Next May, a new Centre For Research Excellence: Finding Indigenous Solutions to Alcohol Problems is scheduled to begin operations, with a primary focus on building and supporting a strong cohort of Indigenous researchers to identify and evaluate solutions to alcohol problems.
In the article below, written on behalf of the Centre’s investigators, Professor Kate Conigrave and Scott Wilson say the Centre is founded on an understanding of the talent, strengths and commitment of Indigenous communities and community controlled services to prevent and address risky drinking and associated harms.
The focus will be on research “that is practically relevant and with a high capacity for translation into practice and policy”, they say.
Kate Conigrave and Scott Wilson write:
Alcohol is the top contributor to risk of death and disease worldwide in people aged 15-49 years. It gets to that lead position because of its role in accidents and violence, and in suicide, and by its contribution to over 200 health conditions. These conditions include common cancers, such as breast and colorectal cancer, as well as Type 2 diabetes, liver disease and hypertension.
As well as alcohol’s impacts on health, Aboriginal and Torres Strait Islander (Indigenous) Australian communities have repeatedly expressed strong concern about its impacts on families and communities.
While Indigenous Australians are less likely to drink alcohol at all than other Australians, those who do drink are more likely to drink at risky levels. These patterns of risky drinking are rooted in the history of colonisation, and in ongoing experience of trauma, disadvantage and stress.
However, these patterns of drinking are in turn associated with up to eight times the hospitalisation rate, and up to five times the death rate from alcohol-related conditions (compared with other Australians), and so contribute to ongoing trauma.
There has been great work by many Indigenous communities, services and individuals in reducing harms from alcohol. However, funding is often not available to evaluate their efforts.
Until recently the main research on the effectiveness of ways to prevent or reduce harms from alcohol was focused on supply restrictions in remote communities. There was little other data to guide workers in the field, or for communities and agencies to use in supporting their applications for services or programs.
So, research on preventing and treating alcohol problems among Indigenous Australians has lagged well behind research on physical disorders, such as kidney disease, heart disease and diabetes. Up until recently, NHMRC-funded research into prevention or treatment of unhealthy drinking among Indigenous Australians had been relatively piecemeal, with one-off project grants.
In the nine years between 2005 and 2013, we could identify only three NHMRC project grants focused on alcohol issues among Indigenous Australians. This trend in NHMRC funding has reversed in the last three years, with three separate NHMRC project grants focused on ways of working with alcohol-related issues among Indigenous Australians.
Nonetheless, to date we could not find any NHMRC project grant focused on alcohol with an Indigenous lead investigator, and to our knowledge, there is still no Indigenous Australian PhD graduate who has chosen alcohol issues as their central field of work. This in part perhaps reflects the challenge and sensitivity of the field, and also the broader lack of research focus in this area in the past.
In recognition of the pressing need for a larger pool of skilled Indigenous researchers in this field, in late 2015 we applied for funding for a Centre for Research Excellence for Indigenous Researcher Development aimed at “Finding Indigenous Solutions to Alcohol Problems”.
In doing so, we were building on our learnings from training and supporting Indigenous researchers, clinicians and staff, and on our longstanding connections with Indigenous communities and community organisations. We were honoured to be awarded funding for this Centre in late October this year, and the Centre will commence operation in May 2017.
Our team is made up of Indigenous and non-Indigenous chief investigators with a broad range of experience in research, clinical skills, health promotion and policy. Team members are based at a range of institutions across three states, including universities, an Aboriginal agency, and at Aboriginal community controlled and mainstream health services.
The Centre’s key focus is on building and supporting a strong and skilled cohort of Indigenous researchers to identify and evaluate solutions to alcohol problems. Such a critical mass of Indigenous researchers will help to provide support and shared learning in this challenging field, and help ensure Indigenous research leadership into the future.
The Centre is founded on an understanding of the talent, strengths and commitment that lies within Indigenous communities and within community controlled services to prevent and address risky drinking and associated harms. The Centre’s research and support will be guided by ongoing partnerships with Indigenous communities and agencies.
The new Centre will attract and support Indigenous researchers, and further grow their capacity through a program of training and mentoring. The research students will be supported through research traineeships and PhD stipends, and early career researchers will be mentored and receive practical support.
The Centre will also provide strong links to Indigenous and non-Indigenous research leaders, clinicians and policy makers in the field. These broad collaborative networks will provide support, advice and ongoing opportunity to the emerging Indigenous researchers.
Research for impact
At the same time the Centre will develop, expand and evaluate an integrated suite of prevention and treatment initiatives to reduce the health impact of alcohol. The team will further develop and evaluate pilot programs that have shown promise in urban and regional community settings in New South Wales, Queensland and South Australia. These programs have shown evidence of reducing risky drinking, improving mental health and increasing empowerment.
Projects will range from grass-roots community-led prevention, right through to treatment of alcohol dependence in specialist settings. The investigators’ broad mix of skills in research, clinical practice, policy and community-led health promotion, will help ensure research that is practically relevant and with a high capacity for translation into practice and policy.
Many Indigenous services and communities have already worked to reduce alcohol-related harms. This Centre offers the opportunity to draw such cultural and community expertise together with research, clinical and policy expertise, in order to grow the evidence base for what works.
In the process the Centre will offer rich opportunities for new and emerging Indigenous researchers. It will build and support a critical mass of skilled Indigenous researchers in this complex and sensitive field.
And while this is happening, the Centre will conduct research with short term as well as long term benefits to community.
The Centre draws together chief investigators from seven sites: the Aboriginal Drug and Alcohol Council South Australia (Scott Wilson), the Inala Indigenous Health Service (Noel Hayman), Illawarra Aboriginal Medical Service (Rowena Ivers), from four Universities (Sydney [Kate Conigrave, Paul Haber, Kylie Lee], NSW [Anthony Shakeshaft, Tim Dobbins], Central Queensland [Chris Doran] and Queensland [Anton Clifford]). Two of the team also work as Addiction Medicine Specialists within a mainstream urban hospital (Royal Prince Alfred Hospital, Sydney) with outreach to prison (Haber) and to an Aboriginal Medical Service (Conigrave).