Implementing alcohol harm reduction interventions in an Australian Indigenous context

  • Megan Whitty

    Student thesis: Doctor of Philosophy (PhD) - CDU


    Implementing alcohol misuse interventions in the Northern Territory is challenging and the role of evaluation in this process ill defined. Indigenous Australians are at higher-risk of premature death and disability from alcohol misuse than the general population. The aim of this study is to investigate the dissemination of alcohol harm-reduction research into practice settings.

    This program of research was designed to provide important new information on the quality and direction of dissemination studies with a view to improving future implementation efforts in this field. Implementation science models and frameworks offer the potential to bridge current knowledge gaps. The primary objectives were to determine: (a)the scope and nature of the evidence that underpins implementation within the literature; (b) detail of the implementation contexts; and (c), methods for facilitating implementation and improving outcomes.

    A combination of research approaches were employed including a systematic review using a validated appraisal tool and narrative synthesis. Two mixed methods case studies were also conducted. Both explored in detail the process of implementing alcohol interventions; one in a tertiary care setting, the other in the context of a holistic community-action approach. The Promoting Action on Research Implementation in Health Services (PARIHS) framework provided an overarching conceptual framework and post hoc reference guide.

    Key findings are that there is a lack of quality research that is culturally inclusive, and inconsistencies in the evaluation and reporting of implementation outcomes. In addition, the role of facilitator and the facilitators’ ability to rectify contextual impediments to implementation, particularly at the macro level, is generally undervalued. There is a need for both funding bodies and researchers to prioritise the conduct of robust implementation research studies. Maximal contextual support and demonstrated Indigenous involvement needs to be tied into funding allocation.

    Date of AwardMar 2017
    Original languageEnglish
    SupervisorTricia Nagel (Supervisor), Rama Jayaraj (Supervisor), Rachael Hinton (Supervisor) & Elizabeth McDonald (Supervisor)

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