Rowan Margo, Poole Nancy, Shea Beverley, Gone Joseph P, Mykota David, Farag Marwa, Hopkins Carol, Hall Laura, Mushquash Christopher, Dell Colleen
Department of Sociology, University of Saskatchewan, 1109 - 9 Campus Drive, Saskatoon, SK S7N 5A5, Canada.
Subst Abuse Treat Prev Policy. 2014 Sep 1;9:34. doi: 10.1186/1747-597X-9-34.
Cultural interventions offer the hope and promise of healing from addictions for Indigenous people.a However, there are few published studies specifically examining the type and impact of these interventions. Positioned within the Honouring Our Strengths: Culture as Intervention project, a scoping study was conducted to describe what is known about the characteristics of culture-based programs and to examine the outcomes collected and effects of these interventions on wellness.
This review followed established methods for scoping studies, including a final stage of consultation with stakeholders. The data search and extraction were also guided by the "PICO" (Patient/population, Intervention, Comparison, and Outcome) method, for which we defined each element, but did not require direct comparisons between treatment and control groups. Twelve databases from the scientific literature and 13 databases from the grey literature were searched up to October 26, 2012.
The search strategy yielded 4,518 articles. Nineteen studies were included from the United States (58%) and Canada (42%), that involved residential programs (58%), and all (100%) integrated Western and culture-based treatment services. Seventeen types of cultural interventions were found, with sweat lodge ceremonies the most commonly (68%) enacted. Study samples ranged from 11 to 2,685 clients. Just over half of studies involved quasi-experimental designs (53%). Most articles (90%) measured physical wellness, with fewer (37%) examining spiritual health. Results show benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies.
Evidence from this scoping study suggests that the culture-based interventions used in addictions treatment for Indigenous people are beneficial to help improve client functioning in all areas of wellness. There is a need for well-designed studies to address the question of best relational or contextual fit of cultural practices given a particular place, time, and population group. Addiction researchers and treatment providers are encouraged to work together to make further inroads into expanding the study of culture-based interventions from multiple perspectives and locations.
文化干预为原住民戒除成瘾问题带来了治愈的希望。然而，专门研究这些干预措施的类型和影响的已发表研究较少。在“尊重我们的力量：以文化为干预手段”项目中，开展了一项范围界定研究，以描述基于文化的项目的特征，并研究这些干预措施对健康状况的收集结果和影响。
本综述遵循了范围界定研究的既定方法，包括与利益相关者进行咨询的最后阶段。数据搜索和提取也以“PICO”（患者/人群、干预措施、对照和结果）方法为指导，我们对每个要素进行了定义，但不要求在治疗组和对照组之间进行直接比较。截至2012年10月26日，检索了12个科学文献数据库和13个灰色文献数据库。
检索策略共得到4518篇文章。其中19项研究来自美国（58%）和加拿大（42%），涉及住院项目（58%），并且所有研究（100%）都整合了西方和基于文化的治疗服务。共发现17种文化干预类型，其中发汗小屋仪式最为常见（68%）。研究样本数量从11名到2685名客户不等。略超过一半的研究采用了准实验设计（53%）。大多数文章（90%）测量了身体健康状况，较少文章（37%）考察了精神健康状况。结果表明，在所有健康领域都有益处，特别是在74%的研究中减少或消除了物质使用问题。
这项范围界定研究的证据表明，用于原住民成瘾治疗的基于文化的干预措施有利于帮助改善客户在所有健康领域的功能。需要开展精心设计的研究，以解决在特定地点、时间和人群中文化实践的最佳关系或背景契合问题。鼓励成瘾研究人员和治疗提供者共同努力，从多个角度和地点进一步深入开展基于文化的干预措施研究。
