Effective vs. Popular: An analysis of local alcohol policies & prevention initiatives
Methods: Three methods were used: Following an initial extraction of 7,000 articles, 18 systematic reviews on alcohol prevention strategies were assessed; a survey of 36 public health units (PHU) was conducted via the PHU’s Medical Officer of Health; key informant interviews (KII) were conducted with 9 experts from alcohol or tobacco and results coded using NVivo 10 software.
Results: Seven policy interventions were assessed: pricing and taxation controls; regulating physical availability; marketing /advertising restrictions; modifying the drinking environment; drinking and driving countermeasures; education/ awareness-raising strategies; treatment / early intervention. The PHU survey and KII pointed to the importance of all 7 interventions; nevertheless, there was a contrast between evidence of systematic reviews and PHU activities. Pricing and taxation controls with extensive international evidence of effectiveness, was one of the least advocated policy measures by PHUs. In contrast education and awareness-raising strategies, with equivocal evidence of impact, was most highly-valued of the seven, commonly advocated and most often mentioned as the most important issue not currently addressed.
Conclusions/recommendations: Without wide public support for the most effective alcohol policies there are current limitations on local action. We recommend building capacity through training on comprehensive approaches, and demonstrating how effectiveness and scope of impact are important in strategic decisions on allocating resources and assigning priorities.
Learning Areas:Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health or related public policy
Assess the dichotomy between evidence based policy interventions to decrease alcohol related harms and interventions by Ontario Public Health Units. Identify barriers or challenges that public health units are experiencing that are resulting in a disconnect between the recommended evidence-based strategies/interventions and local public health action. Identify what a comprehensive public health approach to alcohol is and the related public health strategies that can be implemented at the local level which will result in a reduction in drinking that is in excess of the low risk drinking guidelines.
Keyword(s): Alcohol Use, Public Health Policy
Qualified on the content I am responsible for because: I have 15 years Public Health Experience, with involvement in several research projects related to chronic disease / injury prevention. I am Durham Region Health Department's lead manager for Alcohol Prevention. I was the co-lead of the LDCP research project. Among my professional interests has been identification of a comprehensive approach/ evidence-based Public Health strategies that will decrease alcohol consumption / alcohol related harms at the community level.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.