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The effectiveness of a community-based intervention (community reinforcement approach) at reducing substance use and related harms among Aboriginal and non-Aboriginal Australians
journal contributionposted on 06.12.2017, 00:00 by B Calabria, A Knight, A Shakeshaft, A Clifford, J Allan, D Bliss, Christopher Doran, C Stone
Introduction and Aims: The Community Reinforcement Approach (CRA) is a community-based cognitive-behavioural intervention for problem drinkers. CRA has recently been tailored for Aboriginal Australians. This study aims to: (i) implement the CRA program with Aboriginal and non-Aboriginal Australians; and (ii) measure the effectiveness of the CRA program on reducing substance use and increasing social and emotional wellbeing. Design and Methods: Participants were recruited through a drug and alcohol treatment agency in rural New South Wales. Data were collected through interviews pre-intervention, four weeks and three months after CRA treatment started. Measures include demographics, substance misuse (Alcohol, Smoking and Substance Involvement Screening Test), psychological distress (Kessler-5) and empowerment (Growth and Empowerment Measure). The effectiveness of CRA was analysed using a pre- and post-program delivery demonstration study design.Results: Overall, 55 participants (44% identified as Aboriginal) completed a pre-intervention interview.Thirty-two participants completed the four week interview and 31 participants completed the three month follow-up interview. Alcohol, cannabis and stimulant misuse scores were lower four weeks after CRA started (t = 3.25, P < 0.005; t = 3.10, P < 0.005; t = 2.16, P = 0.04 respectively). Stimulant use and harm scores were significantly reduced three months after CRA started compared to baseline scores (t = 2.67, P = 0.01). Psychological distress and empowerment scores were not reduced post-intervention. Discussion and Conclusions: Pre- and post-program analyses on the effectiveness of CRA have demonstrated support for the CRA program in reducing substance use and related harms. This finding has implications for public health treatment initiatives and future research pertaining to alcohol use and related harms for Aboriginal and non-Aboriginal Australians.