HSC318 Rural and Remote Health Assessment Help

Addressing Illicit Drug Use in Rural Australia

Executive Summary

Illicit drug use in the rural communities of Australia is a grave challenge. Patterns of drug usage are variable across urban and rural centers in the country with rural communities accounting for a greater burden of drug consumption (National Rural Health Alliances Inc., 2015). This trend is attributable to the fact that several determinants of illicit drug use prevail within rural communities including lack of economic opportunities, isolation, shame in admitting to drug use, unwillingness to seek help, poor educational outcomes, deviant peer group influences and a limited presence of leisure activities.

Being one of the largest remote areas which has more than 2,300 inhabitants, Maningrida community is marred with a significant rate of unemployment and limited access to higher education opportunities. 51.8% of the community’s inhabitants are males while only 36.8% of the inhabitants are actively enrolled in educational institutions. The school-based drug prevention program presents a comprehensive framework which can be implemented at the community’s largest school which runs through Preschool to Year 12 and is administered by the West Arnhem Regional Council.

The program addresses three areas of drug prevention amongst youth including their motivation for drug consumption, existing knowledge and awareness about the consequences of this activity as well as their personal decision-making and commitment towards eradicating illicit drug use. The program will be based on holding sessions led by trained counsellors to provide accurate information about the adverse consequences of drug use and enable youths to take informed decisions about their life. This will make them more empowered and increase their personal commitment towards steering away from drug consumption. The program’s evaluation criteria will be based on four stages which will include evaluating the target group before the commencement of the program and one year after the implementation of the program. This will help identify the efficacy of the project in introducing health literacy and driving long-term behavioral change.

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Key Outcome

The key outcome of the program is to enhance participants’ awareness about the adverse consequences of consuming illegal drugs, non-prescribed pharmaceutical drugs in addition to volatile substances. Other outcomes of the program include improving participants’ ability to control their desire for drug consumption and improving their decision-making capabilities and coping mechanisms.

Name of Australian rural remote community

The health program will be run in the Maningrida community. As one of the largest remote towns based in the Northern Territory, Maningrida emerged as a settlement towards the latter half of the 1940s and is now recognized as a key Aboriginal town (West Arnhem Regional Council, 2020).

Target group 

The health program will be targeted towards men aged 18 and above from the Maningrida community. As per the census conducted in 2016, the total population of the community stands at 2308 with the median age of the residents being 27. 51.8% of the community’s residents are males. 16% of the community’s members have acquired education till Year 9 or below and 36.8% were enrolled in an educational institution. 25.9% of the residents in the community are unemployed and 10.7% of the residents serve as laborers with reference to their employment category. 66.1% of the residents are non-English speakers (Australian Bureau of Statistics, 2016). These low levels of education and employment factors suggest that the target group has a low level of health literacy.

Stakeholders 

A major stakeholder for this project would be the West Arnhem Regional Council. The council is responsible for providing an array of services to the community which includes a school that runs through Preschool up to Year 12 (West Arnhem Regional Council, 2020). As the target group of the project are youth aged below 18, other stakeholders of the project would consist of school-based participants, principal and teachers who are employed by the educational institute.

According to Winters et al. (2007), schools are suitable settings for implementing drug screening of students, enforcing behavioral change. Lakshmi et al. (2019) note that school-based health centers play a critical role in helping students navigate through challenges with drug abuse and provide the necessary resources including treatment plans and community assistance to address the issue.

Research suggests that parental warmth, especially during the early stages of adolescence plays an important role in promoting pro-social behavior and allowing youth to disassociate from peers that are deviant (Lee, Padilla-Walker and Memmott-Elison, 2017). This has implications for developing drug abuse prevention programs where parents can counsel their children at home and have a positive influence on their choices, coping mechanisms and selection of peer group members.

Program Activity:

The project will be a 6 months long school-based program for drug abuse prevention which will target youth aged below 18 that are located in the Maningrida community. The program is based on a three-tiered framework which will address various components of drug prevention among the target population. These factors include 1) youths’ motivations behind drug consumption 2) understanding the decisions which lead to the adoption of healthy behaviors and 3) identifying the abilities that the target population should develop for preventing drug abuse.

Factors that motivate youth to consume drugs, which will be addressed during the course of this program include, deviant peer group influences, low levels of health literacy, apprehension regarding anonymity and unfavorable attitudes towards seeking help (National Rural Health Alliances Inc., 2015). The program will also include exercises into improving the decision-making of youths and enabling them to make informed choices related to their health. Research suggests that belonging to a socially disadvantaged background shares a positive correlation with the consumption of drugs. Therefore, the program will also focus on developing strategies to enhance social inclusivity and addressing risk factors identified above. Accordingly, the program will hone the target group’s personal capacity and skill set to prevent drug consumption and undertake decisions that can help improve their chances of acquiring upward social mobility and benefiting from a wide range of economic opportunities.

Overall, the program will hold the target group’s interest by delivering complete and accurate information about the adverse consequences of drug consumption from an environmental, physiological, psychological and social perspective. The program will allow youths to develop and hone their coping skills and the ability to navigate through the challenges posed by illicit drug use. The target group’s interest will also be sustained by enabling youths to take personal responsibility of not consuming illicit substances and taking control of their future.

