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Title Page
Student Name: Laura Southam
Student Number: 2857143
Unit Title: Social Science Research Methods
Unit Code: CCJ32
Assessment: 2A: Research Project Proposal
Unit Conveyor: Dr Lacey Schaefer
Tutor: David Romyn
Due Date: 24/2/16
Word Count: 4395
Grade: 87% High Distinction (7)
Assessing the Extent, Patterns and Associated Harms of Crystal Methamphetamine
(ice) Use in the Indigenous Community of Palm Island
Table of Contents
Item Page
Introduction……………………………………………………………………………………1
Literature Review and Research Question…………………………………………………….2
Ethical Considerations………………………………………………………………………...7
Research Design……………………………………………………………………………….8
Research Site…………………………………………………………………………………..9
Sampling Strategy……………………………………………………………………………10
Data Collection Methods…………………………………………………………………….12
Research Plan………………………………………………………………………………...13
Conclusion…………………………………………………………………………………...14
References……………………………………………………………………………………15
Appendix A………………………………………………………………………………….19
Appendix B…………………………………………………………………………………..22
Appendix C…………………………………………………………………………………..23
Appendix D…………………………………………………………………………………..25
1
Introduction
In recent years there has been growing concern in the community and among the health care
sector and criminal justice system about the apparent rise in crystal methamphetamine (ice)
use in Australia. These concerns, fuelled by moral panic media reporting of an ice epidemic,
lead to the creation of a National Ice Taskforce in 2015 with the aim of addressing the
growing problem of ice use and associated harms (Commonwealth of Australia, 2015;
Madigan, 2015). Fears about increasing use appear warranted. Recent figures from the
National Drug Strategy Household Survey estimate there are in excess of 200 000 ice users in
Australia in 2013, double the figure reported in 2010 (Australian Institute of Health and
Welfare, 2014). Ice is now the most commonly used illicit substance after cannabis (AIHW,
2014). The report also sites evidence suggesting users are consuming ice with increasing
frequency, with 30.5% of users using at least once a week (Commonwealth of Australia,
2015). Ice use among the ATSI community is estimated to be twice that of non-ATSI
individuals (AIHW, 2014). Those living in rural and remote areas are twice as likely to use
ice compared with those living in urban areas (AIHW, 2014).
Submissions to the National Ice Taskforce identified a range of gaps in knowledge
pertaining to ice use, particularly in ATSI communities (Commonwealth of Australia, 2015).
There is a substantial lack of reliable quantitative data on the prevalence and patterns of ice
use among the 25% of Aboriginal and Torres Strait Islander (ATSI) people who live in
regional and remote areas, with very little community-level data available (National
Aboriginal and Torres Strait Islander Legal Services, 2015; NDRI, 2015; Putt & Delahunty,
2006; Youth off the Streets). There is an identified need to understand the links between ice
use and mental health issues (NDRI, 2015). Previous research has largely centred on urban
users, police detainees, injecting users, and police and frontline workers’ perception of use in
these communities (Blue Moon Research and Planning, 2008; Clough et al., 2015; Delahunty
2
& Putt, 2006; Youth off the Streets, 2015). ATSI population surveys largely report use in
urban centres and figures are likely to underestimate the prevalence of use (NDRI, 2015).
These knowledge gaps are of particular concern considering the range of structural
disadvantages and health and welfare disparities experienced by the ATSI community (Youth
off the Streets, 2015). Taken together, it is apparent there an urgent need for quantitative
research into the extent, patterns and harms associated with ice use in regional and remote
ATSI communities.
Literature Review
Ice is a powerful, easily obtained stimulant, with a strong market presence despite
efforts by law enforcement to stem its supply (Commonwealth of Australia, 2015). Ice use far
outstrips use of other forms of methamphetamine such as base or powder, with ice use among
methamphetamine users increasing from 22% to 50% between 2010 and 2013 (AIHW, 2014).
During the same period, use of powder methamphetamine decreased significantly from 51%
to 29% (AIHW, 2014). Impacts of ice use include: severe psychological and physical
disorders and disease, mortality, suicide and family violence, placing undue burden on
frontline health care workers and criminal justice agencies (National Drug Research Institute,
2015; Youth off the Streets, 2015). Despite mounting concerns among ATSI communities,
frontline health workers and police, crystal methamphetamine use among ATSI peoples has
not been extensively researched. Studies on drug use in remote ATSI communities have
typically focused on alcohol, kava, cannabis and petrol sniffing (Clough, Guyula, Yunupingu,
& Burns, 2002; Clough et al., 2004; Clough et al., 2006).
Perceptions of ice use in ATSI communities was examined in 2014 study of
Indigenous-controlled health services, in which 92% of workers believed ice to be a
significant issue within their community (as cited in Commonwealth of Australia, 2015).
Clough and others’ (2015) qualitative study of 1158 frontline service workers and community
3
members examined the perceived impacts of ice in 25 Indigenous communities in North
Queensland. This research found that the closer the ATSI community is to a town, the greater
the perception that ice is being used in these communities (Clough et al., 2015). This has
particular implications for the ATSI community of Palm Island, which is easily accessed by
boat from nearby Townsville. Additionally, participants reported a 60% increase in meth-
related health worker workload in 2015, compared with the previous year. The main
weakness in this study is perceived rather than actual hospitalisations. A study reported by
the New South Wales Health in 2015 found the rate of ice-related hospitalisations among
ATSI people tripled from 5% to 15.6% in the four years to 2013-2014. This is of significant
concern given ATSI represent just two percent of the population (NSW Health, 2015).
Perceptions of ice use and associated harms has been examined in a cross-sectional
survey study of 792 police in Queensland, South Australia, Western Australia and the
Northern Territory (Putt & Delahunty, 2006). The aim of this research was to compare
perceptions of use and harms between urban and rural/remote ATSI communities. Ice was
reported as the second most commonly used drug after cannabis, with 25% of respondents
reporting ice as being commonly used (Putt & Delahunty, 2006). The top three reported
problems associated with use in this was domestic and family violence, mental health
problems, and crime to fund drug use. The major limitations in this study presented threats to
validity: just 58 respondents worked in remote ATSI communities. Additionally, perceived
estimates of use do not equate to actual prevalence: drug use by its nature is hidden, and
Indigenous mistrust of authority figures is likely to confound this validity issue.
With regards to actual use, at a national level, cross-sectional population surveys
specifically designed for the ATSI community provide a truer estimate of prevalence in
comparison to the National Drug Strategy Household Survey (Putt & Delahunty, 2006). The
NDSHS survey is unable to provide large enough ATSI samples for robust estimations of the
4
extent of use, as Indigenous people represent just 2% of the sample (AIHW, 2015). Results
from the most recent National Aboriginal and Torres Strait Islander Social Survey
(NATSISS) discovered around 10% reported using amphetamines, 5% of which had used in
the previous 12 months (Australian Bureau of Statistics, 2008). The 2004-2005 National
Aboriginal and Torres Strait Islander Health Survey (NATSIHS) found 7% had used
amphetamines in the previous 12 months (Australian Bureau of Statistics, 2006). The
drawback evident in both NATSISS and NATSILS is they do not distinguish between ice and
other forms of methamphetamines, such as base or powder. Furthermore, non-respondent
issues inherent with self-administered questionnaires are likely to underestimate actual
prevalence.
Smaller, focused studies reveal higher rates of methamphetamine use than population
surveys. The GOANNA survey was the first national survey of ATSI aged 16-29 (Saulo,
2015). This cross-sectional, anonymous, computer-assisted self-administered (CASI) survey
covered all Australian jurisdictions, and aimed to investigate methamphetamine use, and
knowledge and attitudes of associated risk behaviours, sexually-transmitted infections and
blood-borne viruses. The sample included 2877 participants recruited from sporting events
through promotional materials, self-referral, incentives and word-of-mouth. Forty four
percent of respondents were aged between 16-19, with 52% from urban centres, 37% from
regional areas, and just 9% from remote regions. Findings showed that 15% of participants
had used meth in their lifetime, with 9% having used in the past 12 months. Those aged 20-
24 reported the highest rates of methamphetamine use. Poly-drug use was common among
users, with 65% using at least three other drugs, namely cannabis, ecstasy, cocaine and
alcohol. The study has several limitations: those sampled participated in sporting activities
which may serve as a protective factor against drug use, and as such participants may have a
lower rate of methamphetamine consumption compared with the general ATSI population.
