Author (year)a | Participant characteristics | Classification of alcohol consumption | Study type | Length of follow-up | Client outcomesb: effectiveness or perceptions | Staff/service outcomesb |
---|---|---|---|---|---|---|
Treatment effectiveness | ||||||
Savard [75] (1968) | 1) n = 30 alcoholic males 2a) n = 62 alcoholic males 2b) n = 39 non-abstinent, non-alcoholic males | ndpc | 1) Follow up study of 30 disulfiram-treated alcoholics (sic) 2ab) Quantitative (cross-sectional) | 1) 18 months 2ab) baseline interview only | 1) decreased binge drinking and increased sober periods; 2ab) disulfiram is accepted excuse to decline alcohol and social pressures reduced (consumption not measured). | |
Ferguson [73] (1970) | 65 clan groups; 1) Intervention group n = 115 2) Comparison group n = 60 | WHO ‘alcoholism’ | Non-randomised controlled trial | 6 months | Reduced incarceration; n = 50/115 sober 12–24 month following disulfiram therapy; sobriety not measured in controls. | |
O’Malley et al. [24] (2008) | 12 tribal groups; n = 68 American Indian/Alaska Native (AI/AN) participants | DSM-IV; CIWA-Ar | RCT | 68 weeks | Significant decrease in alcohol-related consequences for naltrexone monotherapy vs placebo (p < 0.026) | |
Venner et al. [69] (2016) | n = 8 members of one tribe | DSM-IV | Uncontrolled, pre-post study | 8 months | Increase in days abstinent; decrease Addiction Severity Scores | |
Implementation research | ||||||
Kahn and Fua [72] (1992) | n = 240 participants | ndp | Uncontrolled pre-post study | N/Ad | n = 138/145 maintained sobriety post-graduation | |
Clifford and Shakeshaft [59] (2011) | n = 32 health staff; n = 24 clients | ndp | Mixed methods, pre-post study | N/A | Increased staff confidence to deliver BI; increase documentation and delivery; high-risk drinkers resistant to alcohol referral | |
Clifford et al. [61] (2013) | n = 4 Indigenous health services n = total of 50 clients | 2001 NHMRC guidelines | Uncontrolled, pre-post study | N/A | Increased BIs | |
D’Abbs et al. [62] (2013) | n = 19 clients; n = 30 quasi control; n = 32 program staff/other stakeholders | ndp | Trial with quasi-controls | N/A | n = 15/19 reported decrease or stop drinking post program contact. n = 21/30 quasi-control with similar result. | Implementation challenges incl: time constraints, staff turnover, GP hesitancy to prescribe naltrexone; strengths incl multidisciplinary care, flexibility |
Lovett et al. [67] (2014) | n = 34 health service staff | ndp | Mixed methods: quantitative (cross-sectional); literature review | N/A | Proposed ‘yarning style’ BI; implementation challenges noted; staff least confident in BI when client not seeking help | |
Brett et al. [29] (2017) | Qual: n = 7 staff (1 GP, 1 GP trainee, 2 nurses, 3 Aboriginal DandA workers), n = 4 clients; n = 8 community stakeholders (incl. 4 Elders) Quant: n = 8 clients | 2009 NHMRC guidelines | Mixed methods (cross-sectional) | N/A | Qual: clients rate program as accessible, streamlined and holistic; challenges also noted. Quant: n = 5/8 abstinent at 6-week follow up; n = 8/8 still engaged with supports. No major adverse events reported during detox | Qual: desired model principles incl. cultural safety, privacy (preventing community shame), keeping family together, peer support, accessible and streamlined. Feedback given on strengths and challenges of model as implemented |
Treatment access and/or acceptability | ||||||
Hall [74] (1986) | n = 44 servicese | ndp | Quantitative (descriptive) | N/A | n = 22 services incl. sweat lodge or encouraged use at external sites; n = 8 provided access to community-based sweat lodge; medicine man used on and off-site | |
Brady et al. [70] (1998) | n = 29 services | ndp | Quantitative (cross-sectional) | N/A | Aboriginal health services more likely to offer exclusive abstinence-based/Minnesota model of care; BI offered in half of services | |
