Serving the Underserved: Providing Effective AOD Services to Culturally Diverse Populations

Background: While health research consistently finds cultural disparities in healthcare generally, little research has looked specifically at access and outcomes in AOD services.  This research was conceived as a way to investigate whether some cultural groups experience barriers to accessing and receiving effective AOD prevention, treatment, and recovery services.  Findings helped support a statewide project to translate the CLAS standards developed for traditional healthcare services specifically for use by the AOD field. 

Methodology: Twenty-five focus groups were convened, involving 268 consumers of AOD services.  Based on knowledge of historically underserved populations, these groups included representative samples of API, LGBTQ, Latinos, African-Americans and Native-Americans,  as well as women and youth consumers. Prevention, treatment, and recovery services were represented, and all  groups were recorded and transcribed.

Results: Transcripts revealed that most participants had difficulty accessing culturally responsive AOD services, and  that participation in culturally unresponsive services was often unsuccessful.  However, cultural groups defined barriers to service in distinct ways.  Cultural differences in understandings of  addiction, as well as family, religious, and linguistic norms, determined the needs of different cultural communities.  Many AOD service consumers encountered hostility, racism, or homophobia from service providers.

Conclusions: Public health strategies must support the capacity of the AOD field to deliver culturally informed and responsive services.  This includes community needs assessment; targeted outreach and community engagement; education about diverse perspectives on health; and the development and implementation of culturally appropriate interventions. The AOD specific CLAS standards developed for this project could be used to build this capacity.