Barriers and facilitators to alcohol support for South Asian communities: a qualitative framework analysis of service provider perspectives

Abstract

Background Despite displaying pronounced alcohol-related physical and psychological harms, South Asian groups are critically underrepresented in alcohol treatment and research. Aggregate categorisation of diverse ethnic groups into ‘BAME’ collectives has perpetuated substantial knowledge gaps about the alcohol support needs of individual ethnic groups. Whilst there has been a recent growth in studies exploring the specific alcohol behaviours and support needs of South Asian groups, there is limited knowledge of professional experiences. This study aimed to address this gap by exploring service provider perspectives on barriers and facilitators to alcohol support for South Asian communities in the UK.

Methods We carried out individual semi structured interviews with multidisciplinary staff spanning statutory and specialist services within East London in the UK. Interviews explored staff experiences and attitudes towards topics such as alcohol use triggers, maintenance factors, suitability of support options, and professional training needs. We adopted an intersectional lens during analysis to explore the influence and interplay of other relevant characteristics with ethnicity. We used qualitative framework analysis to identify relevant themes and map them onto a pre-existing risk environment framework across different levels (micro, meso, macro) of influence.

Results 10 participants took part. 5 themes were developed that reflect barriers and facilitators to alcohol support across macro (‘service structure’), meso (‘cultural competence’, ‘gendered experience’ ‘religio-cultural norms’) and micro (‘lifestyle choice’) levels of influence. An intersectional lens indicated gendered, ethnic, and religious nuances in drinking and treatment seeking experiences. Whilst the overlapping nature of the micro-meso-macro levels was evident in the study findings, meso level factors were most established.

Conclusions This study highlighted key areas of focus and unique barriers for diverse South Asian groups seeking support for alcohol misuse, with clear implications for culturally competent policy and practice in the UK context. Barriers such as short funding cycles, historical discrimination, ‘one size fits all’ approaches and training gaps on sensitive communication strategies pose challenges. Conversely, facilitators like targeted family education strategies and improving collaborative efforts between alcohol service types enhance support. Tailored specialist alcohol support for South Asian women is crucial.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study was funded by Barts Health Charity (grant number MGU0405).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics Committee of Queen Mary University of London and Camden and King's Cross Research (21/LO/0337) gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

The dataset generated during this study are not publicly available to maintain confidentiality agreements and avoid potential identification of involved organisations and individuals. Contact the corresponding author for further information.

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