5
The sampling methods used and the population targeted may not be representative, increasing
the likelihood of sampling error. Thirdly, those living in remote regions were
underrepresented in the sample.
The sample and methodology of the GOANNA survey was also utilised by Bryant
and others to investigate patterns of illicit drug use among ATSI people aged 16-19 (2015).
The study examined illicit drug use, injecting behaviours and associations of use separately in
regional, remote and urban settings (Bryant et al., 2015). Findings showed that 3% of
respondents had injected illicit drugs in the past 12months, with 37% of these injecting
methamphetamines. A further 37% of participants who injected methamphetamines engaged
in needle-sharing practices, with men more likely to inject than women (62% v 39%).
Correlates of frequent use in remote settings included those in the 25-29 age group, and
among those who drank alcohol at least three times a week. The same limitations outlined in
Saulo’s 2015 study are also applicable to this study. Additionally, this research did not
provide information on use for each drug separately. It is likely that patterns of illicit drug use
differ between drug types, and these patterns may be different in urban, regional and remote
settings.
Very few studies have examined ice use among current users. The qualitative research
project undertaken by Blue Moon Research and Planning (2008) is one exception. This
research project aimed to assess patterns of methamphetamine use, motivators for use and
risks and harms of use among selected sections of the community. The results for Indigenous
users are of most value to the current discussion and thus the findings will focus on this. The
methodology involved in-depth, semi-structured interviews with current methamphetamine
users aged 18-36 in urban Sydney. Almost all participants reported having commenced
methamphetamine use before age 19. Poly-drug use among users was very common, many
using alcohol and ice together. The majority had used between 10-15 years, with around half
6
using 4-5 times per week. Motivators for use included weight loss and wanting to fit in.
Respondents reported many negative effects of ice use, including panic attacks, paranoia,
hallucinations, psychosis, aggression, body aches and vein damage among injecting users.
The limitations to this study include the small sample size. Additionally, qualitative data does
not lend itself easily to quantification. The study had an urban focus and thus information on
users in remote and regional areas was not assessed. The study also did not distinguish
between the different forms of methamphetamine. This is particularly important as the use of
ice in recent years has outstripped use of other forms of methamphetamines such as base or
powder (AIHW, 2014).
Merton’s strain theory provides a theoretical framework for understanding why ice
use is greater among ATSI people compared to the non-ATSI community. The crux of
Merton’s theory is that structural disadvantage such as unemployment, low-socioeconomic
status and low educational attainment results in the inequality of opportunity of legitimate
means available to achieve culturally desirable goals such as success and wealth (Williams,
2012). These inequalities give rise to strain, driving people to resort to criminal activity such
as drug use as a passive act of opposition to achieving these goals (Williams, 2012).
Taken together, the literature review and gaps in knowledge present a clear need for
quality quantitative and representative data assessing the extent and patterns of ice use and
harms arising from use, particularly in remote ATSI communities in order to tailor culturally-
appropriate interventions and collaborative policy and health-care responses.. With this in
mind, the proposed research question for the current research project is: Assessing the extent,
patterns and associated harms of crystal methamphetamine (ice) use in the Indigenous
community of Palm Island. Two hypotheses are proposed. H1: there will be a relationship
between the frequency of crystal methamphetamine use and number of psychological harms
7
experienced as a consequence of use. H2 : crystal methamphetamine users who inject will use
more frequently compared to those who do not inject.
Ethical Considerations
Ethical issues are inherent to research conducted on illicit drug use and with
Indigenous populations. The first issue is the risk of harm from participation in the survey.
Harms include psychological discomfort: participation may act as trigger for drug use
relapse. Another trigger is among respondents who use ice and who may seek it following
participation. Remedies to mitigate these risks include: providing information for referral to
fact-to-face and/or telephone counselling services and drug rehabilitation centres such as
Ferdy’s Haven on Palm Island. Additionally, informing participants of the nature of the
survey, that participation is voluntary and they can cease at any time will ensure these risks
are minimised (National Health and Medical Research Centre, 2012).
Secondly, ethical-legal issues arise when undertaking research on illicit drug use
behaviour. These issues centre on information in the survey that may be of interest to law
enforcement agencies. Such information includes that which relates to supply and distribution
networks, and crimes currently under investigation and those that have not been adjudicated
in the courts (Clough & Conigrave, 2008). The first solution to this issue is ensuring
anonymity and non-identifiability of responses (NHMRC, 2012). Secondly, as outlined in
Appendix A, providing information in the consent statement outlining what the research
seeks to know and what it doesn’t seek to know, translated into plain English by ATSI
investigators, will ensure participants are fully cognisant of the aims of the study (Clough &
Conigrave, 2008). Past research has adopted this strategy and has found it to significantly
increase respondent participation (Clough & Conigrave, 2008).
Informed consent is another salient issue in performing illicit drug use research.
Participants may be under the influence of alcohol and/or other drugs (AOD), or may be
8
experiencing AOD withdrawal effects, thus being unable to provide informed consent
(NHMRC, 2012). Furthermore, those with a mental illness or intellectual disability or
impairment may not be able to provide informed consent (NHMRC, 2012). Remedies for
these issues include: rescheduling interviews for a time when the aforementioned issues don’t
impair an individual’s ability to provide informed consent, and screening respondents for
withdrawal symptoms and/or AOD-induced impairment prior to conducting the interview
(NHMRC, 2012). A related concern is associated with potential harm to researchers
conducting the interviews and surveys. There are risks inherent regarding participants who
may be under the influence of AOD or experiencing withdrawal and/or drug-induced
psychosis (NHMRC, 2012). These risks are particularly important when research is being
conducted in a private, non-public arena. Solutions to these issues include ensuring
interviews are conducted in the presence of an informal guardian such as a co-investigator, in
addition to making sure interviews are not conducted alone in a respondent’s home
(NHMRC, 2012).
Research Design
The proposed research design will utilise a deductive, quantitative strategy, using a
cross-sectional approach in order to gain a snapshot of crystal amphetamine use in the remote
ATSI community of Palm Island in Queensland. The proposed research project seeks to
identify how many people use ice, and for those who do use, patterns of use including
frequency of use and method of ingestion. This study also aims to identify correlates of
frequency of use and consequent physical and/or psychological harms as a consequence use.
The cross-sectional design was chosen as it is best placed to finer distinction between cases
as a result of testing multiple cases at one point in time, and is well-placed to test the
previously outlined hypotheses and theory. Ergo, much of the research into ATSI illicit drug
use has employed a cross-sectional approach (Clough, et al., 2002; Clough et al., 2004;
9
Clough et al., 2006). The data collection method will employ a computer-assisted self-
interviewing (CASI) survey.
The major advantage of utilising a cross-sectional design is it is simple, cost-effective
and provides quantifiable data, allowing for measurement of variation between cases and
correlations between variables (Bryman, 2008). This provides a reliable yardstick upon which
further research can be built (Bryman, 2008). A related disadvantage to employing this
design is it is low on internal validity as it is only possible to examine patterns of association
between variables, rather than causal relations, as there is no manipulation of the independent
variables, nor considerations of variable time-ordering (Adler & Clark, 2011; Bryman, 2008).
As this research proposes to assess ice use, it would be highly unethical to assign participants
to use ice.
External validity or generalisability is strong in cross-sectional research that employs
a random sampling procedure, which will be achieved in this proposal (Hagan, 2010).
Reliability and replicability of quantitative measures are typically high when the procedures
undertaken in the research are thoroughly outlined. This will be achieved through a detailed
consideration of sampling and data collection methods and analysis. Measurement validity, or
consistency of measures is potentially high in cross-sectional, quantitative research (Bryman,
2008).
