Service providers' perceptions of barriers to the implementation of trauma-focused substance use services for women in Cape Town, South Africa.

Journal: The International journal on drug policy

Volume: 75

Issue: 

Year of Publication: 2020

Affiliated Institutions:  Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, PO Box , Francie van Zyl Drive, Tygerberg , South Africa; Division of Addiction Psychiatry, Psychiatry and Mental Health, University of Cape Town, South Africa. Electronic address: bmyers@mrc.ac.za. Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, PO Box , Francie van Zyl Drive, Tygerberg , South Africa; Division of Addiction Psychiatry, Psychiatry and Mental Health, University of Cape Town, South Africa. Electronic address: tcarney@mrc.ac.za. Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, PO Box , Francie van Zyl Drive, Tygerberg , South Africa. Electronic address: kim.johnson@mrc.ac.za. Substance Use, Gender and Applied Research, RTI International, East Cornwallis Road, Research Triangle Park, NC, United States. Electronic address: fbrowne@rti.org. Substance Use, Gender and Applied Research, RTI International, East Cornwallis Road, Research Triangle Park, NC, United States; Health Policy and Administration, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC, United States; Department of Psychology, North Carolina State University, United States; Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, United States. Electronic address: wmw@rti.org.

Abstract summary 

A substantial number of South African women with substance use disorders also report psychological trauma related to experiences of physical and sexual abuse. Trauma-focused substance use programmes may support recovery from co-occurring substance use disorders and psychological trauma, yet integrated programmes are not widely available in South Africa. As part of the process of developing a trauma-focused substance use programme for South African women, we explored service providers' views of the feasibility of implementing trauma-focused substance use interventions within usual care settings in Cape Town, including potential barriers that need to be considered when planning for implementation.We conducted 16 in-depth interviews with key informants responsible for planning or delivering substance use, psychological trauma or gender-based violence services to women in Cape Town. Guided by Extended Normalisation Process Theory, interviews explored participants' perceptions of the potential value of trauma-focused substance use programmes, the feasibility of their implementation, and factors that may facilitate or hinder the implementation of trauma-focused substance use programmes. Qualitative data were analysed using the framework approach.Three themes emerged: (1) Potential for the implementation of trauma-focused substance use programmes, describing participants' views of the acceptability of these programmes; (2) Capacity for intersectoral collaboration, which participants considered necessary for limiting barriers to implementation; and (3) Co-operation with community structures to enhance capability for implementation.Findings show potential for implementing trauma-focused substance use interventions in South Africa, however context-specific capacity and capability barriers need to be considered and addressed for implementation to be successful.

Authors & Co-authors:  Myers Bronwyn B Carney Tara T Johnson Kim K Browne Felicia A FA Wechsberg Wendee M WM

Study Outcome 

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Citations :  Atkins S, Lewin S, Ringsberg KC, Thorson A (2011). Provider experiences of the implementation of a new tuberculosis treatment programme: a qualitative study using the normalisation process model. BMC Health Services Research, 11, 275. doi: 10.1186/1472-6963-11-275
Authors :  5
Identifiers
Doi : 10.1016/j.drugpo.2019.102628
SSN : 1873-4758
Study Population
Women
Mesh Terms
Attitude of Health Personnel
Other Terms
Extended Normalisation Process Theory;Implementation;Low-and-middle income country;South Africa;Substance use;Trauma;Women
Study Design
Cross Sectional Study
Study Approach
Qualitative
Country of Study
Mali
Publication Country
Netherlands