通过“我们可以做到”的网络应用程序减少原住民和托雷斯海峡岛民社区的甲基苯丙胺使用:可接受性和可行性的定性评估。

IF 2 Q3 HEALTH CARE SCIENCES & SERVICES
Leda Sivak, Rachel Reilly, Shani Crumpen, Carla Treloar, Rebecca McKetin, Julia Butt, Yvette Roe, Nadine Ezard, Brendan Quinn, Jack Nagle, Wade Longbottom, Clifford Warrior, James Ward
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引用次数: 0

摘要

背景:预防和治疗土著和托雷斯海峡岛民中与甲基苯丙胺有关的伤害是卫生保健服务面临的重大挑战。数字卫生保健可以提供机会,以补充现有的甲基苯丙胺治疗方案的方式支持个人和家庭。这项研究回应了社区确定的优先事项,因为土著社区控制的保健服务将甲基苯丙胺的使用确定为一个关键问题,并寻求支持,以满足甲基苯丙胺使用者及其家庭的需求。目的:本文报告了客户和临床医生在住宅康复服务和初级保健中使用web应用程序的可接受性和可行性的过程评估。这项研究是名为“解决土著和托雷斯海峡岛民社区甲基苯丙胺使用问题的新干预措施”(NIMAC)的一个更大项目的一部分,该项目旨在制定适合文化和基于优势的预防和治疗干预措施,以减少甲基苯丙胺相关危害。“我们可以做到”是一个为原住民和托雷斯海峡岛民开发的网络应用程序,他们正在寻求减少或停止使用冰毒。方法:在维多利亚州和南澳大利亚州的城市和地区,通过土著社区控制健康服务和土著居民住宅康复服务招募使用网络应用程序的临床医生和客户。收集了所有参与者的未识别使用数据。在使用了web应用程序后,那些表示愿意接受采访的人通过电话或亲自联系和采访,并询问web应用程序的可行性和可接受性。采用框架分析方法对所得定性数据进行组织和总结。结果:通过对24名患者和11名临床医生的访谈,探讨了网络应用的可接受性和可行性。可接受性包括以下几个方面:情感态度、负担、伦理、文化适宜性、一致性、机会成本、感知有效性和自我效能。可行性评估评估了项目实施的障碍和促进因素,重点是需求、实用性、保真性和整合性。结果表明,客户和临床医生都认为网络应用程序内容连贯,相关,授权和文化安全。客户使用web应用程序的障碍包括缺乏互联网连接和个人问题,如日程安排。结论:过程评价常被低估。然而,由于“我们能做到这一点”是新颖的,创新的,针对的是难以接触到的人群,了解其作为临床工具的可行性和可接受性对于了解其潜力至关重要。“我们能做到这一点”是独一无二的,因为它是唯一一个基于证据的、文化上合适的、基于互联网的治疗项目,专门为使用甲基苯丙胺的土著和托雷斯海峡岛民设计的。研究结果表明,在住宅康复和初级保健环境中,作为一种低成本的常规护理辅助,它是可接受和可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reducing Methamphetamine Use in Aboriginal and Torres Strait Islander Communities With the "We Can Do This" Web App: Qualitative Evaluation of Acceptability and Feasibility.

Background: Preventing and treating methamphetamine-related harm in Aboriginal and Torres Strait Islander populations is a significant challenge for health care services. Digital health care may offer opportunities to support individuals and families in ways that complement existing methamphetamine treatment options. This study responds to a community-identified priority as Aboriginal Community Controlled Health Services identified methamphetamine use as a key concern and sought support to respond to the needs of people who use methamphetamine and their families.

Objective: This paper reports on a process evaluation of the web application's acceptability and feasibility when used by clients and clinicians in residential rehabilitation services and primary care. This study is part of a larger project entitled "Novel Interventions to address Methamphetamine use in Aboriginal and Torres Strait Islander Communities" (NIMAC), which seeks to develop culturally appropriate and strengths-based prevention and treatment interventions to reduce methamphetamine related harm. "We Can Do This" was a web application developed for Aboriginal and Torres Strait Islander people who are seeking to reduce or stop methamphetamine use.

Methods: Clinicians and clients who had used the web application were recruited through Aboriginal Community Controlled Health Services and Aboriginal residential rehabilitation services in urban and regional Victoria and South Australia. Unidentified usage data was collected from all participants. After using the web application, those who indicated a willingness to be interviewed were contacted and interviewed by phone or in person and asked about the feasibility and acceptability of the web application. The framework method of analysis was used to structure and summarise the resulting qualitative data.

Results: Interviews with 24 clients and 11 clinicians explored the acceptability and feasibility of the web application. Acceptability incorporated the following domains: affective attitude, burden, ethicality, cultural appropriateness, coherence, opportunity cost, perceived effectiveness, and self-efficacy. The evaluation of feasibility assessed barriers and facilitators to the implementation of the program, with a focus on demand, practicality, fidelity, and integration. Results indicated that both clients and clinicians found the web application content coherent, relatable, empowering, and culturally safe. Barriers to using the web application for clients included a lack of internet connectivity and personal issues such as scheduling.

Conclusions: Process evaluation is often under-valued. However, as "We Can Do This" was new, innovative and targeted a hard-to-reach population, understanding its feasibility and acceptability as a clinical tool was essential to understanding its potential. "We Can Do This" is unique as the only evidence-based, culturally appropriate internet-based therapeutic program specifically designed for Aboriginal and Torres Strait Islander people who use methamphetamine. Findings suggest it was both acceptable and feasible as a low-cost adjunct to usual care in residential rehabilitation and primary care settings.

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来源期刊
JMIR Formative Research
JMIR Formative Research Medicine-Medicine (miscellaneous)
CiteScore
2.70
自引率
9.10%
发文量
579
审稿时长
12 weeks
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