Research site
Palm Island is a remote ATSI community 65km off the coast of Townsville,
Queensland. The most recent figures report a population of 2590 people, 94.2% being of
ATSI decent (Australian Bureau of Statistics, 2014). The median age is 26, and 30% of the
population are under 15 years of age (ABS, 2014). There are 387 households with an average
of 4.8 people per household (ABS, 2014). Palm Island has an autonomous Palm Island
Aboriginal Council, established in 1985 under the Community Services (Aborigines) Act 1984
10
(Qld) (Queensland Government, 2015). Like many other ATSI communities, the residents of
Palm Island experience a range of disadvantages. Unemployment is high at 37%, despite 27%
having obtained post-high school qualifications (ABS, 2014). Twenty nine percent of those
employed undertake manual labour jobs (ABS, 2014). Twelve percent of the population
receive income benefits from Centrelink in the form of the Newstart allowance – 80% of
those on Newstart have been receiving benefits in excess of one year (ABS, 2014). Just 3%
speak a language other than English at home, and 88% of households have access to the
internet (ABS, 2014). The site was chosen because of its status as a remote community
(Clough et al., 2015). Also, compared to many other remote ATSI communities, the
population is less transient due to movement between communities and outstations, making
sampling and recruitment more straightforward (Donovan & Spark, 1997).Furthermore, the
site was chosen on the basis of evidence suggesting ice use is more prevalent in regional
Australia, and perceptions that the closer an ATSI community is to a town, the greater the ice
problem (Clough et al., 2015). These are important considerations as the purpose of the
research is to identify the extent of ice problem on Palm Island in order to ensure culturally-
appropriate harm minimisation strategies can be employed in a holistic manner. Finally, Palm
Island has never been the subject of research in relation to illicit substances.
Sampling Strategy
Several research projects on illicit substance use in remote ATSI communities have
utilised a proportional stratified random approach to sampling and as such will be utilised for
the proposed research, using information from population rolls (Clough et al., 2002; Clough
et al., 2004; Clough et al., 2006). The eligible ATSI population will be divided into strata
based on 5- and 6-year age bands and gender, both of which are not normally distributed in
the population. This will ensure a representative sample. The reader is referred to Appendix B
for a detailed table of eligible participants and sample size based on both age and gender.
11
The ATSI population of Palm Island is 2440; 94.2% of the total population (ABS,
2014). The proposed research will assess ice use among ATSI people aged between 18-44.
This age range has been chosen based on the age-crime curve of offending (Moffitt, 1993).
This sampling strategy will provide the most accurate and rich data on those who are most
likely to engage in unlawful drug use behaviour. To ensure maximum validity, 5% of the
eligible population will be sampled, which is 54 participants. The sample size will be rounded
up to 100 to mitigate potential refusal to participate and incomplete surveys. Based on
calculations from best estimates of the population figures presented in the 2013 National
Regional Profile of Palm Island, 1083 ATSI individuals are eligible for the study (ABS,
2014). Recruitment will be achieved by personal contact made by a volunteer ATSI co-
researcher and respected Indigenous Elder or local community member.
The exclusion criteria for participation in the study are as follows: those who do not
identify as ATSI, who are under 18 or 45 and over at the time of sampling, individuals of no
fixed address and those in correctional or palliative care facilities at the time of sampling, and
individuals who suffer from a physical or mental condition that would impair their ability to
provide informed consent. Once participants have been recruited, they will be temporarily
excluded from participation if they present as being under the influence of AOD, or
presenting with withdrawal or psychosis symptoms at the time of interview. The inclusion
criteria includes those who are not excluded as discussed above.
The major advantage of employing a proportional stratified random sample is it
provides a proportionate representation of the actual population under investigation (Bryman,
2008). This approach is superior to other types of probability sampling as it provides a means
of identifying under-represented groups in society (Bryman, 2008). Stratified random
sampling also reduces the possibility of sampling and coverage error (Bryman, 2008;
Neuman, 1997). A disadvantage of using this approach is it is only useful when the
12
stratifying criteria information is available (Bryman, 2008). Using active population rolls will
mitigate this potential disadvantage.
Data Collection
The survey will be conducted in a private room at the community centre. As the
survey will be administered through the use of an ipad using surveymonkey, alternate
locations where respondents’ feel most comfortable will be provided as an option. Although
a self-complete questionnaire will be used, appointments will be made for participants to
mitigate non-response bias. Prior to the survey being conducted, participants will be actively
screened for AOD intoxication or any impairment that undermine their ability to provide
informed consent. As per Appendix A, participants will be provided with a consent form to
sign. In recognising the Indigenous tradition of reciprocity, a can of soft drink will be
provided to participants .
The data to be collected will involve fixed-choice questions only and will be outlined
below. Please refer to Appendix C for operationalisation of survey questions relating to the
following concepts. Methamphetamine use will be limited to crystal methamphetamine (ice),
as research has shown this is the predominant form of methamphetamine used (AIHW,
2014). Extent of use is conceptualised as a distinction between those who have used in their
lifetime and those who have not used. Patterns of use is conceptualised as the frequency of
use, the amount used in one ice-taking episode, and the predominant method of ingestion.
Harms as a consequence of ice use is conceptualised as negative individual psychological and
physical effects as a direct result of using ice. Data analysis will involve providing
descriptive statistics relating to the aforementioned concepts. To address the relationship
between frequency of use, an ordinal variable, and consequent harms, which will be totalled
to provide a scale measure, data analysis H1 will involve utilising Spearman’s rho for
13
measures of correlation. To address H2, a chi-square r x c test for independence will be used
to analyse relationships between the two ordinal variables.
The advantages of using a CASI method of survey administration are numerous. They
are quicker and more cost-effective to administer, and they reduce the social desirability issue
present in structured interviewing, due to the confidential and anonymous nature of such
methods (Bryman, 2008). Furthermore, the absence of interviewer effects is a distinct
advantage of self-complete questionnaires (Adler & Clark, 2011). Disadvantages inherent to
self-complete questionnaires such as lower response rates, and non-response bias will be
mitigated by the presence of a researcher during the administration of the survey. This will
allow for clarification of questions if required for those who have English literacy problems.
The disadvantages of self-complete questionnaires include the under-reporting of stigmatised
behaviour, not being able to prompt the respondent, and a greater risk of missing data
(Bryman, 2008).
Research Plan
Please refer to Appendix D for a Gantt chart outlining tasks to be completed. The first
task will be to submit the ethics application in March. The literature review will be
commenced in March and will take four month. The project plan will also be completed in
the first month. Advertisements for volunteer ATSI research assistants will be placed on
govolunteerqld.com.au in the first month. The survey will be designed in April. It is
estimated ethics approval and/or meeting will take place mid-April to the end of May. This
project will allow for up to two months of community consultation with the Palm Island , to
be undertaken in April and May. Survey administration will take place over the two months
between June and July. Codification of data will take place in the first two weeks of August.
Quantitative data analysis will be undertaken in August and September, allowing two and a
half months for the research report to be prepared. Budget costings will be minimal as
14
volunteer co-researchers will be used, and the survey will be conducted on a computer.
Access to surveymonkey will be required for nine months and will cost $225 in total. One
hundred cans of soft drinks for participants will cost approximately $70.
Conclusion
The impact of crystal methamphetamine use and associated harms is an issue
warranting significant concern. The outlined research proposal is designed to address the
deficits in knowledge regarding the nature and patterns of ice use among ATSI people living
in a remote community. The importance of conducting the proposed research can have
marked impacts on effective and culturally-appropriate health care service delivery, with the
aim of improving the health outcomes for this already disadvantaged community. The
strengths of this proposal include the use of proportional stratified random sampling, and
computer-assisted self-administered survey software in order to provide a true prevalence of
the nature and impact of ice use on Palm Island. This proposal demonstrates that ethical
concerns can be mitigated, and it is doable within time and budget constraints. Although this
is not a comparative study, results from this research could potentially be used to provide
more robust data on the difference between ice use in urban and remote ATSI communities,
and comparing use of ATSI and non-ATSI peoples. Taken together, this proposal provides a
strong argument for its necessity.
