Community Alcohol Research Articles

EVALUATING COMMUNITY DEVELOPMENT PROGRAMS FOR HEALTH PROMOTION: PROBLEMS ILLUSTRATED BY A NEW ZEALAND EXAMPLE

This paper illustrates problems in the evaluation of community development programs for health promotion. It is based on the authors' retrospective process evaluation of the Wanganui Community Alcohol Action Program (WCAAP), a recent example of a health promotion program directed at reducing alcohol‐related problems in a small New Zealand town. Described by its designers as a community‐based program, it included coordination of community organizations, education, publicity and increased enforcement of drinking laws. Discussion of the problems in the evaluation of such programs puts them within the context of the substantial body of previous social science research in both evaluation and community development. This, it is argued, is a body of knowledge with which health promotion researchers need to be conversant. Community development programs usually stem from a process of negotiation between interest groups with differing objectives. This results in a changing definition of both the problem to be solved and the nature of the solution, making evaluation difficult. Community development is also likely to be seen as a new solution providing a panacea for old problems. This can lead to such programs being too ambitious. From the point of view of experimental design these programs are likely to have a number of technical problems. This paper argues that these problems are so significant that it is often unwise to attempt large scale evaluations of community development programs. Rather, attention should be concentrated on critically assessing the policy‐making process and disseminating previous knowledge about such programs.

Alcohol and Drug Abuse Prevention in Wisconsin Public Schools

This survey assessed the status of Wisconsin public school district programs designed to prevent alcohol and other drug related problems among students. The assessment involved surveying prevention program directors of 102 school districts that received grants for prevention initiatives since 1981. Most districts (70%) implemented programs at the elementary, middle, and senior high school levels. Typical program strategies involved combining information dissemination with refusal skill and self-concept development. School programs predominantly were school-based and did not systematically involve community members or agencies. The greatest obstacles to providing effective prevention services include high rates of alcohol and other drug use in homes and communities, denial of alcohol and other drug related problems among students, parents, and community members, and lack of staff time for prevention activities. Project directors indicated a need for schools to initiate greater involvement of parents, nonschool alcohol and drug abuse prevention agencies, and other community organizations in school efforts.

Data Note-15. Alcohol and tobacco tax in the European Community.

Data Note-15. Alcohol and tobacco tax in the European Community.

Isligton HA aims to set up alcohol help system.

Building up a community alcohol team and establishing closer links with accident and emergency staff are two of the current aims of Ralph MacCormack, Islington Health Authority's Senior Nurse Specialist on alcohol.

The liver and alcohol

Barely one quarter of the world's population consumes some four-fifths of the available alcohol. With the inexorable rise in world production it is not surprising that some communities are facing an explosive increase in alcohol-related problems. Yet, as Kreitman has pointed out [1], a great number of alcohol problems derive not from the hard core of very excessive and addicted consumers, with their very high risks, but from among the large 'middle-ground' of so-called moderate consumers, This fact serves to highlight the paradox for the hepatologist which, despite colossal endeavour, is still unanswered - namely: why do only a proportion of drinkers suffer from alcoholic liver disease (ALD)_ Although overall the level of consumption of alcohol in communities is determinative and risks rise with increasing daily consumption [2], factors other than alcohol itself are also clearly involved [3]. These factors doubtless include endogenous determinants (predisposition) and exogenous determinants (such as other hepatotoxins and possibly viral infections) [4].

Interview with Maxine Womble Regarding the National Black Alcoholism Council

Maxine Womble is the Chairperson for the National Black Alcoholism Council (NBAC), a voluntary, nonprofit organization which was incorporated in 1979. NBAC is dedicated to addressing the needs and concerns of Blacks through the promotion and support of activities aimed at the prevention and treatment of alcoholism. NBAC works with government agencies and private organizations as well as community groups and alcoholism professionals to facilitate alcoholism education and training in effective intervention and treatment modalities.

Reduction of community alcohol problems: computer simulation experiments in three counties.

