Effective Interventions to Reduce Alcohol Use Among Aboriginal Youth

The high frequency of alcohol and other psychoactive substance consumption among Aboriginal youth and the consequences associated with this consumption raise the importance of targeting effective interventions to reduce this consumption. This knowledge synthesis aims to:

• identify and describe effective interventions to prevent or reduce the concurrent use of alcohol and other psychoactive substances among young people aged 7 to 20;
• analyze their effects according to the guiding principles of the framework Honor our strengths in order to appreciate their cultural relevance and ultimately;
• identify courses of action in terms of practices to be favored in interventions.

The results show that:

• Five practices characterize effective interventions to reduce co-consumption of alcohol and other psychoactive substances. Three of them are culturally relevant practices: partnership with Aboriginal communities, engagement of Aboriginal stakeholders, and promotion of Aboriginal concepts and values. The other two refer to educational practices, namely the motivational approach and education on the risks and consequences of the consumption of psychoactive substances. To observe effects, the results show the importance of combining culturally relevant practices with educational practices;
• Interventions that have effects on reducing substance use nevertheless have methodological and cultural appropriateness limitations. These limitations call for caution in interpreting the results of these interventions, which may appear promising;
• Two other practices, namely the development of social and personal skills of young people and cultural activities on the territory, emerged from the interventions that had effects on indicators of well-being, such as social support and distress. These indicators of well-being are factors associated with the consumption of psychoactive substances among young people, which supports the relevance of considering these practices. In order to increase the probability of success of an intervention, it is more appropriate to combine these two practices with those which have shown an effect on the consumption of psychoactive substances;
• Interventions that have effects on substance use tend to meet fewer guiding principles, while interventions with effects on wellness meet more. It would appear to be difficult to develop a culturally relevant and effective intervention to reduce substance use. An analysis of the number of activities, the way in which the themes are addressed in the activities and the frequency of the activities would contribute to the observation of effects on the consumption of psychoactive substances;
• The evaluation of an intervention involves significant methodological challenges. In particular, an intervention must be evaluated using reliable and rigorous Aboriginal and non-Aboriginal research methodologies.

Three courses of action have been formulated on the basis of these major findings to guide future interventions:

• Foster the combination of culturally relevant practices and educational practices that explicitly address the risks and consequences of alcohol and other psychoactive substance use;
• Ensure the cultural relevance of interventions by establishing a partnership with Aboriginal populations that takes into account the specificities of each community, including urban communities;
• Include indigenous knowledge and methods in the evaluation of interventions in order to better meet the needs and aspirations of the target population.