Service Provision, the Need for Targeted Services and Resources

In some circumstances, existing evidence-based interventions are either not effective at engaging a cultural group or enabling that group to achieve positive outcomes. Similarly, existing interventions may not adequately respond to unique risks or resilience factors, or unique symptoms in a particular community. Cultural adaptation, or the modification of standard evidence-based interventions to be culturally responsive and targeted to CALD community needs, may increase recruitment, retention, and treatment outcomes in some situations. In addition to language and worker ethnicity matching, adaptations also include incorporating cultural health beliefs, cultural values (such as the importance of family) and health practices into treatment. 

One comprehensive review of the literature on Screening, Brief Intervention and Referral to Treatment (SBIRT) in racial and ethnic subgroups in the United States found that special attention to validated screeners, appropriate use of language/literacy, trust building, and incorporation of patient and community health care preferences may enhance SBIRT acceptability and effectiveness in diverse populations. More recently, Newcombe and colleagues (2019) put forward the use of the Talanoa approach, a Pacific peoples-focused methodology of conversation and information exchange whilst administering the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to allow for a more in-depth exploration of substance use among Pacific peoples. Further research eliciting specific effective cultural adaptations in an Australian context would improve CALD treatment provision. 

Others have proposed the design of new cultural models of health interventions. The Drug and Alcohol Multicultural Education Centre’s (DAMEC) culturally responsive model of service draws on shared communal understandings and experiences, recognises the influence of culture on individual and family identity, addresses impacts of inter-generational change, acculturation, and discrimination in treatment provision. Another method, the Fonofale model (Pulotu-Endemann), outlines a holistic approach that can be applied with Pacific communities in a health context and incorporates (amongst others) familial, spiritual, and cultural elements.