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