■传播和实施(D&I)科学在土著社区中不断发展。土著社区正在调整和实施基于证据的药物使用障碍治疗(SUD),以适应其社区的需求。D&I科学提供了框架,模型,以及提高实施成功率的理论,但是需要研究以土著知识为中心,加强D&I,使其在土著环境中更适用。在这次范围审查中,我们研究了土著社区中SUD干预的D&I科学现状,并确定了最佳实践SUD实施方法.
■PubMed和PsycINFO数据库被查询为英文文章,在美国出版,加拿大,澳大利亚,和新西兰。我们包括了针对土著居民的关键搜索词和35个内容关键词。我们使用改编和扩展的范围对数据进行分类,有效性,收养,实施,和维护(RE-AIM)框架,强调公平和可持续性。RE-AIM也被用作一致确定实施成果的主要模型。
■从超过24,000的原始未重复计数中确定了20篇文章。超过一半的文章讨论了与Reach相关的流程,收养,和实施。50%的研究(n=10)讨论了有效性,25%的文章讨论维护/可持续性(n=4)。调查结果还强调了应用每个RE-AIM域的重要性,定义明确的社区参与方法。
■发现表明需要优先考虑土著方法以文化为中心,重新调整和调整西方的治疗方法和框架,以增加健康公平性并改善SUD治疗结果。还指出了使用经修改的RE-AIM的效用以及对土著社区的持续修改。
Dissemination and Implementation (D&I) science is growing among Indigenous communities. Indigenous communities are adapting and implementing evidence-based treatments for substance use disorders (SUD) to fit the needs of their communities. D&I science offers frameworks, models, and theories to increase implementation success, but research is needed to center Indigenous knowledge, enhancing D&I so that it is more applicable within Indigenous contexts. In this scoping review, we examined the current state of D&I science for SUD interventions among Indigenous communities and identified best-practice SUD implementation approaches.
PubMed and PsycINFO databases were queried for articles written in English, published in the United States, Canada, Australia, and New Zealand. We included key search terms for Indigenous populations and 35 content keywords. We categorized the data using the adapted and extended Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework that emphasizes equity and sustainability. RE-AIM has also been used as a primary model to consistently identify implementation outcomes.
Twenty articles were identified from the original unduplicated count of over 24,000. Over half the articles discussed processes related to Reach, Adoption, and Implementation. Effectiveness was discussed by 50% of the studies (n = 10), with 25% of the articles discussing Maintenance/sustainability (n = 4). Findings also highlighted the importance of the application of each RE-AIM domain for meaningful, well-defined community-engaged approaches.
Finding indicated a need to prioritize Indigenous methods to culturally center, re-align and adapt Western treatments and frameworks to increase health equity and improve SUD treatment outcomes. Utility in the use of the modified RE-AIM and the continued modification for Indigenous communities was also noted.