A series of alcohol abuse prevention strategies was evaluated using computer simulation for three counties in the United States: Wake County, North Carolina, Washington County, Vermont and Alameda County, California. A system dynamics model composed of a network of interacting variables was developed for the pattern of alcoholic beverage consumption in a community. The relationship of community drinking patterns to various stimulus factors was specified in the model based on available empirical research. Stimulus factors included disposable income, alcoholic beverage prices, advertising exposure, minimum drinking age and changes in cultural norms. After a generic model was developed and validated on the national level, a computer-based system dynamics model was developed for each county, and a series of experiments was conducted to project the potential impact of specific prevention strategies. The project concluded that prevention efforts can both lower current levels of alcohol abuse and reduce projected increases in alcohol-related problems. Without such efforts, already high levels of alcohol-related family disruptions in the three counties could be expected to rise an additional 6% and drinking-related work problems 1-5%, over the next 10 years after controlling for population growth. Of the strategies tested, indexing the price of alcoholic beverages to the consumer price index in conjunction with the implementation of a community educational program with well-defined target audiences has the best potential for significant problem reduction in all three counties.

Is there a Better Word than ‘Craving’?

British Journal of AddictionVolume 82, Issue 1 p. 44-44 Free Access Is there a Better Word than ‘Craving’? Tim Stockwell, Community Alcohol Team, The 59 Centre, 59 Magdalen Street, Exeter, Devon, EX2 4HY, U.K.Search for more papers by this author Tim Stockwell, Community Alcohol Team, The 59 Centre, 59 Magdalen Street, Exeter, Devon, EX2 4HY, U.K.Search for more papers by this author First published: January 1987 https://doi.org/10.1111/j.1360-0443.1987.tb01435.xCitations: 7AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume82, Issue1January 1987Pages 44-44 ReferencesRelatedInformation

Depressed selenium and vitamin E levels in an alcoholic population

Serum selenium and vitamin E levels have been measured in subjects with established alcoholic liver disease, in alcoholics within the community, and in appropriate controls. Both serum selenium and vitamin E levels were shown to be significantly depressed (P less than 0.01) in the alcoholic study groups and serum selenium was more markedly depressed in subjects with established liver disease (controls, serum selenium 108 +/- 13 micrograms/liter, vitamin E 27.6 +/- 7.2 mumol/liter; community alcoholics, serum selenium 94 +/- 19 micrograms/liter, vitamin E 15.3 +/- 3.4 mumol/liter; alcoholic liver disease, serum selenium 78 +/- 15 micrograms/liter, vitamin E 14.7 +/- 5.6 mumol/liter). Depressed serum selenium levels correlated closely with poor nutritional status (r = 0.91). There were no changes in serum glutathione peroxidase activity. Liver disease activity, as judged by transaminase (AST), was more markedly abnormal in subjects with combined vitamin E and selenium deficiency compared to those with normal levels or isolated deficiencies (no deficiency, AST 48 +/- 19 units, combined deficiency, AST 75 +/- 21 units, P less than 0.03). Serum lipid peroxides were elevated in those with combined deficiency and the values correlated significantly with serum transaminases (r = 0.40, P = 0.03).

Understanding the Alcoholic in the Context of Community Consumption Patterns

Abstract: Community alcohol consumption in the Queensland mining town of Mt. Isa was studied in an attempt to establish drinking patterns and associated problems. Data were collected via morbidity and mortality records, surveys of general practitioners and hospital patients, a review of coroner's records, and case studies. Baseline data were established through a postal survey. Ten per cent of the population were considered to be drinking heavily or very heavily. An attempt was made to understand the place of alcohol in the social and cultural life of Mt. Isa.

The previous training and present training needs of nurses in charge of alcohol treatment units and community alcohol teams.

The aim of the study was to collect information on the educational needs of nurses in charge of alcohol treatment units and community alcohol teams. The sample of all such nurses in England and Wales was asked to complete a postal questionnaire and give information on the training and education they had already received, what further training they needed and brief details about their background and future plans. It was expected that a small proportion of the respondents would have had specialized training and this expectation was borne out. The results do provide evidence of considerable dissatisfaction amongst the group as to the training they receive. It is shown that these nurses wish to develop behavioural and psychotherapeutic skills and that training provided so far has not met these needs. Suggestions are made as to the content of future training events for nurses.

Cracking an old chestnut: is controlled drinking possible for the person who has been severely alcohol dependent?

British Journal of AddictionVolume 81, Issue 4 p. 455-456 Cracking an Old Chestnut: is controlled drinking possible for the person who has been severely alcohol dependent? TIM STOCKWELL, TIM STOCKWELL Community Alcohol Team, The 59 Centre, 59 Magdalen Street, Exeter EX2 4HY, Devon, U.K.Search for more papers by this author TIM STOCKWELL, TIM STOCKWELL Community Alcohol Team, The 59 Centre, 59 Magdalen Street, Exeter EX2 4HY, Devon, U.K.Search for more papers by this author First published: April 1986 https://doi.org/10.1111/j.1360-0443.1986.tb00355.xCitations: 21AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume81, Issue4April 1986Pages 455-456 RelatedInformation

Detoxification from alcohol at home managed by general practitioners.

