The Dissemination of Alcohol Interventions for Indigenous Australians: A Mixed Studies Review Using Narrative Synthesis

Abstract

Issues: Indigenous Australians experience disproportionately high rates of alcohol related harms. The implementation of best evidence alcohol interventions to reduce these harms is therefore a priority. This review synthesises evidence from the peer reviewed literature on factors influencing implementation. Approach: A systematic appraisal of journal articles based on alcohol-related harm reduction interventions for Indigenous Australians with scope for dissemination. This involved a systematic database search, categorisation, data extraction, quality appraisal, and preliminary analysis. A thorough textual analysis of identified papers was carried out using narrative synthesis. Key findings: Thirteen publications met the inclusion criteria. Included studies assessed either: (a) Acceptability/ feasibility of alcohol interventions for implementation in Indigenous-specific healthcare settings and/or delivery to Indigenous Australians (n=7); (b) The effectiveness of strategies designed to improve the uptake/delivery of an alcohol intervention (n=4); or (c) The process of implementing an alcohol intervention with Indigenous Australians (n=2). Implications: Flexibility in study implementation, an emphasis on capacity building and prioritising the reporting of implementation evidence is needed. Conclusion: Overall, the number of dissemination studies focusing on alcohol interventions for Indigenous peoples is low, and their quality varied. Evidence detailing the circumstances for optimal implementation of such interventions is thin, despite the value of this information to future research. This review presents knowledge gained to date on the alcohol interventions considered appropriate and practicable for Indigenous people. Future efforts should reflect greater researcher reflexivity and implementation transparency, and extend measurement of outcomes to health considerations determined to be meaningful by the affected Indigenous people themselves.