The cultural adaptation process of an alcohol controlled-drinking program to the aboriginal culture

Background

In Canada, the focus put on the abstinence model within addiction control services offered to Indigenous people is increasingly challenged. Moderate drinking, which has been rejected for a long time as an intervention objective, is now being considered. Considering the inexistence of brief controlled drinking programs within the aboriginal populations, an overall approach aiming to adapt the Alcochoix+ Program was initiated in 2018 for this program to be congruous with the needs, values and traditions of these populations.

Method

Program cultural adaptation refers to modifications made to a program to make it more sensitive to the culture of a specific population, in this case, the aboriginal population of Quebec. It is crucial to modify the program in a way that considers the language, the culture and the context to ensure that it is compatible with the cultural reasoning, the principles and the values of the targeted population. This adaptation needs to be part of a process ensuring fidelity to the key elements of the program as well as responding to the specific cultural needs of the Indigenous people. Too often, the traditional knowledge of this population has been left out in the decisions made on the services to be provided. The methodological approach that has been adopted is consistent with the principles of the Tri-Council Policy on Ethical Research Involving Indigenous Peoples in Canada, which recommends a consistent and continuous involvement of the Aboriginals in the project. This project has been designed from a co-construction standpoint, bringing together workers specialized in the field of addiction from various aboriginal peoples of Quebec.

Objective: This presentation will lay out the cultural adaptation process of the controlled drinking program Alcochoix+.

Results and conclusion

Through the steps of a group analysis method (Méthode d’analyse en groupe [MAG]), working seminars and multimodal consultations, each aspect of the controlled-drinking program has been reviewed. In the revised version, main concepts of the aboriginal teachings such as the medicine wheel and community values have been put at the forefront of the program. In practical terms, there are various recommended adaptations such as shortening the text as often as possible, using figurative representations, adapting the examples to situations experienced by indigenous people, introducing motivational elements, etc.. Then, will follow a training phase for the native clinician who will animate the program and an implementation study that monitors adherence, exposure, dosage, participation, quality of animation, participant characteristics, etc. ... in several communities. This poster depicts the adaptation process and concretely illustrates the various adjustments made to the program.