Alcohol management plans in Aboriginal and Torres Strait Islander (Indigenous) Australian communities in Queensland: community residents have experienced favourable impacts but also suffered unfavourable ones

Alan R Clough,Michelle S Fitts,Valmae Ypinazar,Stephen A Margolis,Anthony Shakeshaft,Jan A Robertson,Adrian Miller,Katrina Bird,Simon Towle,Caryn West,Bronwyn Honorato,Robert Sanson-Fisher,David Martin,Christopher M Doran,Robyn Mcdermott

doi:10.1186/s12889-016-3995-8

Abstract

BackgroundIn Australia, ‘Alcohol Management Plans’ (AMPs) provide the policy infrastructure for State and Commonwealth Governments to address problematic alcohol use among Aboriginal and Torres Strait Islanders. We report community residents’ experiences of AMPs in 10 of Queensland’s 15 remote Indigenous communities.MethodsThis cross-sectional study used a two-stage sampling strategy: N = 1211; 588 (48%) males, 623 (52%) females aged ≥18 years in 10 communities. Seven propositions about ‘favourable’ impacts and seven about ‘unfavourable’ impacts were developed from semi-structured interviews. For each proposition, one-sample tests of proportions examined participant agreement and multivariable binary logistic regressions assessed influences of gender, age (18–24, 25–44, 45–64, ≥65 years), residence (≥6 years), current drinking and Indigenous status. Confirmatory factor analyses estimated scale reliability (ρ), item loadings and covariances.ResultsSlim majorities agreed that: AMPs reduced violence (53%, p = 0.024); community a better place to live (54%, 0.012); and children were safer (56%, p < 0.001). More agreed that: school attendance improved (66%, p < 0.001); and awareness of alcohol’s harms increased (71%, p < 0.001). Participants were equivocal about improved personal safety (53%, p = 0.097) and reduced violence against women (49%, p = 0.362). The seven ‘favourable’ items reliably summarized participants’ experiences of reduced violence and improved community amenity (ρ = 0.90).Stronger agreement was found for six ‘unfavourable’ items: alcohol availability not reduced (58%, p < 0.001); drinking not reduced (56%, p < 0.001)); cannabis use increased (69%, p < 0.001); more binge drinking (73%, p < 0.001); discrimination experienced (77%, p < 0.001); increased fines, convictions and criminal records for breaching restrictions (90%, p < 0.001). Participants were equivocal (51% agreed, p = 0.365) that police could enforce restrictions effectively. ‘Unfavourable’ items were not reliably reflected in one group (ρ = 0.48) but in: i) alcohol availability and consumption not reduced and ii) criminalization and discrimination.In logistic regressions, longer-term (≥ 6 years) residents more likely agreed that violence against women had reduced and that personal safety had improved but also that criminalization and binge drinking had increased. Younger people disagreed that their community was a better place to live and strongly agreed about discrimination. Current drinkers’ views differed little from the sample overall.ConclusionsThe present Government review provides an opportunity to reinforce ‘favourable’ outcomes while targeting: illicit alcohol, treatment and diversion services and reconciliation of criminalization and discrimination issues.

Highlights

In Australia, ‘Alcohol Management Plans’ (AMPs) provide the policy infrastructure for State and Commonwealth Governments to address problematic alcohol use among Aboriginal and Torres Strait Islanders
For Indigenous populations living in remote parts of the western United States [1, 2] and Alaska [3,4,5,6,7,8], northern Canada [9, 10], Greenland [11], and in rural [12,13,14] and remote [15,16,17,18,19,20,21] Australia, robust legal and regulatory interventions to address alcohol misuse and associated harms have been shown to have mainly positive effects
In Australia, for Indigenous (Aboriginal and Torres Strait Islander) populations living in remote areas, regulatory interventions known as ‘Alcohol Management Plans’ (AMPs) have been used by State and Commonwealth Governments during the past two decades [22, 23]

Summary

Introduction

In Australia, ‘Alcohol Management Plans’ (AMPs) provide the policy infrastructure for State and Commonwealth Governments to address problematic alcohol use among Aboriginal and Torres Strait Islanders. In Australia, for Indigenous (Aboriginal and Torres Strait Islander) populations living in remote areas, regulatory interventions known as ‘Alcohol Management Plans’ (AMPs) have been used by State and Commonwealth Governments during the past two decades [22, 23]. Police powers to search for and seize illicit alcohol were increased by the Queensland Government, and liquor outlets in the neighbouring towns within the very large, Government-defined ‘catchments’ of AMP communities became subject to ‘minimising harm’ provisions to prevent the sale of prohibited alcohol that could reach the ‘restricted areas’ [23]

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