Lessons learned and future directions: A scoping review of American Indian and Alaska Native participants in the National Drug Abuse Treatment Clinical Trials Network.

Autor: Crouch MC; Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States. Electronic address: maria.crouch@yale.edu., Venner KL; University of New Mexico, 1 University of New Mexico, MSC03 2220, Albuquerque, NM 87131-0001, United States., Wendt DC; McGill University, 3700 McTavish St., Room 614, Montreal, QC H3A 1Y2, Canada., Burlew AK; University of Cincinnati, 2600 Clifton Ave., Cincinnati, OH 45220, United States., Baukol P; Berman Center for Outcomes & Clinical Research, 701 Park Ave., Suite PP7.700, Minneapolis, MN 55415, United States., Funaro MC; Harvey Cushing/John Hay Whitney Medical Library, Yale University, 333 Cedar St, New Haven, CT 06510, United States., Sorrell T; Rush University Medical Center, 1645 W Jackson Blvd, Westgate Building, Suite 600, Chicago, IL 60612, United States., Haeny AM; Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
Jazyk: angličtina
Zdroj: Journal of substance use and addiction treatment [J Subst Use Addict Treat] 2023 Oct; Vol. 153, pp. 209081. Date of Electronic Publication: 2023 May 23.
DOI: 10.1016/j.josat.2023.209081
Abstrakt: Introduction: American Indian and Alaska Native (AI/AN) populations are disproportionately affected by substance use disorders (SUDs) and related health disparities in contrast to other ethnoracial groups in the United States. Over the past 20 years, substantial resources have been allocated to the National Institute on Drug Abuse Clinical Trials Network (CTN) to disseminate and implement effective SUD treatments in communities. However, we know little about how these resources have benefitted AI/AN peoples with SUD who arguably experience the greatest burden of SUDs. This review aims to determine lessons learned about AI/AN substance use and treatment outcomes in the CTN and the role of racism and Tribal identity.
Method: We conducted a scoping review informed by the Joanna Briggs framework and PRISMA Extension for Scoping Reviews checklist and explanation. The study team conducted the search strategy within the CTN Dissemination Library and nine additional databases for articles published between 2000 and 2021. The review included studies if they reported results for AI/AN participants. Two reviewers determined study eligibility.
Results: A systematic search yielded 13 empirical articles and six conceptual articles. Themes from the 13 empirical articles included: (1) Tribal Identity: Race, Culture, and Discrimination; (2) Treatment Engagement: Access and Retention; (3) Comorbid Conditions; (4) HIV/Risky Sexual Behaviors; and (5) Dissemination. The most salient theme was Tribal Identity: Race, Culture, and Discrimination, which was present in all articles that included a primary AI/AN sample (k = 8). Themes assessed but not identified for AI/AN peoples were Harm Reduction, Measurement Equivalence, Pharmacotherapy, and Substance Use Outcomes. The conceptual contributions used AI/AN CTN studies as exemplars of community-based and Tribal participatory research (CBPR/TPR).
Conclusion: CTN studies conducted with AI/AN communities demonstrate culturally congruent methods, including CBPR/TPR strategies; consideration/assessment of cultural identity, racism, and discrimination; and CBPR/TPR informed dissemination plans. Although important efforts are underway to increase AI/AN participation in the CTN, future research would benefit from strategies to increase participation of this population. Such strategies include reporting AI/AN subgroup data; addressing issues of cultural identity and experiences of racism; and adopting an overall effort for research aimed at understanding barriers to treatment access, engagement, utilization, retention, and outcomes for both treatment and research disparities for AI/AN populations.
Competing Interests: Declaration of competing interest Drs. Crouch, Venner, Wendt, Burlew, Sorrell, Haeny, Ms. Baukol, and Ms. Funaro, declare that they have no actual or potential conflicts of interest.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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