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首页> 外文期刊>Journal of substance abuse treatment >Focus groups to increase the cultural acceptability of a contingency management intervention for American Indian and Alaska Native Communities
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Focus groups to increase the cultural acceptability of a contingency management intervention for American Indian and Alaska Native Communities

机译：焦点小组提高美国印度和阿拉斯加本地社区的应急管理干预的文化可接受性

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IntroductionMany American Indian and Alaska Native (AI/AN) people seek evidence-based, cost-effective, and culturally acceptable solutions for treating alcohol use disorders. Contingency management (CM) is a feasible, low-cost approach to treating alcohol use disorders that uses “reinforcers” to promote and support alcohol abstinence. CM has not been evaluated among AI/AN communities. This study explored the cultural acceptability of CM and adapted it for use in diverse AI/AN communities. MethodsWe conducted a total of nine focus groups in three AI/AN communities: a rural reservation, an urban health clinic, and a large Alaska Native healthcare system. Respondents included adults in recovery, adults with current drinking problems, service providers, and other interested community members (n?=?61). Focus group questions centered on the cultural appropriateness of “reinforcers” used to incentivize abstinence and the cultural acceptability of the intervention. Focus groups were audio-recorded, transcribed, and coded independently by two study team members using both a priori and emergent codes. We then analyzed coded data. ResultsAcross all three locations, focus group participants described the importance of providing both culturally specific (e.g., bead work and cultural art work supplies), as well as practical (e.g., gas cards and bus passes) reinforcers. Focus group participants underscored the importance of providing reinforcers for the children and family of intervention participants to assist with reengaging with family and rebuilding trust that may have been damaged during alcohol use. Respondents indicated that they believed CM was in alignment with AI/AN cultural values. There was consensus that Elders or a well-respected community member implementing this intervention would enhance participation. Focus group participants emphasized use of the local AI/AN language, in addition to the inclusion of appropriate cultural symbols and imagery in the delivery of the intervention. ConclusionsA CM intervention for alcohol use disorders should be in alignment with existing cultural and community practices such as alcohol abstinence, is more likely to be successful when Elders and community leaders are champions of the intervention, the intervention is compatible with counseling or treatment methodologies, and the intervention provides rewards that are both culturally specific and practical.
机译：Lightmany American Indian和Alaska Native（AI / AN）人员寻求循证，经济效益和文化可接受的解决方案，用于治疗酒精使用障碍。应急管理（CM）是一种可行，低成本的方法来治疗使用“增强剂”来促进和支持酒精禁欲的饮酒障碍。 CM尚未在AI /社区之间进行评估。本研究探讨了CM的文化可接受性，并适用于各种AI /社区使用。方法网络在三个AI /社区进行了九个焦点小组：农村预订，城市健康诊所和大型阿拉斯加本地医疗保健系统。受访者包括恢复成年人，成年人有当前饮酒问题，服务提供商和其他感兴趣的社交成员（n？=？61）。焦点小组质疑以“强化者”的文化适当性为中心，用于激励禁欲和干预的文化可接受性。焦点小组由两个研究团队成员使用先验和紧急代码独立录制，转录和编码。然后，我们分析了编码数据。结果荣档所有三个地点，焦点集团参与者描述了提供文化特定的（例如，珠子工作和文化艺术工作用品）的重要性，以及实用（例如，加油卡和公共汽车通行证）增强剂。焦点集团参与者强调为儿童和干预参与者提供强化者的重要性，以协助重新登记家庭和重建可能在酒精使用期间受损的信任。受访者表示，他们认为CM与AI /文化价值一致。达成共识，即将提高参与的长老或尊敬的社区成员。焦点集团参与者强调了使用本地AI /一种语言，除了包含适当的文化符号和图像在交付干预方面。结论AUTIOSA CM干预酒精使用障碍应与现有的文化和社区实践相一致，如酒精禁欲，当长老和社区领导人是干预的冠军时，更有可能是成功的，干预符合咨询或治疗方法，以及干预提供了文化特定和实用的奖励。

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