Barriers and facilitators to implementing a first managed alcohol program in Montreal, Canada
Bibliographic record
Abstract
Background Indigenous people experiencing homelessness, are disproportionately affected by the health risks associated with alcohol use. Managed alcohol programs (MAPs) are interventions that address alcohol use and homelessness by providing housing and regulated doses of alcohol. While research has shown MAPs to be beneficial, little is known about their implementation. Our paper addresses this gap by exploring the barriers and facilitators to implementing a MAP for Indigenous men in Montreal, Canada.Methods The study follows a qualitative approach. Semi-structured and informal interviews along with questionnaires were conducted with the program’s residents, staff and medical team members. The collected data were thematically analyzed.Results Participants identified barriers including resistance to adhering to the individualized alcohol plan, hostile behaviours and conflicts, loss of purpose and boredom, and staff workload and turnover. The facilitators reported were teamwork, flexibility, cultural safety, and trusting relationships.Conclusion Our findings about certain barriers, particularly hostile behaviours and conflicts, and staff workload and turnover, remain undocumented in the literature. Certain facilitators including flexibility, trusting relationships, and cultural safety merit further exploration. In offering a detailed description of the implementation of a MAP, we hope to inform policies supporting the dissemination of similar programs in other contexts.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".