National Native Alcohol and Drug Abuse Program (NNADAP) - General Review 1998 - Final Report

Introduction

The review of National Native and Alcohol and Drug Abuse (NNADAP) that is presented in the following pages is the result of a considerable chain of developments. The Review was initiated since there had been only a limited review of NNADAP in 1989. It was timely to re-examine the program to determine any modifications that should be considered to ensure that a practical and appropriate program is in place.

The NNADAP review process was guided by the NNADAP Review Steering Committee (NRSC) and was intended to be conducted in the spirit of partnership and full transparency. It was a principle of this Steering Committee that the key elements of a successful review would be in openness, the sharing of information, and input of First Nations and Inuit people towards the review. The Steering Committee was formed based upon a partnership approach between First Nation and Medical Services Branch of Health Canada. The members of the NRSC are:

• Deanna Greyeyes, Co-Chair, Society of Aboriginal Addiction Recovery
• Paul Glover, Co-Chair, Director General, Medical Services Branch
• Chief Lindsay Kaye, Sakimay First Nation
• Paul Kyba, Associate Regional Director, Pacific Region
• Ronald Linklater, A\NNADAP Consultant, Manitoba Region
• Lisa Tabobondung, Assembly of First Nations, (later replaced by Keith Conn and Elsie Casaway)

A First Nations firm, selected under the set-aside program for Aboriginal Business through a tendering process, conducted the review. It was guided by terms of reference (see annex I) developed by the Steering Committee over a two year period.

The review process was carried out under a multi-phase approach to assure that there is a high level of cross-referencing of findings. The Review process was as follows:

• A Literature Review was conducted on the field of addictions, evaluation methodologies in the field of addictions, and an analysis of relevant research and studies in Aboriginal addictions. The literature review is attached as Annex II.
  
  
• Interviews of key informants both within First Nations and within Health Canada were carried out to determine the major issues that were of concern to the key stakeholders.
  
  
• Mail out surveys were developed and approved by the NRSC. These surveys were targeted at:
  
  
  1. NNADAP workers
  2. First Nations and Inuit leadership
  3. Health workers at the community level
  4. Social services workers at the community level
  5. Senior management of treatment centers
     
     
• The return rate for these surveys were as follows:
  
  
  • NNADAP Workers total response    285 or 48%;
  • Leadership total response    179 or 30%
  • Health Services total response    205 or 35%
  • Social Services total response    191 or 32%
  • Total responses    860 or 37%
    
    
• The surveys were coded and frequency reports were compiled for each group. These reports are attached as Annex IV.
  
  
• Field visits were carried out with 37 communities based upon a process of random selection. During site visits the following groups were targeted for interviews: Chief and Council, health workers, social services workers, NNADAP workers, community members focus group, treatment center focus group. Interviews were carried out largely during the months of June, July, and August with some communities finished in the fall of 1997. Site visits were open-ended experiential discussions based upon field visit instruments approved by the Steering Committee. Summaries of these interviews are included as Annex V.(* Annex V (Summaries of Interviews) is not included in this Report for the purpose of brevity, but if required can be obtained from: Health Canada, First Nation and Inuit Health Programs Directorate, Jeanne Mance Building, Tunney's Pasture, Ottawa, Ontario, K1A 0L3. )
  
  
• Following conclusion of the field visits, the review teams met to discuss the main findings of the community based visits. The results from these visits were incorporated into draft findings, which were then presented to the Steering Committee as well as to relevant focus groups as described in the following section.
  
  
• More detailed studies were carried out on the literature, and on the financial history of NNADAP. These studies are attached as Annexes II and III.
  
  
• The study design assured cross-referencing of findings by using various respondents and processes for information gathering. There was a remarkable consistency among respondents.
  
  
• Focus group sessions were held in all regions at various stages of the review. The focus groups provided useful feedback to the review team and confirmed the approaches taken for the review. The results of the focus groups are attached as Annex VI. Part of the design of focus groups was to provide preliminary feedback on the outcome of the review.
  
  
• General findings, frequency reports from the mail survey, and draft recommendations were presented to the Steering Committee on November 10, 1997. Analysis and synthesis of findings proceeded over December 1997 and January 1998, with report drafting taking place over the months of February and March 1998.