15
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enforcement’s inquiry into crystal methamphetamine (ice). Retrieved from http://
www.aph.gov.au/DocumentStore.ashx?id=9fb97183-edc3-46e8.
National Health and Medical Research Council. (2012). Ethical issues in research into
alcohol and other drugs: An issues paper exploring the need for a guidance
framework. Retrieved from http://www.nhrmc.gov.au
Neuman, W. L. (1997). Social research methods: Qualitative and quantitative approaches
(3rd ed.). Boston, MA: Allyn and Bacon.
New South Wales Health. (2015). Crystalline methamphetamine background paper:
New South Wales data. Retrieved from http://www.health.nsw.gov.au
18
Putt, J., & Delahunty, B. (2006). Illicit drug use in rural and remote Indigenous communities.
Trends and Issues in Crime and Criminal Justice, 322, 1-6. Retrieved from
http://www.aic.gov.au
Queensland Government. (2015). Palm Island. Retrieved from http://www.qld.gov.au/atsi
/cultural-awareness-heritage-arts/community-histories
Saulo, D. (2015). First national survey of Aboriginal and Torres Strait Islander people aged
16-29yrs related to STI’s and BBV’s knowledge risk beh and health services access.
Paper presented at the National Methamphetamine Symposium convened by the
National Centre for Education and Training on Addiction and held in Melbourne, 12
May, 2015. Retrieved from http://www.nceta.flinders.edu.au
Williams, K. (2012). Textbook on criminology (7th ed.). Oxford, UK: Oxford University
Press.
Youth off the Streets. (2015). Submission to the parliamentary joint committee on law
enforcement on crystal methamphetamine inquiry. Retrieved from http://www.aph.
gov.au/DocumentStore.ashx?id=e1383ed4-f2d9-4ffd
19
Appendix A
Participant Consent Form
Ethics Committee Approval Number:
Project Title:
Researcher:
Aim of the research: We want to know about crystal methamphetamine (ice) use so people
will be able to get proper help when they need it.
I would like to ask you for your permission to participate in the research project.
1. Method:
Your involvement in this research project will involve -
 Stating whether or not you have ever used crystal methamphetamine (ice)
 If you do use ice, how often you use
 If you do use ice, how you take it
 If you do use ice, how much you use
 Any negative mental health problems you have noticed because of your ice
use
2. Information sought:
What we ARE NOT trying to find out -
 Who is selling ice
 Who is buying ice for the people who sell it (ie trafficking)
 Who may have sold ice in the past
 Who may have bought ice in the past
 Crimes that may be under investigation by police
 Crimes that have not been heard in the court
20
What we ARE trying to find out -
 How many people are using ice
 How much people use and how often they use
 How they take ice when they use it
 Whether using ice has had any bad effects on their health
3. Voluntary Participation
Your participation in the research is entirely voluntary. If you DO NOT WISH to take part in
the interview/survey, you ARE NOT required to. If you give your consent and change your
mind later, you are welcome to stop the survey at any time you wish. You ARE NOT under
any obligation to answer ANY questions asked in the survey, and you are free to refuse to
answer any questions you do not wish to answer.
If you have any questions about this research, you are welcome to contact the researcher:
(Names of researchers’)
(Researchers’ university/faculty)
(address)
(contact telephone)
Participant:
 I have read the consent form and the nature and aim of the research has been clearly
explained to me.
 I understand the aim of the research and my participation in it.
 I understand that I am able to withdraw from the study at any point.
 I understand information obtained from the study may be published, and that the
information I give will remain anonymous and confidential.
21
I (full name)
___________________________________________________________________________
of (address)
___________________________________________________________________________
consent to participating in this study ___________________________________________
___________________
(Signature)
______/______/______
(Date)
22
Appendix B
Table 1B
Palm Island eligible population and sample size (N = 100)
Age Tot pop. F no. M no. F % M % N tot. n F n M
18-24 361 171 190 47 53 33 16 17
25-29 194 102 92 53 47 18 10 8
30-34 162 78 84 48 52 15 7 8
35-39 172 78 94 45 55 16 7 9
40-44 194 103 91 53 47 18 10 8
Total 1083 532 551 n/a n/a 100 50 50
23
Appendix C
Pilot Survey Sample Questions
1. Have you ever used ice in your life? (please tick appropriate box)
Yes
No
2. If you have used ice, how often do you take it? (please tick one box)
At least once a week
At least once a month
At least once every 3 months
At least once every 6 months
At least once every twelve months
Less than once a year
Rather not say
Can’t remember/not sure
3. When you do use ice, how do you mostly take it? (please tick one box)
Snort it
Inject it
Smoke it on top of a marijuana cone
Smoke it in a glass pipe
Smoke it in a light bulb
Smoke it on aluminium foil
Eat it
Other
Rather not say
24
4. When you take ice, how much do you usually take at one time? (please tick one box)
Please ask the researcher to see pictures of amounts if you are unsure
Less than one point
One to less than two points
Two to less than three points
Three points or more
Not sure
Rather not say
5. Have you noticed any negative (bad) psychological effects from taking ice? (please tick
all that apply)
Please ask the researcher if you unsure what any of these mean
Sleeping problems
Feeling more angry than usual
Anxiety
Panic attacks
Feeling violent (wanting to do things that would hurt other people)
Hallucinations (seeing or hearing things that aren’t there)
Trouble remembering things (memory problems)
Paranoia (thinking someone is out to ‘get you’)
Suicidal thoughts (wanting to hurt or kill yourself)
Other (please provide a description of the problem/s)
25
Appendix D
Project Plan: Gantt Chart
STAGE TASK Mar Apr May Jun July Aug Sept Oct Nov
Planning Literature Review
Submit ethics application
Ethics committee meeting/approval
Project plan: design, sample etc.
Palm Island community consult.
