Realist evaluation for programs designed to reduce demand and harms of substance misuse at the community level in Australian remote Indigenous community settings

Abstract:

Cape York’s Indigenous communities, small (<1000 people), very remote and socially complex experience significant excess health burden due to substance misuse, in particular alcohol, tobacco and cannabis. Cannabis is the main psychoactive substance available where alcohol is controlled. Data from the Cape York Cannabis Project (CYCP) exemplified a lack of convincing effect of substance misuse programs in these contexts with controlled and quasi‐experimental study designs. This thesis considered theory‐driven evaluation for substance misuse harm and demand reduction programs in the context of Indigenous Australian communities.