Effectiveness and appropriateness of culturally adapted approaches to treating alcohol use disorders in Indigenous people: a mixed methods systematic review protocol

Abstract

The objective of this review is to investigate the effectiveness and appropriateness of culturally adapted approaches for treating alcohol use disorders in Indigenous peoples in Canada, New Zealand, Australia and the USA. Poor and disadvantaged people, particularly those who are Indigenous, suffer more health effects due to alcohol misuse and are therefore subject to more law enforcement actions. Analyses have identified strategies for improving health services for Indigenous people; chief among these is culturally safe care specifically tailored to the context. Alcohol addiction is a chronic relapsing condition that usually requires ongoing treatment, so it is vital that treatment therapies are appropriate, meaningful and effective. Many evidence-based therapies for substance abuse have not been specifically designed for or tested in Indigenous and First Nations communities. This absence of cultural considerations may be a contributor to the failure of these programs to engage with clients and successfully influence their behavior. This review will consider qualitative and quantitative studies of any methodology, published in any language after 1998. Studies including adult and/or adolescent participants in inpatient or outpatient alcohol treatment programs described as being adapted to meet cultural needs will be considered. This review will use the convergent segregated approach to mixed methods reviews. A range of databases will be searched, including MEDLINE, CINAHL, Embase and PsycINFO. Two reviewers will critically appraise and extract data from studies meeting the inclusion criteria. Qualitative research findings will, where possible, be pooled using JBI SUMARI with the meta-aggregation approach and quantitative studies will, where possible be pooled in statistical meta-analysis using JBI SUMARI. The JBI convergent segregated approach to mixed methods reviews will be followed.