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Substance Use Among People with a Migration Background a Community-Based Participatory Research (Cbpr) Project

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Substance Use Among People with a Migration Background a Community-Based Participatory Research (Cbpr) Project 3 SUBSTANCE USE AMONG PEOPLE WITH A MIGRATION BACKGROUND A COMMUNITY-BASED PARTICIPATORY RESEARCH (CBPR) PROJECT Belgian Science Policy Office (BELSPO) - Research Programme on Drugs Charlotte De Kock (UGent) Julie Schamp (UGent) Bert Hauspie (UGent) Dr. Muriel Sacco (ULB) Prof. Dr. Tom Decorte (UGent) Prof. Dr. Wouter Vanderplasschen (UGent) Prof. Dr. Ilse Derluyn (UGent) Prof. Dr. Dirk Jacobs (ULB) CONTENTS LIST OF TABLES ................................................................................................................................... 3 1 INTRODUCTION ................................................................................................................. 3 1.1 Situating the research ......................................................................................................... 3 1.2 Research questions and goals ............................................................................................ 4 1.3 Methodology ........................................................................................................................ 5 1.4 People with a migration background ................................................................................... 6 1.5 Substance use .................................................................................................................... 7 1.6 Substance use and society ................................................................................................. 8 2 THE PREVALENCE AND NATURE OF SUBSTANCE USE IN PEOPLE WITH A MIGRATION BACKGROUND .......................................................................................... 10 2.1 Prevalence ........................................................................................................................ 10 2.2 Social mechanisms ........................................................................................................... 13 2.3 Barriers to care and treatment .......................................................................................... 19 2.4 Overall assessment of the state of the art ........................................................................ 23 3 COMMUNITY-BASED PARTICIPATORY RESEARCH .................................................. 25 3.1 History and goals of the research design.......................................................................... 25 3.2 Empowerment ................................................................................................................... 26 3.3 The CBPR model in this study .......................................................................................... 28 3.4 Community organisations ................................................................................................. 29 3.5 The community researchers and participants ................................................................... 32 3.6 Community advisory boards ............................................................................................. 35 3.7 Data collection: interviews ................................................................................................ 38 3.8 Data analysis and dissemination ...................................................................................... 39 3.9 Difficulties in CBPR ........................................................................................................... 39 4 SUBSTANCE USE IN THE TURKISH COMMUNITY IN GHENT .................................... 43 4.1 The Turkish community in Ghent ...................................................................................... 43 4.2 The participants ................................................................................................................. 45 4.3 Nature and patterns of substance use .............................................................................. 50 4.4 Help-seeking behaviour .................................................................................................... 58 4.5 Experience with services .................................................................................................. 63 4.6 Discussion ......................................................................................................................... 68 5 SUBSTANCE USE IN EASTERN EUROPEAN COMMUNITIES IN GHENT ............. 72 5.1 Eastern European communities in Ghent ......................................................................... 72 5.2 The participants ................................................................................................................. 76 5.3 Nature of substance use ................................................................................................... 82 5.4 Patterns of substance use ................................................................................................ 87 5.5 Help-seeking behaviour .................................................................................................... 91 5.6 Discussion ......................................................................................................................... 92 6 ASYLUM APPLICANTS, REFUGEES AND UNDOCUMENTED MIGRANTS ................ 97 6.1 Introduction ....................................................................................................................... 97 6.2 Socio-demographic characteristics of the participants ................................................... 100 6.3 Substance use ................................................................................................................ 104 6.4 The road to professional support .................................................................................... 113 6.5 Informal support: addiction as a taboo ............................................................................ 119 6.6 Discussion ....................................................................................................................... 121 Page 1 of 200 7 SUBSTANCE USE IN THE CONGOLESE COMMUNITY IN BRUSSELS .................... 123 7.1 Contextual introduction ................................................................................................... 123 7.2 The respondent pool ....................................................................................................... 126 7.3 Nature and patterns of substance use ............................................................................ 137 7.4 Use of treatment and other facilities ............................................................................... 150 7.5 Discussion ....................................................................................................................... 154 8 CONCLUSIONS ACROSS THE CASE STUDIES ......................................................... 157 8.1 Nature and patterns of use ............................................................................................. 157 8.2 Mechanisms at work in substance and treatment use .................................................... 159 8.3 Specific barriers to treatment .......................................................................................... 162 9 RECOMMENDATIONS................................................................................................... 165 9.1 Macro: system and societal levels .................................................................................. 165 9.2 Meso ............................................................................................................................... 166 10 LIMITATIONS ................................................................................................................. 173 11 FUTURE RESEARCH .................................................................................................... 175 12 REFERENCES ................................................................................................................ 178 ANNEX I: INTERVIEW GUIDE ........................................................................................................... 191 ANNEX II: BOROUGHS IN GHENT MUNICIPALITY......................................................................... 200 Page 2 of 200 LIST OF TABLES Table 1: Criteria for CBPR evaluation (Green et al. 1995) ........................................................... 27 Table 2: Characteristics of the Turkish community researchers ................................................. 33 Table 3: Characteristics of the reserchers from the Eastern European communities .............. 34 Table 4: Characteristics of the community researchers in the target group of asylum applicants, refugees and undocumented migrants ........................................................................ 35 Table 5: Age and problem substance use in the Turkish sample (n=55) .................................. 46 Table 6: Prevalence of substance use in the Turkish sample (n=55) ........................................ 47 Table 7: The evolution of EU citizens in Ghent from 2003 to 2015 (Integratiedienst, 2016) .. 73 Table 8: EU citizens in Ghent at the end of 2015 (Integratiedienst Gent, 2016) ...................... 73 Table 9: Prevalence of substance use in the Bulgarian sample (n=43) ..................................... 83 Table 10: Age and problem substance use in the Bulgarian sample (n=43) ............................ 83 Table 11: Prevalence of substance use in the Slovakian sample (n=19) .................................. 85 Table 12: Age and problem
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