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Abstract
Aboriginal Australians have experienced trauma, racism and disempowerment as a result of the legacies of colonisation and dispossession. One of the most visible manifestations of this is the disproportionately higher rate of substance-related harms compared to non-Aboriginal Australians. These harms impact the social and emotional wellbeing of Aboriginal Australians, and often extend beyond the person misusing substances to their families and communities. In the rural Australian context, where more Aboriginal people live, per capita rates of substance misuse are higher and access to specialised treatment is limited, compared to cities. Aboriginal communities are well aware of the devastating impacts that substance misuse has for their communities, as evidenced by the range of programs to reduce these harms initiated by Aboriginal people, which often incorporate cultural elements as a primary mechanism for healing. These programs are rarely robustly evaluated.
The overarching aim of this thesis was to evaluate three distinct, real-world examples of Aboriginal-led, community-based drug and alcohol programs to better understand the mechanisms of partnerships between academics and Aboriginal communities and services. Study 1 retrospectively examined the impact of a drug and alcohol radio advertising campaign implemented in a remote Aboriginal community. Study 2 described and retrospectively analysed the impact of community-led programs implemented across four rural NSW Aboriginal communities from 2012-2015. Study 3 focused on a three-year, mixed methods, prospective community-based participatory research project with a remote Aboriginal drug and alcohol residential rehabilitation service.
The research presented in this thesis makes a unique contribution to the evidence-base by identifying the key characteristics of effective partnerships between researchers and Aboriginal communities and services. The final chapter concludes that Aboriginal Australians should be the drivers for programs to reduce disproportionately high substance-related harms. To more effectively support program development, community-based participatory research offers a culturally acceptable, rigorous model in which academics can work in partnership with, not for, Aboriginal communities to strengthen the quality and quantity of the research in this field and, more importantly, improve health outcomes and healing for Aboriginal Australians.