How Do Providers Serving American Indians and Alaska Natives With Substance Abuse Problems Define Evidence-Based Treatment?
How Do Providers Serving American Indians and Alaska Natives With Substance Abuse Problems Define Evidence-Based Treatment?
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DOI：
10.1037/ser0000022
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发表时间：
2015-05-01
影响因子：
2.3
通讯作者：
Novins, Douglas K.
中科院分区：
文献类型：
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作者：
Moore, Laurie A.;Aarons, Gregory A.;Novins, Douglas K.
在美洲印第安人和阿拉斯加原住民(AI/AN)人口中，药物滥用的比率仍然很高。虽然有许多针对物质使用问题的循证治疗(EBT)，但还没有研究描述服务于AI/ANS的治疗计划的主任如何感知和使用EBTS。对有药物使用问题的AI/ANS的18个治疗项目进行了21名关键线人与项目管理员的访谈和与临床医生的10个焦点小组的访谈。没有收集人口统计数据来保护参与者的隐私。对成绩单进行编码，以确定相关主题。大多数与会者使用该短语的标准定义中的关键术语“有效”和“研究”正确地定义了环境保护措施。更详细的描述并不常见。与对EBTS的态度有关的普遍主题包括对文化相关性的关切、使用EBTS的外部任务以及它们对西方对药物滥用概念化的依赖。虽然大多数因药物滥用而治疗AI/AN客户的管理人员和临床医生对什么构成EBT有基本的了解，但对于它们与AI/AN使用的相关性几乎没有达成共识。认识到人工智能/人工智能人群中广泛的地理和部落差异可能会影响关于EBTS得出的结论，有几个因素可能会增强方案工作人员确定最适合当地实施的EBTS的能力。这些措施包括更详细地了解EBT是如何开发的，以及如何评估其科学基础，以及利用EBT的定义，不仅包括研究证据，还包括临床专业知识和判断，并符合消费者的选择、偏好和文化。
Rates of substance abuse remain high in American Indian and Alaska Native (AI/AN) populations. While there are many evidence-based treatments (EBTs) for substance use problems, no studies exist describing how directors of treatment programs serving AI/ANs perceive and use EBTs. Twenty-one key informant interviews with program administrators and 10 focus groups with clinicians were conducted at 18 treatment programs for AI/ANs with substance use problems. Demographic data were not collected to protect participant privacy. Transcripts were coded to identify relevant themes. A majority of participants correctly defined an EBT using the key terms "effective" and "research" found in standard definitions of the phrase. More detailed descriptions were uncommon. Prevalent themes related to attitudes about EBTs included concerns about cultural relevance, external mandates to use EBTs, and their reliance on western conceptualization of substance abuse. While most administrators and clinicians who treat AI/AN clients for substance abuse had a basic understanding of what constitutes an EBT, there was little consensus regarding their relevance for use with AI/ANs. Recognizing that broad geographic and tribal diversity among AI/AN populations may impact conclusions drawn about EBTs, several factors may enhance the abilities of program staff to identify EBTs most appropriate for local implementation. These include gaining a more detailed understanding of how an EBT is developed and how to assess its scientific grounding, as well as utilizing definitions of EBTs that include not only research evidence, but also clinical expertise and judgment, and fit with consumer choice, preference, and culture.