Dr Anton Clifford
School of Population Health, University of Queensland
Professor Komla Tsey
The Cairns Institute & School of Education, James Cook University
Professor Christopher Doran
School of Medicine and Public Health, University of Newcastle
Associate Professor Melissa Haswell-Elkins
School of Public Health and Community Medicine, UNSW
Associate Professor Myfanwy Maple
School of Health, University of New England
Dr Kathy McKay
School of Health, University of New England
Indigenous Australians experience disproportionately high rates of drug and alcohol harms and young people are particularly vulnerable: over 50% of 10-17 year old juvenile detainees are Indigenous, despite comprising only 2% of the population. There is no reliable evidence about which interventions might reduce these harms. This study investigates the outcomes, and quantifies the benefit-cost, of a complex, multi-component intervention that combines cognitive-behaviour therapy with a community-reinforcement strategy to reduce substance-related harms among high risk young Indigenous Australians.
Despite the disproportionately high burden of physical, social and psychological drug and alcohol harms borne by young Indigenous Australians, there is very little evidence from rigorous intervention trials as to which strategies are most beneficial for reducing these harms. However, early findings from overseas studies suggest that complex, multi-component interventions that focus on different aspects of complexity in a young person’s life at the individual, family and community levels are proving to be most effective in reducing risk behaviours in high risk young people. Information resulting from an evaluation of a complex, multi-component intervention that combines aspects of cognitive behavioural therapy (individual focus) and an Aboriginal-specific community empowerment program for reducing alcohol and drug related harms in high risk young Indigenous Australians (family and community focus), will make an invaluable contribution to the development of an effective intervention model for high risk young Indigenous Australians.
This study aims to determine the outcomes, and estimate the benefit-cost of a complex, multi-component intervention that combines cognitive behavioural therapy and an Aboriginal-specific community empowerment program for high risk young Indigenous Australians. It is hypothesised that the benefits of this multi-component intervention will outweigh the costs.
An existing complex, multi-component intervention (BackTrack) which combines components of the Adolescent Community Reinforcement Approach (A-CRA) and Family Well Being therapy (FWB) will be examined and evaluated. Baseline data will be collected in the communities of Tamworth (NSW) and Yarrabah (QLD), followed by implementation of the BackTrack intervention and post-test data analyses. The implementation of the intervention will be staggered across the communities by six months and the order of implementation determined randomly.
Qualitative data will also be collected to assist with understanding participant perceptions of the intervention and to investigate the contextual issues that are most pertinent to the impact of the intervention.
To date, baseline and three month follow-up surveys have been completed in Tamworth, and early analysis of the data is in progress. Six month follow-up surveys will be implemented in February 2014. To assist with implementation of the survey, an electronic version has been designed which can be completed by program participants on laptop, tablet or iPhone.
Qualitative interviews with program graduates have been conducted, and further interviews are planned with current program participants within the next six months.
Consultation and planning for implementation of the program in Yarrabah has commenced.
Alice Knight is in the process of drafting several papers for publication in the peer-review literature later in 2014. These will present the results from the self-reported data. She is also collaborating on a paper with BackTrack staff and UNE academics that will describe the BackTrack program.
Through the development of a more effective and acceptable intervention model for high risk young Indigenous Australians this research has the potential to not only prevent risks and harms amongst the young people, but also to promote positive developmental outcomes. It also provides an opportunity to deliver disproportionately high returns to communities across the life trajectory of the young person, through improved productivity and reduced costs, primarily from reduced welfare payments, health- and legal-related costs.