Journal article
Formative process evaluation of a guideline-driven process for improving the cultural responsiveness of alcohol and drug treatment services
BMC Health Services Research, Vol.21(1), pp.1-11
2021
PMID: 33858384
Abstract
Background: To improve Australian Aboriginal and Torres Strait Islander people’s access to, and experience of, healthcare services, including Alcohol and other Drug (AoD) treatment services, principles and frameworks have been developed to optimise cultural responsiveness. Implementing those principles in practice, however, can be difficult to achieve. This study has five aims: i) to describe a five-step process developed to operationalise improvements in culturally responsive practice in AoD services; ii) to evaluate the fidelity of implementation for this five-step process; iii) to identify barriers and enablers to implementation; iv) to assess the feasibility and acceptability of this approach; and v) to describe iterative adaptation of implementation processes based on participant feedback.
Methods: Participating services were 15 non-Aboriginal AoD services in New South Wales, Australia. Implementation records were used to assess the implementation fidelity of the project. Structured interviews with chief executive officers or senior management were conducted, and interview data were thematically analysed to identify project acceptability, and the key enablers of, and barriers to, project implementation. Quantitative descriptive analyses were performed on the post-implementation workshop survey data, and responses to the free text questions were thematically analysed.
Results: A high level of implementation fidelity was achieved. Key enablers to improving culturally responsive practice were the timing of the introduction of the five-step process, the active interest of staff across a range of seniority and the availability of resources and staff time to identify and implement activities. Key barriers included addressing the unique needs of a range of treatment sub-groups, difficulty adapting activities to different service delivery models, limited time to implement change in this evaluation (three months) and the varied skill level across staff. The project was rated as being highly acceptable and relevant to service CEOs/managers and direct service staff, with planned changes perceived to be achievable and important. Based on CEO/management feedback after the project was implemented at the initial services, several improvements to processes were made.
Conclusion: The operationalisation of the five-step process developed to improve cultural responsiveness was feasible and acceptable and may be readily applicable to improving the cultural responsiveness of a wide variety of health and human services.
Details
- Title
- Formative process evaluation of a guideline-driven process for improving the cultural responsiveness of alcohol and drug treatment services
- Authors
- Sara Farnbach (Author) - UNSW SydneyJulaine Allan (Corresponding Author) - University of WollongongRaechel Wallace (Author) - Network of Alcohol and Other Drug Agencies (Australia)Alexandra Aiken (Author) - UNSW SydneyAnthony Shakeshaft - UNSW Sydney
- Publication details
- BMC Health Services Research, Vol.21(1), pp.1-11
- Publisher
- BioMed Central Ltd.
- Date published
- 2021
- DOI
- 10.1186/s12913-021-06367-7
- ISSN
- 1472-6963
- PMID
- 33858384
- Copyright note
- © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Data Availability
- The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
- Grant note
- The Alcohol and Other Drugs Treatment Guidelines for Working with Aboriginal and Torres Strait Islander people in a non-Aboriginal setting project was initiated and funded by a coalition of six Primary Health Networks (PHNs) in NSW, Australia.
- Organisation Unit
- School of Health - Psychology
- Language
- English
- Record Identifier
- 991241468902621
- Output Type
- Journal article
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