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Evaluation of the young Aboriginal drug and alcohol service (yAdas)

Citation

Barnett, AP and Auckland, SRJ and Stewart, FE and Dennis, SL, Evaluation of the young Aboriginal drug and alcohol service (yAdas), Cornerstone Youth Services, 1 (2013) [Contract Report]


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Abstract

The Young Aboriginal Drug and Alcohol Service (yAdas) was developed in response to the high level of need for a clinically and culturally competent service for Aboriginal youth in Northern Tasmania. Despite the devastating impact of alcohol and drug use on Aboriginal youths, their families and the community, it is clear that drug and alcohol services are not being accessed commensurate with this need (Westerman 2010). Very often associated with a range of other health problems such as high levels of psychological distress and suicide, substance use among Aboriginal youth severely affects quality of life and wellbeing (AIHW 2009). Funded by the Office of Aboriginal and Torres Strait Islander Health (OATSIH), yAdas aims to respond to this need by providing a clinically and culturally competent service, delivered via a collaboration between Cornerstone Youth Services Inc (CYS) and Relationships Australia Tasmania (RA). The University Department of Rural Health (UDRH) at the University of Tasmania was engaged to evaluate the program. With a strong research focus, the UDRH has extensive experience in undertaking evaluations and a reputation for producing locally relevant, and nationally and internationally recognised research. The program evaluation consisted of three phases: development of the framework and specification of the evaluation, a pilot, and the program evaluation. The first phase involved the development of an appropriate evaluation framework, development of the audit tool, identification of key stakeholders and the establishment of an evaluation team. The second phase involved the pilot of the evaluation audit tool with service provider agencies and referral agencies and the collection and collation of baseline information and the provision of formative feedback to the program. The final phase involved the implementation of the full evaluation of the project, utilising the audit tool and including stakeholder and end-user (clients) representatives. The yAdas team were engaged and extensively involved in the first phase of the project to ensure that the evaluation framework reflected the mission of the program and the realities of service delivery. The yAdas WiP (Work in Progress) meetings provided an opportunity for members of the evaluation team to meet with and develop a framework suited to the program. The following are key findings from the evaluation: 1. Clients’ experiences of yAdas were overwhelmingly positive. Not only did some clients report actual decreases in the amount of drug and alcohol used, but they also reported increased knowledge of the impact of drug and alcohol use on their health. 2. In addition to the direct effect of yAdas on substance use, clients reported experiencing a range of interventions/support that impacted on their emotional health more generally. The practical support provided by yAdas was highly valued and ranged from helping clients with school enrolments to providing information on sexual health and wellbeing. 3. Participants suggested that a key success of the program could be attributed to the outreach model adopted, which increased access for clients. In addition, clients reported that yAdas workers are readily contactable and available, with the Facebook page being a particularly effective form of communication. 4. Both service providers and referrers generally reported that the services provided by yAdas were culturally appropriate and accessible for young Aboriginal people. This has been achieved through ongoing and readily available cultural mentoring for staff, and ongoing consultations with the local Aboriginal community. 5. Overall there was a sense that relationships between yAdas and the community are improving, but general acknowledgment that there is still work to be done. 6. Staffing levels within service provider agencies have fluctuated. Whilst the impact of this on service delivery was widely acknowledged, the degree to which this affected client outcomes was not ascertained. 7. Clarification regarding the roles of service providers (yAdas personnel) was highlighted by some as an issue requiring attention. 8. Professional development and clinical and cultural supervision was highly valued, with participants reporting ready access to such support. 9. The regular yAdas program team meetings (WiP meetings) were generally well regarded, mainly for the point of getting the team together on a weekly basis. 10. The lack of clinical reviews was highlighted as a significant risk to the program, and processes are now in place to ensure that these occur. 11. The relationship between CYS and RA was, for some, a source of strength for the program given the diversity in the approaches of the two services. 12. Among the middle and upper management members of the yAdas team, the quality assurance policies and procedures were well known. However, less confidence was noted among the on the ground workers. 13. A girls group being run from a local high school was consistently reported as a highly successful example of community engagement. 14. yAdas was generally well regarded among referrers to the program. Involvement by referrers with the program ranged from a highly successful occasion of co-case managing a client, to facilitating community development/education activities. One referrer however, felt that yAdas did not know the ‘grass roots Aboriginal community’, and therefore was not able to effectively impact the substance use problems among young people in the community. Based on these findings, the following issues were identified for further consideration by the service: • How can yAdas incorporate research emphasising the importance of involving family in drug and alcohol work? Most of the clinical work done is with clients on an individual basis (families are not typically involved) and this is also the case for group work. Could this evolve? Should this be a priority for the direction of the service? Is this need being partially addressed by community work? • As referrals to yAdas continue to increase, how will this be managed? Will time be taken from community work for clinical work? Consideration should be given to how to manage this increasing demand on the service. • How will the level of community involvement be evaluated and monitored in the future? • On-the-ground workers reported being largely unaware of elements of the yAdas quality assurance plan. Given this, is a review of the processes for disseminating information to staff required? • How are client outcomes currently evaluated and measured? • Clarification regarding the expectations for attendance at the Work in Progress (WiP) meetings would be beneficial. Some weeks, attendance is very poor. What impact does this have on the morale of the team? How productive are the meetings when staff do not consistently attend? • Some staff queried the format of the WiP meetings, with suggestions to broaden the scope of the meeting to include, for example, case reviews and good news stories. Could an extended WiP be accommodated? Could this extended WiP occur monthly for example? • Is there consistency with regard to the roles and responsibilities of staff across the two services (CYS and RA)? • Is it possible to increase opportunities for workers across sites to work together? How does targeting different geographical areas impact on this? Does this work well? Is there room for more collaboration? How would this impact on the service?

Item Details

Item Type:Contract Report
Keywords:Aboriginal, drug and alcohol, substance abuse, Tasmania
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Aboriginal and Torres Strait Islander Health
Objective Division:Health
Objective Group:Indigenous Health
Objective Field:Aboriginal and Torres Strait Islander Health - Determinants of Health
Author:Barnett, AP (Associate Professor Tony Barnett)
Author:Auckland, SRJ (Mr Stuart Auckland)
Author:Stewart, FE (Ms Frances Stewart)
Author:Dennis, SL (Ms Sharon Dennis)
ID Code:86360
Year Published:2013
Deposited By:Centre for Rural Health
Deposited On:2013-09-09
Last Modified:2014-03-20
Downloads:0

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