Key Performance Indicators 

The Activity will be measured against the following Key Performance Indicator/s (KPI):

The delivery of drug prevention programs is measured through a number of qualitative and quantitative measures – these evaluations are conducted on a periodic basis depending upon the nature of the program (Sloboda and Bukoski, 2007). For this particular activity, the key performance indicators (KPIs) will be:

• Average test scores on drug awareness-related questions
• Average test scores on questions related to peer influences and drug consumption
• Reduction in the usage of illicit drugs (for example cocaine, marijuana, meth, ecstasy and cannabis)
• Reduction in the usage of non-prescribed pharmaceutical drugs
• Reduction in the usage of volatile substances (for example glue and petrol)

The parameters for describing the outcomes for each of these key performance indicators (KPIs) would be that of – favorable change, no change and unfavorable change. KPIs that are associated with the use of drugs will be calculated every 30 days over a period of 6 months and will be reported on a monthly basis to identify trends. Knowledge-related questions will focus on asking respondents about the consequences of drug consumption while questions related to peer influences will focus on uncovering information regarding peer pressure and asking youths to report about positive activities that they can participate in with their peers.

Funding Allocation

The budgetary allocation for the program will be divided into four sub-categories which are that of fixed costs, variable costs, direct costs and indirect costs. The respective heads and funding allocations for each of the categories are presented in the table below:

The capital equipment which will be procured during the first month of launching the program includes projectors, audio-visual devices, laptops and furniture which will be procured for executing the school-based sessions every month. It is expected that once these items are procured they last throughout the course of the program and will not be procured against. Any damages to the items will be reclaimed against insurance payments. The most significant percentage of costs within this budget is that of staff salaries. This includes salaries paid to counsellors as well as support staff members who will be a part of the project. These salaries will be fixed as per the contract of the staff members. Miscellaneous administrative expenses will account for costs that are incurred during the course of the program but have not been accounted for in specific. For example, costs of printing and catering. Travel and accommodation costs are that expenses will be incurred for lodging staff members and arranging their arrival to and departure from the Maningrida community. The costs for travel are higher in Month 1 and 2 because they include trips back to the respective destinations of  staff members and trainers.

Evaluation criteria 

The evaluation criteria is based on assessing the status of the target population across four stages – 1) before intervention 2) on a monthly basis 3) at the end of the intervention and 4) one year after the intervention. According to Finley et al. (2018), periodic evaluations are especially useful when the objective of a health program is to introduce behavioral change over a long period of time. Periodic evaluations are also conducted to identify the efficacy of treatments and help practitioners understand whether there is a need to change the treatment plan (Bakken, 2019).

The evaluation will aid in examining whether expected outcomes have been attained if significant differences are recorded between the reported results of the target population in terms of their knowledge about drug prevention and any noted reduction in the use of illicit drugs. These are the major outcome variables on which the project will take place. Findings will be reported across the four-time periods identified above to indicate when the intervention proved to be the most effective. The comparative data will help identify whether a health behavior change was introduced in the target group one year after the execution of the project.

References

Australian Bureau of Statistics, 2016. 2016 Census Data. Australian Bureau of Statistics. Accessed online at [https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/SSC70172?opendocument#:~:text=People%20%E2%80%94%20demographics%20%26%20education&text=In%20the%202016%20Census%2C%20there,up%2089.2%25%20of%20the%20population.&text=The%20median%20age%20of%20people,State%20Suburbs)%20was%2027%20years.]

Bakken, A. (2018). The benefits of periodic health evaluation in professional football: A focus on musculoskeletal screening.

Finley, E. P., Huynh, A. K., Farmer, M. M., Bean-Mayberry, B., Moin, T., Oishi, S. M., … & Hamilton, A. B. (2018). Periodic reflections: a method of guided discussions for documenting implementation phenomena. BMC medical research methodology, 18(1), 153.

Lakshmi, T., Rajeshkumar, S., Roy, A., & Gurunathan, D. (2019). Knowledge, Awareness and Practice Regarding Drug Abuse among Teenagers between the Age Group of 14-19 Years:

A Questionnaire Survey. Indian Journal of Public Health Research & Development, 10(11).

Lee, C. T., Padilla-Walker, L. M., & Memmott-Elison, M. K. (2017). The role of parents and peers on adolescents’ prosocial behavior and substance use. Journal of Social and Personal Relationships, 34(7), 1053-1069.

National Rural Health Alliances Inc., (2015). Illicit Drug Use in Rural Australia. National Rural Health Alliances, Fact Sheet 33.

Sloboda, Z., & Bukoski, W. J. (2007). Handbook of Drug Abuse Prevention. Boston, MA: Springer Science+Business Media, LLC.

West Arnhem Regional Council (2020). Maningrida. West Arnhem Regional Council. Accessed online at [https://www.westarnhem.nt.gov.au/our-communities/maningrida]

Winters, K. C., Leitten, W., Wagner, E., & O’Leary Tevyaw, T. (2007). Use of brief interventions for drug abusing teenagers within a middle and high school setting. Journal of School Health, 77(4), 196-206.

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