Design survey
Advertise for research assistant/s
Data collection Interviews/survey administration
Data analysis Codify survey data
Quantitativedata analysis
Writing up Prepare research report

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s2857143SouthamLCCJ32A2ResearchProposal

  • 1. Title Page Student Name: Laura Southam Student Number: 2857143 Unit Title: Social Science Research Methods Unit Code: CCJ32 Assessment: 2A: Research Project Proposal Unit Conveyor: Dr Lacey Schaefer Tutor: David Romyn Due Date: 24/2/16 Word Count: 4395 Grade: 87% High Distinction (7)
  • 2. Assessing the Extent, Patterns and Associated Harms of Crystal Methamphetamine (ice) Use in the Indigenous Community of Palm Island
  • 3. Table of Contents Item Page Introduction……………………………………………………………………………………1 Literature Review and Research Question…………………………………………………….2 Ethical Considerations………………………………………………………………………...7 Research Design……………………………………………………………………………….8 Research Site…………………………………………………………………………………..9 Sampling Strategy……………………………………………………………………………10 Data Collection Methods…………………………………………………………………….12 Research Plan………………………………………………………………………………...13 Conclusion…………………………………………………………………………………...14 References……………………………………………………………………………………15 Appendix A………………………………………………………………………………….19 Appendix B…………………………………………………………………………………..22 Appendix C…………………………………………………………………………………..23 Appendix D…………………………………………………………………………………..25
  • 4. 1 Introduction In recent years there has been growing concern in the community and among the health care sector and criminal justice system about the apparent rise in crystal methamphetamine (ice) use in Australia. These concerns, fuelled by moral panic media reporting of an ice epidemic, lead to the creation of a National Ice Taskforce in 2015 with the aim of addressing the growing problem of ice use and associated harms (Commonwealth of Australia, 2015; Madigan, 2015). Fears about increasing use appear warranted. Recent figures from the National Drug Strategy Household Survey estimate there are in excess of 200 000 ice users in Australia in 2013, double the figure reported in 2010 (Australian Institute of Health and Welfare, 2014). Ice is now the most commonly used illicit substance after cannabis (AIHW, 2014). The report also sites evidence suggesting users are consuming ice with increasing frequency, with 30.5% of users using at least once a week (Commonwealth of Australia, 2015). Ice use among the ATSI community is estimated to be twice that of non-ATSI individuals (AIHW, 2014). Those living in rural and remote areas are twice as likely to use ice compared with those living in urban areas (AIHW, 2014). Submissions to the National Ice Taskforce identified a range of gaps in knowledge pertaining to ice use, particularly in ATSI communities (Commonwealth of Australia, 2015). There is a substantial lack of reliable quantitative data on the prevalence and patterns of ice use among the 25% of Aboriginal and Torres Strait Islander (ATSI) people who live in regional and remote areas, with very little community-level data available (National Aboriginal and Torres Strait Islander Legal Services, 2015; NDRI, 2015; Putt & Delahunty, 2006; Youth off the Streets). There is an identified need to understand the links between ice use and mental health issues (NDRI, 2015). Previous research has largely centred on urban users, police detainees, injecting users, and police and frontline workers’ perception of use in these communities (Blue Moon Research and Planning, 2008; Clough et al., 2015; Delahunty
  • 5. 2 & Putt, 2006; Youth off the Streets, 2015). ATSI population surveys largely report use in urban centres and figures are likely to underestimate the prevalence of use (NDRI, 2015). These knowledge gaps are of particular concern considering the range of structural disadvantages and health and welfare disparities experienced by the ATSI community (Youth off the Streets, 2015). Taken together, it is apparent there an urgent need for quantitative research into the extent, patterns and harms associated with ice use in regional and remote ATSI communities. Literature Review Ice is a powerful, easily obtained stimulant, with a strong market presence despite efforts by law enforcement to stem its supply (Commonwealth of Australia, 2015). Ice use far outstrips use of other forms of methamphetamine such as base or powder, with ice use among methamphetamine users increasing from 22% to 50% between 2010 and 2013 (AIHW, 2014). During the same period, use of powder methamphetamine decreased significantly from 51% to 29% (AIHW, 2014). Impacts of ice use include: severe psychological and physical disorders and disease, mortality, suicide and family violence, placing undue burden on frontline health care workers and criminal justice agencies (National Drug Research Institute, 2015; Youth off the Streets, 2015). Despite mounting concerns among ATSI communities, frontline health workers and police, crystal methamphetamine use among ATSI peoples has not been extensively researched. Studies on drug use in remote ATSI communities have typically focused on alcohol, kava, cannabis and petrol sniffing (Clough, Guyula, Yunupingu, & Burns, 2002; Clough et al., 2004; Clough et al., 2006). Perceptions of ice use in ATSI communities was examined in 2014 study of Indigenous-controlled health services, in which 92% of workers believed ice to be a significant issue within their community (as cited in Commonwealth of Australia, 2015). Clough and others’ (2015) qualitative study of 1158 frontline service workers and community
  • 6. 3 members examined the perceived impacts of ice in 25 Indigenous communities in North Queensland. This research found that the closer the ATSI community is to a town, the greater the perception that ice is being used in these communities (Clough et al., 2015). This has particular implications for the ATSI community of Palm Island, which is easily accessed by boat from nearby Townsville. Additionally, participants reported a 60% increase in meth- related health worker workload in 2015, compared with the previous year. The main weakness in this study is perceived rather than actual hospitalisations. A study reported by the New South Wales Health in 2015 found the rate of ice-related hospitalisations among ATSI people tripled from 5% to 15.6% in the four years to 2013-2014. This is of significant concern given ATSI represent just two percent of the population (NSW Health, 2015). Perceptions of ice use and associated harms has been examined in a cross-sectional survey study of 792 police in Queensland, South Australia, Western Australia and the Northern Territory (Putt & Delahunty, 2006). The aim of this research was to compare perceptions of use and harms between urban and rural/remote ATSI communities. Ice was reported as the second most commonly used drug after cannabis, with 25% of respondents reporting ice as being commonly used (Putt & Delahunty, 2006). The top three reported problems associated with use in this was domestic and family violence, mental health problems, and crime to fund drug use. The major limitations in this study presented threats to validity: just 58 respondents worked in remote ATSI communities. Additionally, perceived estimates of use do not equate to actual prevalence: drug use by its nature is hidden, and Indigenous mistrust of authority figures is likely to confound this validity issue. With regards to actual use, at a national level, cross-sectional population surveys specifically designed for the ATSI community provide a truer estimate of prevalence in comparison to the National Drug Strategy Household Survey (Putt & Delahunty, 2006). The NDSHS survey is unable to provide large enough ATSI samples for robust estimations of the
  • 7. 4 extent of use, as Indigenous people represent just 2% of the sample (AIHW, 2015). Results from the most recent National Aboriginal and Torres Strait Islander Social Survey (NATSISS) discovered around 10% reported using amphetamines, 5% of which had used in the previous 12 months (Australian Bureau of Statistics, 2008). The 2004-2005 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) found 7% had used amphetamines in the previous 12 months (Australian Bureau of Statistics, 2006). The drawback evident in both NATSISS and NATSILS is they do not distinguish between ice and other forms of methamphetamines, such as base or powder. Furthermore, non-respondent issues inherent with self-administered questionnaires are likely to underestimate actual prevalence. Smaller, focused studies reveal higher rates of methamphetamine use than population surveys. The GOANNA survey was the first national survey of ATSI aged 16-29 (Saulo, 2015). This cross-sectional, anonymous, computer-assisted self-administered (CASI) survey covered all Australian jurisdictions, and aimed to investigate methamphetamine use, and knowledge and attitudes of associated risk behaviours, sexually-transmitted infections and blood-borne viruses. The sample included 2877 participants recruited from sporting events through promotional materials, self-referral, incentives and word-of-mouth. Forty four percent of respondents were aged between 16-19, with 52% from urban centres, 37% from regional areas, and just 9% from remote regions. Findings showed that 15% of participants had used meth in their lifetime, with 9% having used in the past 12 months. Those aged 20- 24 reported the highest rates of methamphetamine use. Poly-drug use was common among users, with 65% using at least three other drugs, namely cannabis, ecstasy, cocaine and alcohol. The study has several limitations: those sampled participated in sporting activities which may serve as a protective factor against drug use, and as such participants may have a lower rate of methamphetamine consumption compared with the general ATSI population.