Huriwai et al. [76] (2000) | n = 6 servicesf; total n = 105 clients | ndp | Quantitative (cross-sectional) | N/A | Clients rated strongly the importance of cultural elements in treatment | |
Robertson et al. [77] (2001) | n = 90 alcohol and drug-user treatment services; n = 217 staff | ndp | Quantitative (cross-sectional) | N/A | Strong support for cultural interventions with Māori clients | |
Brady et al. [71] (2002) | n = 8 health care workers; n = 6 general practitioners; n = 25 clients | AUDIT (tnsg) and 2Q’s on consumption | Qualitative (not clearly specified) | 18 months | 5/6 doctors still using BI | |
DeVerteuil and Wilson [63] (2010) | n = 7 servicese; total of n = 24 frontline staff; n = 1 staff member identified as Aboriginal | ndp | Qualitative (service case study) | N/A | n = 6 services refer for off-site cultural activities; n = 1 service has on-site cultural programs (incl. sweat lodge accessible by non-residents) | |
Panaretto et al. [68] (2010) | n = 4 health services; total of n = 46 staff | ndp | Mixed methods (cross-sectional) | N/A | n = 3/4 services offered BI in past 12mths; challenges noted | |
Allan [54] (2010) | n = 47 staff (DandA workers; primary health care workers) | ndp | Qualitative (action research) | N/A | Conflicting approaches to care between staff | |
Gone [64] (2011) | n = 4 current/former administrators; n = 4 counsellors; n = 11 clientsh | ndp | Qualitative (ethnography) | N/A | Program philosophy was based on medicine wheel and spiritual elements of AA; positive client experiences documented | |
Allan and Campbell [55] (2011) | n = 149 Aboriginal people attending community events; n = 16 sewing group participants; n = 5 DandA and Aboriginal health workers | ndp | Uncontrolled pre-post study | N/A | Strong client engagement and client acceptability | |
Clifford et al. [60] (2012) | n = 5 ACCHSs; total of n = 37 health staff | ndp | Qualitative (descriptive) | N/A | Scepticism of BI effectiveness and outcomes | |
Conigrave et al. [30] (2012) | n = 47 participants | AUDIT score of 8 + | Mixed methods (cross-sectional) | N/A | Participants unaware of outpatient treatments e.g. ambulatory withdrawal and medicines | |
Legha and Novins [66] (2012) | n = 18 substance abuse treatment programs serving AI/AN communities (representing 3 tribes across 7 states); n = 77 service providers (n = 22 clinical admin staff; n = 55 frontline staff) | ndp | Qualitative (grounded theory) | N/A | Cultural beliefs/values core to program; adapted western models used | |
Calabria et al. [57] (2013) | Clients of an ACCHS or DandA service n = 110 Indigenous; n = 6 non-Indigenous but have Indig. spouse or child | AUDIT (tns) | Quantitative (cross-sectional) | N/A | Strong client acceptability ratings | |
Lee et al. [65] (2013) | n = 21 staff; n = 24 female Aboriginal clients | AUDIT-C score of 4 + | Mixed methods cross-sectional survey; qualitative (descriptive) | N/A | Participant self-esteem and identity improved | |
Brett et al. [56] (2014) | n = 4 Indigenous health services; n = 1–3 staff at each service | 2009 NHMRC guidelines | Qualitative (descriptive) | N/A | Feedback for/on implementation of outpatient detox | |
Calabria et al. [58] (2014) | n = 19 DandA treatment agency staff; n = 3 ACCHS health staff | ndp | Qualitative (not clearly specified) | N/A | Tailoring process is documented and feedback gathered for adapting the counselling and counsellor certification process and improving feasibility | |
Hirchak et al. [31] (2018) | n = 61 participants (incl. individuals with AUDs, treatment providers, and community members) | ndp | Qualitative (not clearly specified) | N/A | Rated culturally acceptable |