australian injecting drug users (Edwards,Frances & Lehmann 1998; McAllister & Makkai 2001).MacLean and d’Abbs (2002) reported on a reviewof petrol sniffing programs, noting that programsaddressing overall health appeared to be moresuccessful.The most common harm-reduction strategy in ruralIndigenous Australian communities is the use ofnight patrols to provide transport to safe locations forintoxicated persons. Qualitative evaluation suggeststhat people in those communities generally ratedthe patrols as effective in reducing alcohol-relatedviolence and getting intoxicated people off thestreets.The experience distilled from a number of projectssuggests some common principles about what makesan intervention feasible and effective (see Loxley etal. 2004). There is a need to address the requirementfor economic development by Indigenous Australianpeople. Included within this notion are the calls fromnoted Indigenous Australian lawyer and activist NoelPearson and others for reform of the system forwelfare provision to Indigenous Australians.Many commentators have emphasised the importanceof Indigenous Australian ownership and controlof interventions, including creating employmentopportunities in agencies which provide services forIndigenous Australian people. Given the diversitywithin the Indigenous Australian population,interventions must be tailored to the needs of9


Preventing drug-related harm in Indigenous Australian communitiesparticular communities. A number of observers havecommented on the potential benefit of encouragingcollaborations between researchers and people inIndigenous Australian communities (for example,Gray & Saggers 2002). Importantly, interventionsneed to be adequately resourced and supported. Thisentails not only funding for project activities, but alsoprovision of appropriate staff training and support.Prevention programs require appropriate andlong-term resourcing. An important componentof adequate resourcing is the building, withincommunities and community organisations, ofinfrastructure, research capabilities and staffdevelopment and support.As there is no single cause for alcohol and drugrelatedharms, policies and programs need to be wellintegrated and linked to broader health and socialplanning. Despite this acknowledgement, substancemisuse policy and service planning largely have beendeveloped in isolation from policies in other portfolioareas such as land, employment, education andhousing. A number of commentators have observedthe need for integrated approaches between differentlevels of government (MacLean & d’Abbs 2002).Intervention research in VictoriaIn a study conducted in Victoria, Alati (1993)reported on the Koorie Alcohol and Drug PreventionProgram. Quantitative data was collected from policerecords in five different locations, and two AboriginalHealth Clinics. The report suggested that there wasa need for culturally appropriate training for alcoholworkers, and the conflict between their roles asmembers of the Indigenous Australian communityand as public servants. The report argued that Koorisgenerally do not use non-Koori alcohol and drugservices, indicating that further funding was requiredto make such services available, and to alleviate thecommunity pressure exerted on the Koori alcohol anddrug workers.Recently in Victoria, the Department of HumanServices secured funding to develop a Kooriappropriateversion of the ABCD Parenting Program.Similar to the original ABCD Parenting Program,the Koori program is designed to build and enhancecommunication and positive interaction betweenparents and adolescents, and thus to increasetheir capacity to deal with issues associated withadolescent drug and alcohol use. However, theKoori program would place particular emphasison increasing participants’ understanding of theirIndigenous culture, heritage and issues specific to theKoori community (Borg 2004). In order to inform thedevelopment of the project, extensive consultationwas undertaken with key stakeholders andcommunities throughout Victoria. The implementationof the Koori ABCD Parenting Program was expected tocommence by April 2004.Intervention programs and policies:Practitioners’ viewsPractitioners recognised that if preventionstrategies were to be successful, then the economicdevelopment of Indigenous Australian communitiesneeded to be addressed. Similarly, it wasacknowledged that short-term funding of preventionstrategies had little impact on the community, andthus long-term resourcing needed to be consideredalongside infrastructure and staff development.Despite restrictions on current programs, practitionerswere confident that there were some successfulprograms currently being implemented in the field.Prevention programsPrevention programs currently being implementedincluded general drug education programs inschools. School programs were said to focus onabstinence, social skills and health and medicalissues. A number of these programs were said to bemainstream drug prevention programs delivered toIndigenous Australian communities (for example, the“Stepping Stones”, “How to Drug Proof your Kids” and“PartySafe” programs). Practitioners, however, alsodescribed less-conventional programs, including nightpatrols, cultural and drama programs. Night patrolswere usually the provision of a bus service on Friday,Saturday and Sunday nights, enabling communitymembers to better monitor young people’s activities.This was said to reduce the number of opportunitiesfor young people to obtain or drink alcohol, andsubsequently to become involved with criminal10


