Abstracts
Résumé
Contexte : Au moment de l’étude, Sage Usage (SU) est un programme novateur s’adressant aux Premières Nations et aux Inuit (PNI) visant le développement de stratégies pour atteindre et maintenir un usage modéré d’alcool (il inclut désormais toutes les substances psychoactives). SU a fait l’objet d’un processus participatif de modification du programme Alcochoix+, visant à le rendre culturellement pertinent et cohérent avec les valeurs et réalités des PNI. L’article présente les résultats d’une étude d’implantation initiale réalisée entre 2020 et 2022.
Objectif : L’étude vise à documenter 1) le degré d’implantation du programme, 2) la perspective des intervenants formés au programme quant à leur expérience au stade d’implantation initiale, et 3) les facilitateurs et les obstacles à l’implantation.
Méthode : Des intervenants des communautés des PNI ayant reçu la formation (n=31) ont participé à des entrevues de groupe et individuelles portant sur leur expérience d’implantation du programme. Les verbatims des entretiens ont fait l’objet d’une analyse qualitative de contenu thématique avec NVivo.
Résultats : SU a été peu implanté dans sa première phase d’expérimentation et des enjeux en lien avec l’acceptabilité, l’adoption et la faisabilité ont été identifiés. SU est perçu par les participants comme ayant un bon niveau de convenance sur le plan du contenu (thèmes abordés, éléments culturels, etc.), mais moins sur celui de sa structure externe (séquence des activités, quantité de texte, vocabulaire, etc.). Des retombées positives sur les pratiques professionnelles des intervenants sont évoquées.
Discussion : SU bonifie l’offre de service des communautés et plusieurs modalités de prestation (formule couple, suivi post-thérapie, etc.) apparaissent prometteuses pour l’adapter aux besoins spécifiques des communautés.
Conclusion : Un engagement à long terme via une démarche flexible permettant aux communautés de s’approprier le programme apparait fondamental pour favoriser une implantation durable et pertinente de SU.
Mots-clés :
- Premières Nations et Inuit,
- implantation de programme,
- usage d’alcool,
- approche participative communautaire
Abstract
Background: At the time of this research, Wise Choices is an innovative program for First Nations and Inuit (FNI) aimed at developing strategies to achieve and maintain moderate alcohol use (it now includes all psychoactive substances). Wise Choices has undergone a participatory and iterative process of modifying Alcochoix+ to make it culturally relevant and consistent with the values and realities of FNI. The article presents the results of an initial implementation study carried out between 2020 and 2022.
Objectives: The purpose of the study is to document 1) the degree of implementation of the Wise Choices program, 2) the perspective of stakeholders trained in the program regarding their experience in the initial implementation stage, and 3) facilitators and barriers to implementation.
Method: Addiction intervention stakeholders in the trained FNI communities (n=31) participated in group and individual interviews about their experience implementing the program. Interview verbatims were subjected to a qualitative thematic content analysis with NVivo.
Results: Throughout the province of Quebec, Wise Choices has been implemented to a limited extent and issues related to acceptability, adoption, and feasibility have been identified. Wise Choices is perceived by participants as having a good level of suitability in terms of content (topics covered, links with culture, etc.), but less so in terms of its delivery structure (sequence of activities, quantity of text, vocabulary, etc.). Unexpected positive impacts on stakeholders’ professional practices were reported.
Discussion: Wise Choices enhances the service offer in the communities and several delivery modalities (couple formula, post-therapy follow-up, ...) appear promising to adapt Wise Choices to the specific needs of each community.
Conclusion: A long-term commitment through a flexible approach that allows communities to take ownership of the program appears fundamental to promote a sustainable and relevant implementation among FNI.
Keywords:
- First Nations and Inuit,
- program implementation,
- alcohol use,
- community-based participatory approach
Resumen
Contexto: En el momento de llevar a cabo esta investigación, Sage Usage es u programa innovador destinado a las Primeras Naciones y a los Inuit, que apunta al desarrollo de estrategias para lograr y mantener un uso moderado de alcohol (incluye ahora todas las sustancias psicoactivas). Sage Usage ha sido objeto de un proceso participativo e iterativo de modificación del programa Alcochoix+, destinado a hacerlo culturalmente pertinente y coherente con los valores y las realidades de las Primeras Naciones y los Inuit. El artículo presenta los resultados de un estudio de implantación inicial realizado entre 2020 y 2022.
Objetivos: El estudio busca documentar: 1) el grado de implantación del programa, 2) la perspectiva de los intervinientes formados en el programa en lo que hace a su experiencia en el estado de implantación inicial y 3) los facilitadores y los obstáculos a la implantación.
Método: Quienes intervienen en materia de dependencia en las comunidades de las Primeras Naciones e Inuit que habían recibido la formación (n=3) participaron en entrevistas de grupo e individuales sobre su experiencia en cuanto a la implantación del programa. Los informes textuales de las entrevistas fueron objeto de un análisis cualitativo del contenido temático con NVivo.
Resultados: Sage Usage ha sido poco implantado en el conjunto del territorio quebequense en su primera etapa de experimentación y se han identificado cuestiones relacionadas con la aceptabilidad, la adopción y la factibilidad del programa. Los participantes perciben a Sage Usage como un programa que posee un buen nivel de conveniencia en el plano del contenido (temas abordados, relaciones con la cultura, etc.), pero menos en lo que respecta a su estructura externa (secuencia de las actividades, cantidad de texto, vocabulario, etc.). Se evocaron resultados positivos sobre las prácticas profesionales de los intervinientes.
Discusión: Dividir el programa para hacer que sus componentes puedan utilizarse independientemente unos de otros parece ser una estrategia que favorece la adecuación cultural del programa. Sage Usage bonifica la oferta de servicio a las comunidades y varias formas de prestación (fórmula pareja, seguimiento posterapéutico, etc.) parecen prometedoras para adaptarlo a las necesidades específicas de cada comunidad.
Conclusione: Un compromiso a largo plazo mediante un enfoque flexible que permita a las comunidades apropiarse del programa parece ser fundamental para favorecer una implantación durable y pertinente en las comunidades de las Primeras Naciones y los Inuit.
Palabras clave:
- Primeras Naciones e Inuit,
- implantación del programa,
- consumo de alcohol,
- enfoque comunitario participativo
Appendices
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