  • 8. 5 The sampling methods used and the population targeted may not be representative, increasing the likelihood of sampling error. Thirdly, those living in remote regions were underrepresented in the sample. The sample and methodology of the GOANNA survey was also utilised by Bryant and others to investigate patterns of illicit drug use among ATSI people aged 16-19 (2015). The study examined illicit drug use, injecting behaviours and associations of use separately in regional, remote and urban settings (Bryant et al., 2015). Findings showed that 3% of respondents had injected illicit drugs in the past 12months, with 37% of these injecting methamphetamines. A further 37% of participants who injected methamphetamines engaged in needle-sharing practices, with men more likely to inject than women (62% v 39%). Correlates of frequent use in remote settings included those in the 25-29 age group, and among those who drank alcohol at least three times a week. The same limitations outlined in Saulo’s 2015 study are also applicable to this study. Additionally, this research did not provide information on use for each drug separately. It is likely that patterns of illicit drug use differ between drug types, and these patterns may be different in urban, regional and remote settings. Very few studies have examined ice use among current users. The qualitative research project undertaken by Blue Moon Research and Planning (2008) is one exception. This research project aimed to assess patterns of methamphetamine use, motivators for use and risks and harms of use among selected sections of the community. The results for Indigenous users are of most value to the current discussion and thus the findings will focus on this. The methodology involved in-depth, semi-structured interviews with current methamphetamine users aged 18-36 in urban Sydney. Almost all participants reported having commenced methamphetamine use before age 19. Poly-drug use among users was very common, many using alcohol and ice together. The majority had used between 10-15 years, with around half
  • 9. 6 using 4-5 times per week. Motivators for use included weight loss and wanting to fit in. Respondents reported many negative effects of ice use, including panic attacks, paranoia, hallucinations, psychosis, aggression, body aches and vein damage among injecting users. The limitations to this study include the small sample size. Additionally, qualitative data does not lend itself easily to quantification. The study had an urban focus and thus information on users in remote and regional areas was not assessed. The study also did not distinguish between the different forms of methamphetamine. This is particularly important as the use of ice in recent years has outstripped use of other forms of methamphetamines such as base or powder (AIHW, 2014). Merton’s strain theory provides a theoretical framework for understanding why ice use is greater among ATSI people compared to the non-ATSI community. The crux of Merton’s theory is that structural disadvantage such as unemployment, low-socioeconomic status and low educational attainment results in the inequality of opportunity of legitimate means available to achieve culturally desirable goals such as success and wealth (Williams, 2012). These inequalities give rise to strain, driving people to resort to criminal activity such as drug use as a passive act of opposition to achieving these goals (Williams, 2012). Taken together, the literature review and gaps in knowledge present a clear need for quality quantitative and representative data assessing the extent and patterns of ice use and harms arising from use, particularly in remote ATSI communities in order to tailor culturally- appropriate interventions and collaborative policy and health-care responses.. With this in mind, the proposed research question for the current research project is: Assessing the extent, patterns and associated harms of crystal methamphetamine (ice) use in the Indigenous community of Palm Island. Two hypotheses are proposed. H1: there will be a relationship between the frequency of crystal methamphetamine use and number of psychological harms
  • 10. 7 experienced as a consequence of use. H2 : crystal methamphetamine users who inject will use more frequently compared to those who do not inject. Ethical Considerations Ethical issues are inherent to research conducted on illicit drug use and with Indigenous populations. The first issue is the risk of harm from participation in the survey. Harms include psychological discomfort: participation may act as trigger for drug use relapse. Another trigger is among respondents who use ice and who may seek it following participation. Remedies to mitigate these risks include: providing information for referral to fact-to-face and/or telephone counselling services and drug rehabilitation centres such as Ferdy’s Haven on Palm Island. Additionally, informing participants of the nature of the survey, that participation is voluntary and they can cease at any time will ensure these risks are minimised (National Health and Medical Research Centre, 2012). Secondly, ethical-legal issues arise when undertaking research on illicit drug use behaviour. These issues centre on information in the survey that may be of interest to law enforcement agencies. Such information includes that which relates to supply and distribution networks, and crimes currently under investigation and those that have not been adjudicated in the courts (Clough & Conigrave, 2008). The first solution to this issue is ensuring anonymity and non-identifiability of responses (NHMRC, 2012). Secondly, as outlined in Appendix A, providing information in the consent statement outlining what the research seeks to know and what it doesn’t seek to know, translated into plain English by ATSI investigators, will ensure participants are fully cognisant of the aims of the study (Clough & Conigrave, 2008). Past research has adopted this strategy and has found it to significantly increase respondent participation (Clough & Conigrave, 2008). Informed consent is another salient issue in performing illicit drug use research. Participants may be under the influence of alcohol and/or other drugs (AOD), or may be
  • 11. 8 experiencing AOD withdrawal effects, thus being unable to provide informed consent (NHMRC, 2012). Furthermore, those with a mental illness or intellectual disability or impairment may not be able to provide informed consent (NHMRC, 2012). Remedies for these issues include: rescheduling interviews for a time when the aforementioned issues don’t impair an individual’s ability to provide informed consent, and screening respondents for withdrawal symptoms and/or AOD-induced impairment prior to conducting the interview (NHMRC, 2012). A related concern is associated with potential harm to researchers conducting the interviews and surveys. There are risks inherent regarding participants who may be under the influence of AOD or experiencing withdrawal and/or drug-induced psychosis (NHMRC, 2012). These risks are particularly important when research is being conducted in a private, non-public arena. Solutions to these issues include ensuring interviews are conducted in the presence of an informal guardian such as a co-investigator, in addition to making sure interviews are not conducted alone in a respondent’s home (NHMRC, 2012). Research Design The proposed research design will utilise a deductive, quantitative strategy, using a cross-sectional approach in order to gain a snapshot of crystal amphetamine use in the remote ATSI community of Palm Island in Queensland. The proposed research project seeks to identify how many people use ice, and for those who do use, patterns of use including frequency of use and method of ingestion. This study also aims to identify correlates of frequency of use and consequent physical and/or psychological harms as a consequence use. The cross-sectional design was chosen as it is best placed to finer distinction between cases as a result of testing multiple cases at one point in time, and is well-placed to test the previously outlined hypotheses and theory. Ergo, much of the research into ATSI illicit drug use has employed a cross-sectional approach (Clough, et al., 2002; Clough et al., 2004;
  • 12. 9 Clough et al., 2006). The data collection method will employ a computer-assisted self- interviewing (CASI) survey. The major advantage of utilising a cross-sectional design is it is simple, cost-effective and provides quantifiable data, allowing for measurement of variation between cases and correlations between variables (Bryman, 2008). This provides a reliable yardstick upon which further research can be built (Bryman, 2008). A related disadvantage to employing this design is it is low on internal validity as it is only possible to examine patterns of association between variables, rather than causal relations, as there is no manipulation of the independent variables, nor considerations of variable time-ordering (Adler & Clark, 2011; Bryman, 2008). As this research proposes to assess ice use, it would be highly unethical to assign participants to use ice. External validity or generalisability is strong in cross-sectional research that employs a random sampling procedure, which will be achieved in this proposal (Hagan, 2010). Reliability and replicability of quantitative measures are typically high when the procedures undertaken in the research are thoroughly outlined. This will be achieved through a detailed consideration of sampling and data collection methods and analysis. Measurement validity, or consistency of measures is potentially high in cross-sectional, quantitative research (Bryman, 2008). Research site Palm Island is a remote ATSI community 65km off the coast of Townsville, Queensland. The most recent figures report a population of 2590 people, 94.2% being of ATSI decent (Australian Bureau of Statistics, 2014). The median age is 26, and 30% of the population are under 15 years of age (ABS, 2014). There are 387 households with an average of 4.8 people per household (ABS, 2014). Palm Island has an autonomous Palm Island Aboriginal Council, established in 1985 under the Community Services (Aborigines) Act 1984
  • 13. 10 (Qld) (Queensland Government, 2015). Like many other ATSI communities, the residents of Palm Island experience a range of disadvantages. Unemployment is high at 37%, despite 27% having obtained post-high school qualifications (ABS, 2014). Twenty nine percent of those employed undertake manual labour jobs (ABS, 2014). Twelve percent of the population receive income benefits from Centrelink in the form of the Newstart allowance – 80% of those on Newstart have been receiving benefits in excess of one year (ABS, 2014). Just 3% speak a language other than English at home, and 88% of households have access to the internet (ABS, 2014). The site was chosen because of its status as a remote community (Clough et al., 2015). Also, compared to many other remote ATSI communities, the population is less transient due to movement between communities and outstations, making sampling and recruitment more straightforward (Donovan & Spark, 1997).Furthermore, the site was chosen on the basis of evidence suggesting ice use is more prevalent in regional Australia, and perceptions that the closer an ATSI community is to a town, the greater the ice problem (Clough et al., 2015). These are important considerations as the purpose of the research is to identify the extent of ice problem on Palm Island in order to ensure culturally- appropriate harm minimisation strategies can be employed in a holistic manner. Finally, Palm Island has never been the subject of research in relation to illicit substances. Sampling Strategy Several research projects on illicit substance use in remote ATSI communities have utilised a proportional stratified random approach to sampling and as such will be utilised for the proposed research, using information from population rolls (Clough et al., 2002; Clough et al., 2004; Clough et al., 2006). The eligible ATSI population will be divided into strata based on 5- and 6-year age bands and gender, both of which are not normally distributed in the population. This will ensure a representative sample. The reader is referred to Appendix B for a detailed table of eligible participants and sample size based on both age and gender.