Preventing drug-related harm in Indigenous Australian communitiesGray D & Saggers S (eds) 2002 Indigenous AustralianAlcohol and other drug issues: Research from theNational Drug Research Institute, Perth: NationalDrug Research Institute, Curtin University ofTechnologyGray D, Saggers S, Sputore B & Bourbon D 2000“What works? A review of evaluated alcohol misuseinterventions among Aboriginal Australians”,Addiction, 95:1, pp. 11–22Guest CS, O’Dea K, Carlin JB & Larkins RG 1992“Smoking in Aborigines and persons of Europeandescent in southeastern Australia: Prevalence andassociations with food habits, body fat distributionand other cardiovascular risk factors”, AustralianJournal of Public Health, 16:4, pp. 397–402Ivers R 2001 Indigenous Australians and tobacco: Aliterature review, Darwin: Menzies School of HealthResearch, Cooperative Research Centre for Aboriginaland Tropical HealthKahn M, Hunter E, Heather N & Tebbutt J 1990“Australian Aborigines and alcohol: A review”, Drugand Alcohol Review, 10, pp. 351–66Lehmann T & Frances R 1998 “Victorian AboriginalHealth Service Cooperative Ltd Injecting Drug UseProject”, Health Promotion Journal of Australia, 8:1,pp. 51–54Loxley W, Toumbourou JW, Stockwell T, Haines B,Scott K, Godfrey C, Waters E, Patton G, FordhamR, Gray D, Marshall J, Ryder D, Saggers S, Sanci L& Williams J 2004 The prevention of substance use,risk and harm in Australia: A review of the evidence,Report prepared by the National Drug ResearchInstitute and the Centre for Adolescent Health for theCommonwealth Department of Health and AgeingMcAullay D, Griew R & Anderson I 2002 “Theethics of Aboriginal health research: An annotatedbibliography” Discussion Paper Number 5, Melbourne:VicHealth Koori Health Research and CommunityDevelopment Unit, The University of MelbourneMacLean S & d’Abbs P 2002 “Petrol sniffing inAboriginal communities: A review of interventions”,Drug and Alcohol Review, 21:1, pp. 65–72Mitchell P, Sanson A, Spooner C, Copeland J, VimpaniG, Toumbourou JW & Howard J 2001 The role offamilies in the development, identification, preventionand treatment of illicit drug problems, Canberra:National Health and Medical Research CouncilCommonwealth of AustraliaNational Aboriginal Health Strategy Working Party1989 “A National Aboriginal Health Strategy”,Canberra: Australian Government Publishing ServiceNational Crime Prevention 1999 Pathways toprevention: Developmental and early interventionapproaches to crime in Australia, Canberra:Commonwealth Attorney Generals DepartmentPatterson KM, Holman CD, English DR, Hulse GK &Unwin E 1999 “First-time hospital admissions withillicit drug problems in indigenous and non-indigenousWestern Australians: An application of record linkageto public health surveillance”, Australian and NewZealand Journal of Public Health, 23:5, pp. 460–63Randall B 2003 Songman: The story of an Aboriginalelder, Sydney: ABC BooksSheehan M, Schonfeld C, Hindson E & Ballard R1995 “Alcohol education in an Indigenous communityschool in Queensland, Australia”, Drugs: Education,Prevention and Policy, 2, pp. 259–73McAllister I & Makkai T 2001 “The prevalence andcharacteristics of injecting drug users in Australia”,Drug and Alcohol Review, 20:1, pp. 29–3614


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