Tailoring a family-based alcohol intervention for Aboriginal Australians, and the experiences and perceptions of health care providers trained in its delivery.

Bianca Calabria,Anthony P Shakeshaft,Anton Clifford,Miranda Rose

doi:10.1186/1471-2458-14-322

Abstract

BackgroundAboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population. Alcohol treatment approaches that simultaneously target individuals and families offer considerable potential to reduce these harms if they can be successfully tailored for routine delivery to Aboriginal Australians. The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two related interventions that are consistent with Aboriginal Australians’ notions of health and wellbeing. This paper aims to describe the process of tailoring CRA and CRAFT for delivery to Aboriginal Australians, explore the perceptions of health care providers participating in the tailoring process, and their experiences of participating in CRA and CRAFT counsellor certification.MethodsData sources included notes recorded from eight working group meetings with 22 health care providers of a drug and alcohol treatment agency and Aboriginal Community Controlled Health Service (November 2009-February 2013), and transcripts of semi-structured interviews with seven health care providers participating in CRA and CRAFT counsellor certification (May 2012). Qualitative content analysis was used to categorise working group meeting notes and interview transcripts were into key themes.ResultsModifying technical language, reducing the number of treatment sessions, and including an option for treatment of clients in groups, were key recommendations by health care providers for improving the feasibility and applicability of delivering CRA and CRAFT to Aboriginal Australians. Health care providers perceived counsellor certification to be beneficial for developing their skills and confidence in delivering CRA and CRAFT, but identified time constraints and competing tasks as key challenges.ConclusionsThe tailoring process resulted in Aboriginal Australian-specific CRA and CRAFT resources. The process also resulted in the training and certification of health care providers in CRA and CRAFT and the establishment of a local training and certification program.

Highlights

Aboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population
Community Reinforcement and Family Training (CRAFT) [8] is a family-based intervention modelled on Community Reinforcement Approach (CRA) and has been identified as an effective cognitivebehavioural intervention with potential to be tailored, in collaboration with locally targeted Aboriginal communities, for delivery in Aboriginal-specific health care settings [3]
This paper reports on a project that involved researchers working with health care services and Aboriginal community members to tailor CRA and CRAFT for Aboriginal Australians in rural New South Wales (NSW), Australia

Summary

Introduction

Aboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population. The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two related interventions that are consistent with Aboriginal Australians’ notions of health and wellbeing. CRA and CRAFT have been found to be acceptable to Aboriginal Australians in rural New South Wales (NSW) for delivery in their local community, when tailored to optimise their cultural appropriateness [10]. Both interventions have been successfully modified for other minority groups [11,12,13,14], they have not been tailored for Aboriginal Australians

Objectives

Methods

Results

Conclusion