  • 14. 11 The ATSI population of Palm Island is 2440; 94.2% of the total population (ABS, 2014). The proposed research will assess ice use among ATSI people aged between 18-44. This age range has been chosen based on the age-crime curve of offending (Moffitt, 1993). This sampling strategy will provide the most accurate and rich data on those who are most likely to engage in unlawful drug use behaviour. To ensure maximum validity, 5% of the eligible population will be sampled, which is 54 participants. The sample size will be rounded up to 100 to mitigate potential refusal to participate and incomplete surveys. Based on calculations from best estimates of the population figures presented in the 2013 National Regional Profile of Palm Island, 1083 ATSI individuals are eligible for the study (ABS, 2014). Recruitment will be achieved by personal contact made by a volunteer ATSI co- researcher and respected Indigenous Elder or local community member. The exclusion criteria for participation in the study are as follows: those who do not identify as ATSI, who are under 18 or 45 and over at the time of sampling, individuals of no fixed address and those in correctional or palliative care facilities at the time of sampling, and individuals who suffer from a physical or mental condition that would impair their ability to provide informed consent. Once participants have been recruited, they will be temporarily excluded from participation if they present as being under the influence of AOD, or presenting with withdrawal or psychosis symptoms at the time of interview. The inclusion criteria includes those who are not excluded as discussed above. The major advantage of employing a proportional stratified random sample is it provides a proportionate representation of the actual population under investigation (Bryman, 2008). This approach is superior to other types of probability sampling as it provides a means of identifying under-represented groups in society (Bryman, 2008). Stratified random sampling also reduces the possibility of sampling and coverage error (Bryman, 2008; Neuman, 1997). A disadvantage of using this approach is it is only useful when the
  • 15. 12 stratifying criteria information is available (Bryman, 2008). Using active population rolls will mitigate this potential disadvantage. Data Collection The survey will be conducted in a private room at the community centre. As the survey will be administered through the use of an ipad using surveymonkey, alternate locations where respondents’ feel most comfortable will be provided as an option. Although a self-complete questionnaire will be used, appointments will be made for participants to mitigate non-response bias. Prior to the survey being conducted, participants will be actively screened for AOD intoxication or any impairment that undermine their ability to provide informed consent. As per Appendix A, participants will be provided with a consent form to sign. In recognising the Indigenous tradition of reciprocity, a can of soft drink will be provided to participants . The data to be collected will involve fixed-choice questions only and will be outlined below. Please refer to Appendix C for operationalisation of survey questions relating to the following concepts. Methamphetamine use will be limited to crystal methamphetamine (ice), as research has shown this is the predominant form of methamphetamine used (AIHW, 2014). Extent of use is conceptualised as a distinction between those who have used in their lifetime and those who have not used. Patterns of use is conceptualised as the frequency of use, the amount used in one ice-taking episode, and the predominant method of ingestion. Harms as a consequence of ice use is conceptualised as negative individual psychological and physical effects as a direct result of using ice. Data analysis will involve providing descriptive statistics relating to the aforementioned concepts. To address the relationship between frequency of use, an ordinal variable, and consequent harms, which will be totalled to provide a scale measure, data analysis H1 will involve utilising Spearman’s rho for
  • 16. 13 measures of correlation. To address H2, a chi-square r x c test for independence will be used to analyse relationships between the two ordinal variables. The advantages of using a CASI method of survey administration are numerous. They are quicker and more cost-effective to administer, and they reduce the social desirability issue present in structured interviewing, due to the confidential and anonymous nature of such methods (Bryman, 2008). Furthermore, the absence of interviewer effects is a distinct advantage of self-complete questionnaires (Adler & Clark, 2011). Disadvantages inherent to self-complete questionnaires such as lower response rates, and non-response bias will be mitigated by the presence of a researcher during the administration of the survey. This will allow for clarification of questions if required for those who have English literacy problems. The disadvantages of self-complete questionnaires include the under-reporting of stigmatised behaviour, not being able to prompt the respondent, and a greater risk of missing data (Bryman, 2008). Research Plan Please refer to Appendix D for a Gantt chart outlining tasks to be completed. The first task will be to submit the ethics application in March. The literature review will be commenced in March and will take four month. The project plan will also be completed in the first month. Advertisements for volunteer ATSI research assistants will be placed on govolunteerqld.com.au in the first month. The survey will be designed in April. It is estimated ethics approval and/or meeting will take place mid-April to the end of May. This project will allow for up to two months of community consultation with the Palm Island , to be undertaken in April and May. Survey administration will take place over the two months between June and July. Codification of data will take place in the first two weeks of August. Quantitative data analysis will be undertaken in August and September, allowing two and a half months for the research report to be prepared. Budget costings will be minimal as
  • 17. 14 volunteer co-researchers will be used, and the survey will be conducted on a computer. Access to surveymonkey will be required for nine months and will cost $225 in total. One hundred cans of soft drinks for participants will cost approximately $70. Conclusion The impact of crystal methamphetamine use and associated harms is an issue warranting significant concern. The outlined research proposal is designed to address the deficits in knowledge regarding the nature and patterns of ice use among ATSI people living in a remote community. The importance of conducting the proposed research can have marked impacts on effective and culturally-appropriate health care service delivery, with the aim of improving the health outcomes for this already disadvantaged community. The strengths of this proposal include the use of proportional stratified random sampling, and computer-assisted self-administered survey software in order to provide a true prevalence of the nature and impact of ice use on Palm Island. This proposal demonstrates that ethical concerns can be mitigated, and it is doable within time and budget constraints. Although this is not a comparative study, results from this research could potentially be used to provide more robust data on the difference between ice use in urban and remote ATSI communities, and comparing use of ATSI and non-ATSI peoples. Taken together, this proposal provides a strong argument for its necessity.
  • 18. 15 References Adler, E., & Clark, R. (2011). An invitation to social research: How it’s done (4th ed.). Belmont, CA: Wadsworth. Australian Bureau of Statistics. (2006). National Aboriginal and Torres Strait Islander Health Survey. (cat. no. 4715.0). Retrieved from http://www.abs.gov.au Australian Bureau of Statistics. (2008). National Aboriginal and Torres Strait Islander Social Survey.(cat. no. 4714.0). Retrieved from http://www.abs.gov.au Australian Bureau of Statistics. (2014). National Regional Profile: Palm Island. Retrieved from http://www.abs.gov.au Australian Institute of Health and Welfare. (2014). Illicit use of drugs (NDSHS 2013 key findings). Retrieved from http://www.aihw.gov.au/alcohol-and-other-drugs/ndshs /2013/illicit-drug-use/ Australian Institute of Health and Welfare. (2014). National drug strategy household survey; Detailed report 2013. Retrieved from http://www.aihw.gov.au Blue Moon Research and Planning. (2008). Patterns of use and harms associated with specific populations of methamphetamine users in Australia. Retrieved from https: //www.health.gov.au/internet/main/publishing.nsf/Content/B32EA1CE756C0B81CA 257BF0001E4499/$File/methamphetamine-users.pdf Bryant, J., Ward, J., Wand, H., Byron, K., Bamblett, A., Waples-Crowe, P., Betts, S., Coburn, T., Delaney-Thiele, D., Worth, H., Kaldor, J., & Pitts, M. (2015). Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia. Drug and Alcohol Review, 34(1), p. 1-9. doi: 10.1111/dar.12320 Bryman, A. (2008). Social research methods (3rd ed.). Oxford, UK: Oxford University Press.
