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识别澳大利亚原住民和托雷斯海峡岛民社区中使用甲基苯丙胺的风险和保护因素,包括文化和身份认同:“关爱社区”模式的相关性。

Identifying risk and protective factors, including culture and identity, for methamphetamine use in Aboriginal and Torres Strait Islander communities: Relevance of the 'communities that care' model.

作者信息

Reilly Rachel, Gendera Sandra, Treloar Carla, Roe Yvette, Conigrave Kate, Azzopardi Peter, Ward James

机构信息

Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia.

Centre for Social Research in Health and Social Policy Research Centre, UNSW Sydney, NSW 2052, Australia.

出版信息

Soc Sci Med. 2020 Dec;266:113451. doi: 10.1016/j.socscimed.2020.113451. Epub 2020 Oct 17.

Abstract

BACKGROUND AND AIMS

There is a need for more evidence to guide efforts to address harmful methamphetamine use amongst young Aboriginal and Torres Strait Islander Australians. 'Communities that Care' (CTC) is an evidence-based process developed to prevent alcohol and other drug-related harm but its suitability for use in Aboriginal contexts has not been established. This study sought to explore whether risk and protective factors for methamphetamine use, as described by Aboriginal stakeholders, align with the CTC risk and protective factor framework.

METHOD

Focus groups and individual interviews were conducted in Aboriginal communities nationally. Data were analysed thematically using the CTC framework as a deductive coding framework. Additional themes were captured and summarised.

RESULTS

Participants were 147 (80% Aboriginal; 44% female) key stakeholders aged between 16 and 69 (median=40), recruited via organisational and community networks in each site. Relevant factors were identified in all four CTC domains: community, family, school, peer/individual. However, these four domains did not capture issues of central importance to Aboriginal people. These were summarised as an additional domain, 'Culture and Identity.'

CONCLUSIONS

Given that the Communities that Care risk and protective framework did not sufficiently capture issues of central importance to Aboriginal people, there is a need for different, community-informed models that reflect the unique determinants of use in this context.

摘要

背景与目标

需要更多证据来指导应对澳大利亚原住民和托雷斯海峡岛民年轻人中有害甲基苯丙胺使用问题的工作。“关爱社区”(CTC)是一个基于证据的预防酒精和其他药物相关危害的过程,但其在原住民环境中的适用性尚未确定。本研究旨在探讨原住民利益相关者所描述的甲基苯丙胺使用的风险和保护因素是否与 CTC 风险和保护因素框架一致。

方法

在全国范围内的原住民社区进行了焦点小组和个人访谈。使用 CTC 框架作为演绎编码框架对数据进行主题分析。捕捉并总结了其他主题。

结果

通过每个地点的组织和社区网络招募了 147 名关键利益相关者(80%为原住民;44%为女性),年龄在 16 至 69 岁之间(中位数 = 40)。在 CTC 的所有四个领域中都确定了相关因素:社区、家庭、学校、同伴/个人。然而,这四个领域并未涵盖对原住民至关重要的问题。这些问题被总结为一个额外的领域,即“文化与身份”。

结论

鉴于“关爱社区”风险和保护框架没有充分涵盖对原住民至关重要的问题,需要不同且基于社区信息的模型来反映这种情况下使用的独特决定因素。

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