Abstract

Alcohol use disorders (AUDs) are not equitably spread across the population, with some groups, such as people who are experiencing homelessness, being more vulnerable to AUDs due to social inequalities, stigma, and complex social and structural processes. Managed alcohol programs (MAPs) are a harm reduction approach first developed in Canada for those experiencing AUDs and homelessness with positive results. This study aimed to describe the factors that should be considered when implementing MAPs in Scotland. Qualitative data were collected in Scotland via semi‐structured interviews with 29 individuals in a range of roles, including strategic informants (n = 12), service staff (n = 8), and potential beneficiaries (n = 9). Vignettes were used to support data collection. Data were analysed using Framework in NVivo. Participants highlighted six considerations to inform the implementation of MAPs in Scotland: the importance of individualized care; provision of alcohol; holistic care and a focus on well-being; types of settings and service models; staffing; and autonomy and rules. Future research should focus on piloting MAPs in a range of service contexts, using different models of care and settings, to develop an enhanced understanding of their effectiveness in addressing harms and promoting well-being for those experiencing AUDs and homelessness.

摘要

酒精使用障碍 (AUD) 在人群中的分布并不公平，由于社会不平等、耻辱感以及复杂的社会和结构过程，一些群体（例如无家可归的人）更容易受到 AUD 的影响。管理酒精计划 (MAP) 是一种减少危害的方法，最初是在加拿大为那些经历 AUD 和无家可归的人开发的，并取得了积极的成果。本研究旨在描述在苏格兰实施 MAP 时应考虑的因素。定性数据是在苏格兰通过对 29 名不同角色的个人进行半结构化访谈收集的，包括战略信息提供者 ( n  = 12)、服务人员 ( n  = 8) 和潜在受益人 ( n = 9)。小插图用于支持数据收集。使用 NVivo 中的框架分析数据。参与者强调了苏格兰实施 MAP 的六个考虑因素：个性化护理的重要性；提供酒精；整体护理和对福祉的关注；设置类型和服务模式；人员配备；和自治和规则。未来的研究应侧重于在一系列服务环境中试行 MAP，使用不同的护理模式和环境，以加深对它们在解决危害和促进那些经历 AUD 和无家可归者的福祉方面的有效性的理解。