  • 19. 16 Clough, A., & Conigrave, K. (2008). Managing confidentiality in illicit drugs research: Ethical and legal lessons from studies in remote Aboriginal Communities. Internal Medicine Journal, 38, 60-63. doi: 10.1111/j.1445-5994.2007.01539.x Clough, A., d’Abbs, P., Cairney, S., Gray, D., Maruff, P., Parker, R., & O’Reilly, B. (2004). Emerging patterns of cannabis and other substance use in Aboriginal communities in Arnhem Land, Northern Territory: A study of two communities. Drug and Alcohol Review, 23(4), 281-390. Retrieved from http://www.citeseerx.ist.psu.edu Clough, A., Guyula, T., Yunupingu, M., & Burns, C. (2002). Diversity of substance use in eastern Arnhem Land (Australia): Patterns and recent changes. Drug and Alcohol Review, 21, 349-356. doi: 10.1080/0959523021000023207 Clough, A., Lee, K., Cairney, S., Maruff, P., O’Reilly, B., d’Abbs, P., & Conigrave, K., (2006). Changes in cannabis use and its consequences over three years in a remote Indigenous population in northern Australia. Addiction, 101, 696-705. doi; 10.1111/j.1360-0443.2006.01393.x Clough, A., Robertson, J., Fitts, M., Lawson, K., Bird, K., Hunter, E., Bynther, B., & Obrecht, K. (2015). Impacts of meth/amphetamine, other drug and alcohol use in rural and remote areas of northern and north-east Queensland: An environmental scan. Submitted for publication. Commonwealth of Australia. (2015). Final report of the National ice Taskforce. Retrieved from http://www.dpmc.gov.au Delahunty, B. & Putt, J. (2006). Policing implications of cannabis, amphetamines and other illicit drug use in Aboriginal and Torres Strait Islander communities. Monograph Series No. 15. Retrieved from http://www.aic.gov.au
  • 20. 17 Donovan, R. & Spark, R. (1997). Towards guidelines for survey research in remote Aboriginal communities. Australia and New Zealand Journal of Public Health, 21(1), 89-95. doi: 10.1111/j.1467-842X.1997.tb01660.x Hagan, F. (2010). Research methods in criminal justice and criminology (8th ed.). Columbus, OH: Prentice Hall. Madigan, M. (2015, September 10). Ice drug horror: epidemic the focus of Brisbane conference. The Courier Mail. Retrieved from http://www.couriermail.com.au Moffitt, T. (1993). Adolescence-limited and life-course-persistent antisocial behavior: A developmental taxonomy. Psychological Review, 100(4), 674-712. National Aboriginal and Torres Strait Islander Legal Services, (2015). Submission to the inquiry on crystal methamphetamine (ice). Retrieved from http://www.natsils.org.au/ portals/natsils/NATSILS%20Submission%20Ice%20docx.pdf?ver=2015-07-16- 111800-333 National Drug Research Institute. (2015). Responding to methamphetamine use and related harms in Australia: A submission to the parliamentary joint committee on law enforcement’s inquiry into crystal methamphetamine (ice). Retrieved from http:// www.aph.gov.au/DocumentStore.ashx?id=9fb97183-edc3-46e8. National Health and Medical Research Council. (2012). Ethical issues in research into alcohol and other drugs: An issues paper exploring the need for a guidance framework. Retrieved from http://www.nhrmc.gov.au Neuman, W. L. (1997). Social research methods: Qualitative and quantitative approaches (3rd ed.). Boston, MA: Allyn and Bacon. New South Wales Health. (2015). Crystalline methamphetamine background paper: New South Wales data. Retrieved from http://www.health.nsw.gov.au
  • 21. 18 Putt, J., & Delahunty, B. (2006). Illicit drug use in rural and remote Indigenous communities. Trends and Issues in Crime and Criminal Justice, 322, 1-6. Retrieved from http://www.aic.gov.au Queensland Government. (2015). Palm Island. Retrieved from http://www.qld.gov.au/atsi /cultural-awareness-heritage-arts/community-histories Saulo, D. (2015). First national survey of Aboriginal and Torres Strait Islander people aged 16-29yrs related to STI’s and BBV’s knowledge risk beh and health services access. Paper presented at the National Methamphetamine Symposium convened by the National Centre for Education and Training on Addiction and held in Melbourne, 12 May, 2015. Retrieved from http://www.nceta.flinders.edu.au Williams, K. (2012). Textbook on criminology (7th ed.). Oxford, UK: Oxford University Press. Youth off the Streets. (2015). Submission to the parliamentary joint committee on law enforcement on crystal methamphetamine inquiry. Retrieved from http://www.aph. gov.au/DocumentStore.ashx?id=e1383ed4-f2d9-4ffd
  • 22. 19 Appendix A Participant Consent Form Ethics Committee Approval Number: Project Title: Researcher: Aim of the research: We want to know about crystal methamphetamine (ice) use so people will be able to get proper help when they need it. I would like to ask you for your permission to participate in the research project. 1. Method: Your involvement in this research project will involve -  Stating whether or not you have ever used crystal methamphetamine (ice)  If you do use ice, how often you use  If you do use ice, how you take it  If you do use ice, how much you use  Any negative mental health problems you have noticed because of your ice use 2. Information sought: What we ARE NOT trying to find out -  Who is selling ice  Who is buying ice for the people who sell it (ie trafficking)  Who may have sold ice in the past  Who may have bought ice in the past  Crimes that may be under investigation by police  Crimes that have not been heard in the court
  • 23. 20 What we ARE trying to find out -  How many people are using ice  How much people use and how often they use  How they take ice when they use it  Whether using ice has had any bad effects on their health 3. Voluntary Participation Your participation in the research is entirely voluntary. If you DO NOT WISH to take part in the interview/survey, you ARE NOT required to. If you give your consent and change your mind later, you are welcome to stop the survey at any time you wish. You ARE NOT under any obligation to answer ANY questions asked in the survey, and you are free to refuse to answer any questions you do not wish to answer. If you have any questions about this research, you are welcome to contact the researcher: (Names of researchers’) (Researchers’ university/faculty) (address) (contact telephone) Participant:  I have read the consent form and the nature and aim of the research has been clearly explained to me.  I understand the aim of the research and my participation in it.  I understand that I am able to withdraw from the study at any point.  I understand information obtained from the study may be published, and that the information I give will remain anonymous and confidential.
  • 24. 21 I (full name) ___________________________________________________________________________ of (address) ___________________________________________________________________________ consent to participating in this study ___________________________________________ ___________________ (Signature) ______/______/______ (Date)
  • 25. 22 Appendix B Table 1B Palm Island eligible population and sample size (N = 100) Age Tot pop. F no. M no. F % M % N tot. n F n M 18-24 361 171 190 47 53 33 16 17 25-29 194 102 92 53 47 18 10 8 30-34 162 78 84 48 52 15 7 8 35-39 172 78 94 45 55 16 7 9 40-44 194 103 91 53 47 18 10 8 Total 1083 532 551 n/a n/a 100 50 50
  • 26. 23 Appendix C Pilot Survey Sample Questions 1. Have you ever used ice in your life? (please tick appropriate box) Yes No 2. If you have used ice, how often do you take it? (please tick one box) At least once a week At least once a month At least once every 3 months At least once every 6 months At least once every twelve months Less than once a year Rather not say Can’t remember/not sure 3. When you do use ice, how do you mostly take it? (please tick one box) Snort it Inject it Smoke it on top of a marijuana cone Smoke it in a glass pipe Smoke it in a light bulb Smoke it on aluminium foil Eat it Other Rather not say
  • 27. 24 4. When you take ice, how much do you usually take at one time? (please tick one box) Please ask the researcher to see pictures of amounts if you are unsure Less than one point One to less than two points Two to less than three points Three points or more Not sure Rather not say 5. Have you noticed any negative (bad) psychological effects from taking ice? (please tick all that apply) Please ask the researcher if you unsure what any of these mean Sleeping problems Feeling more angry than usual Anxiety Panic attacks Feeling violent (wanting to do things that would hurt other people) Hallucinations (seeing or hearing things that aren’t there) Trouble remembering things (memory problems) Paranoia (thinking someone is out to ‘get you’) Suicidal thoughts (wanting to hurt or kill yourself) Other (please provide a description of the problem/s)
  • 28. 25 Appendix D Project Plan: Gantt Chart STAGE TASK Mar Apr May Jun July Aug Sept Oct Nov Planning Literature Review Submit ethics application Ethics committee meeting/approval Project plan: design, sample etc. Palm Island community consult. Design survey Advertise for research assistant/s Data collection Interviews/survey administration Data analysis Codify survey data Quantitativedata analysis Writing up Prepare research report