Take the Best from Both Cultures: An Aboriginal Model for Substance Use Prevention and Intervention

Abstract

Objective: To identify the key components of an Aboriginal model for alcohol (and other drug) harm prevention and intervention. Method: Part of a wider, two-year, Aboriginal-initiated study into the context and Indigenous perceptions of Aboriginal alcohol use and intervention, using a descriptive, grounded theory, participatory action study design. A demographically comprehensive sample of 170 Aboriginal people participated in qualitative, semi-structured interviews within three types of participant groups: the "model planning group" progressively distilling all participants' proposals into the intervention model described here. Results: The model proposes a remotely located, multi-component, youth and family-focused residential Bush College program with integral "cultural", vocational/life skills and followup support components. The program would be staffed by a network of permanent on-site Aboriginal staff, language group elders in residence for "cultural teaching" components, and visiting accredited vocational trainers. Family and peer co-residence would be encouraged. Detailed operational guidelines include staff selection criteria, assessment procedures, program content and operation, rules, follow-up, management, budget, evaluation (discussed in a separate paper), and local agency support. Core program components are presented, with further details available via weblink.Conclusions and implications: Among the study's remote area Aboriginal participants, recommendations for substance misuse prevention and intervention differ markedly from options generally available to them. In contrast with the substance use symptom-focus of most programs, participants detail instead a cause focused approach addressing issues of identity, economic and daily-life opportunity, and a sense of hope for the future. These findings have relevance for understandings of cultural appropriateness, Aboriginal-perceived social determinants and the design of culturally meaningful substance misuse prevention and intervention strategies.