{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:00:42Z","timestamp":1790308842160,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Substance use and related mental illness contribute substantially to Australia's disease burden, with disproportionately high impacts in rural areas where access to specialist care is limited. Understanding local service challenges is critical to improving care delivery and guiding contextually relevant research. The aims of this study were to identify: (i) practice challenges; (ii) practice improvement priorities; and (iii) research priorities among rural drug and alcohol clinicians in Western NSW Local Health District.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A pragmatic qualitative study was conducted using structured focus groups informed by a modified Delphi approach. Three focus groups (two in\u2010person, one online) were held with 16 clinicians from diverse drug and alcohol programs. Discussions were guided by regional treatment data and a clinician workforce survey. Data were audio\u2010recorded, transcribed and analysed using deductive qualitative content analysis, with findings validated through participant member checking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four themes were identified. Service gaps and access barriers included fragmented mental health and drug and alcohol systems, transport limitations, stigma and cultural safety concerns for Aboriginal clients. Workforce and training needs reflected staff shortages, limited preparation for integrated care and insufficient support for vicarious trauma. Technology and innovation were viewed as promising, particularly telehealth, but were constrained by cost, policy and implementation uncertainty. Research priorities focused on developing and evaluating integrated care models, virtual and brief interventions, culturally responsive services, workforce wellbeing and social determinants including housing, transport and stigma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>Persistent structural and workforce challenges shape rural service delivery. Addressing these requires pragmatic, locally grounded research and stronger partnerships between health services and universities to support implementation of context\u2010specific solutions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70232","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T05:34:28Z","timestamp":1786167268000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Practice Challenges and Research Directions in Rural Drug and Alcohol Treatment: A Focus Group Study of Clinician Perspectives"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-5866","authenticated-orcid":false,"given":"Julaine","family":"Allan","sequence":"first","affiliation":[{"name":"Rural Health Research Institute Charles Sturt University  Orange Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Keniry","sequence":"additional","affiliation":[{"name":"School of Rural Medicine Charles Sturt University  Orange Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Eagle","sequence":"additional","affiliation":[{"name":"Western NSW Local Health District Drug and Alcohol Service  Orange Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stan","family":"Theodorou","sequence":"additional","affiliation":[{"name":"Western NSW Local Health District Drug and Alcohol Service  Orange Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Causes of Death, Australia, 2022","author":"Australian Bureau of Statistics","year":"2022"},{"key":"e_1_2_12_3_1","volume-title":"Health Expenditure Australia 2022\u20132023","author":"[A.I.H.W.]'","year":"2024"},{"key":"e_1_2_12_4_1","volume-title":"Alcohol and Other Drug Treatment Services in Australia: Early Insights","author":"Australian Institute of Health and Welfare [AIHW]'","year":"2024"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20457"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.11.029"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2021.108518"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13040999"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/psychoactives3020013"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-020-00588-8"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11852-z"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2023.208959"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11121786"},{"issue":"3","key":"e_1_2_12_14_1","first-page":"361","article-title":"Potential Factors Contributing to and Strategies for Reducing Implementation Science\u2010Practice Gap: A Discussion","volume":"4","author":"Younas A.","year":"2024","journal-title":"Global Implementation Research and Applications"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-11207-5"},{"issue":"11","key":"e_1_2_12_16_1","first-page":"S3","article-title":"Beyond the Black Stump: Rapid Reviews of Health Research Issues Affecting Regional, Rural and Remote Australia","volume":"213","author":"Osborne S. R.","year":"2020","journal-title":"Medical Journal of Australia"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2009.01262.x"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-07064-1"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2021.82.401"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajr.12655"},{"key":"e_1_2_12_21_1","first-page":"7751","article-title":"Translating Research Into Rural Health Practice: A Qualitative Study of Perceived Capability\u2010Building Needs","volume":"23","author":"King O. A. S. A.","year":"2023","journal-title":"Rural and Remote Health"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-023-01030-5"},{"key":"e_1_2_12_23_1","first-page":"27","volume-title":"Qualitative Research in Psychology: Expanding Perspectives in Methodology and Design","author":"Barker C.","year":"2021"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-021-00174-1"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/2059799120937242"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-6405.2009.00358.x"},{"key":"e_1_2_12_27_1","unstructured":"[AIHW] AIoHaW National Drug Strategy Household Survey 2019 2020."},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.52528"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.52525"},{"key":"e_1_2_12_31_1","unstructured":"I.Bourgeault R.Dingwall R.De Vries andS. E.Kelly Qualitative Interviewing Techniques and Styles."},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.5662\/wjm.v11.i4.116"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2022.08.014"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2020.103632"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732316654870"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.2196\/43303"}],"container-title":["Drug and Alcohol Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70232","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dar.70232","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70232","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:33:29Z","timestamp":1790307209000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dar.70232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":36,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/dar.70232"],"URL":"https:\/\/doi.org\/10.1111\/dar.70232","archive":["Portico"],"relation":{},"ISSN":["0959-5236","1465-3362"],"issn-type":[{"value":"0959-5236","type":"print"},{"value":"1465-3362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]},"assertion":[{"value":"2026-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70232"}}