@article{ref1,
title="An ecological model of drug and alcohol use and related harms among Aboriginal and Torres Strait Islander Australians: a systematic review of the literature",
journal="Preventive medicine reports",
year="2021",
author="Stapinski, Lexine and Newton, Nicola and Garlick Bock, Sophia and Ward, James and Stearne, Annalee and Lees, Briana and Snijder, Mieke",
volume="21",
number="",
pages="e101277-e101277",
abstract="Globally, Indigenous populations experience a disproportionately higher burden of disease related to substance use. Effective prevention of harm related to substance  use is a key strategy for improving the health and wellbeing of Aboriginal and  Torres Strait Islander peoples in Australia. To inform preventative approaches, this  review synthesised the evidence of risk and protective factors of substance use and  related harms among Aboriginal and Torres Strait Islander peoples. Eight  peer-reviewed and two grey literature databases were systematically searched for  quantitative or qualitative studies assessing factors associated with substance use  and related harms among Aboriginal and Torres Strait Islander peoples, published  between 1 January 1990 and 30 April 2018. Study quality was assessed using validated  instruments. Risk or odds ratios were extracted or calculated and factors were  summarised in an ecological model into individual, relationship, community, societal  or culturally-distinct levels. Thirty-eight relevant studies were identified and  reviewed. Individual-level risk factors for substance use were identified including  low socio-economic status, high psychological distress, poly drug use and being  male. Relationship-level factors were peer pressure and partner/family substance  use; protective factors were supportive environments and positive role models. Community-level risk factors included availability of substances. Culturally-distinct factors included cultural connection as a protective factor, but  cultural obligations around sharing was a risk factor. Societal risk factors  included intergenerational trauma caused by government policies. These findings  highlight the importance of tailored preventative approaches for Aboriginal and  Torres Strait Islander communities that address identified risk factors and promote  protective factors across all ecological levels.<p /> <p>Language: en</p>",
language="en",
issn="2211-3355",
doi="10.1016/j.pmedr.2020.101277",
url="http://dx.doi.org/10.1016/j.pmedr.2020.101277"
}