General practitioners have an important role in identifying and responding to problem drinkers, but no study has attempted to document their use of detoxification at home. A questionnaire was mailed to all general practitioners in Exeter Health District (n = 168) that was concerned with how they managed patients who presented with problems related to alcohol. The 145 (86%) responses showed that collectively they were identifying many more cases of problem drinking than any other local treatment agency. Of the estimated 230 patients a year for whom detoxification was arranged, half were managed at home, 40% in a local psychiatric hospital, and 9% in a local general hospital. Of those who were managed at home, 38% were unsupervised, a close relative held the medication for 45%, and 17% were supervised by a nurse. Fifty six percent (81) of doctors favoured chlormethiazole (Heminevrin) treatment, and many (17%) were prepared to prescribe this for longer than 10 days. Three quarters of the respondents thought that there was a need for specialist community services, such as community alcohol teams, to support general practitioners by supervising detoxification at home.

The Community Alcohol Use Scale: a scale for use in prevention programs.

The Community Alcohol Use Scale (CAUS) was developed as a continuous, reliable, valid, and acceptable measure for primary prevention studies. Items were written following a comprehensive review of the literature on alcohol dependence and alcoholism. Based upon the responses of 315 respondents to the 100-item initial version of the scale, the 45-item CAUS was developed. The CAUS was then cross-validated on a local sample (n = 274) and a provincial sample (n = 745). Estimates of internal consistency were .91, .96, and .94, respectively, for the initial and cross-validation samples. Correlations of .48 and .69 were obtained between the CAUS and the Michigan Alcohol Screening Test for the initial and local cross-validation samples. In the provincial cross-validation sample a correlation of .62 was obtained between the CAUS and the Usual Weekly Alcohol Index. Preliminary cutting scores were developed to identify those at risk for alcoholism, and alcoholics. The CAUS has potential use as an evaluative and predictive instrument in a variety of primary prevention programs.

Book Reviews

Journal Article Book Reviews Get access Alcohol in the Professions , Le Clair Bissel and Paul W. Haberman , New York , Oxford University Press , 1984 . xvi+214 pp. £28.50. STEPHEN GREEN STEPHEN GREEN Director Norfolk Community Alcohol Services Search for other works by this author on: Oxford Academic Google Scholar The British Journal of Social Work, Volume 15, Issue 5, 1985, Pages 549–550, https://doi.org/10.1093/oxfordjournals.bjsw.a055149 Published: 01 September 1985

Alcohol Awareness Counselor Training: Utilizing a DWI Program

This article describes a cooperative effort of a community agency and a counselor education program in dealing with community alcohol problems. A DWI education and awareness program and a counselor training program in alcohol problems are presented. The training program uses students at four phases of development to counsel court‐referred clients. Each phase is described in terms of goals, activity, feedback focus, and expected outcome. This program provides benefits for all involved: (a) students have real‐life counseling experiences, (b) the agency maintains contact and uses the resources of university programs, and (c) the university has the opportunity to respond to a current issue in the community.

WERNICKE'S ENCEPHALOPATHY IN ALCOHOLISM: TOWARDS A BETTER PERSPECTIVE BY COMPARISON WITH A DEFINED POPULATION GROUP

SUMMARYComparison with a selected group of alcohol-using patients has allowed clear definition of the characteristic features of subjects with Wernicke's encephalopathy. The majority were unemployed Australian men with a very high alcohol intake, thiamin deficiency and abnormal liver function tests. Gross nutritional status ranged from obesity to protein-energy malnutrition.Ophthalmoplegia, nystagmus, abnormal c-ordination and peripheral neuropathy clearly differentiated patients with Wernicke's encephalopathy from other alcohol users. Brain atrophy, Korsakoff's psychosis and alcohol-related dementia were present in 100%, 100%, and 30% of tested subjects with Wernicke's encephalopathy, a much higher incidence than in hospital patients.As the first preventative measure, the importance of reducing community and individual alcohol consumption is stressed. There is very inadequate evidence at present to support the addition of thiamin to beer in the prevention of the relatively few cases of Wernicke's encepha...

Alcoholism outreach in single room occupancies.

Alcoholism flourishes in the community occupying single room occupancy (SRO) dwellings on Manhattan's west side. Individuals in this setting have few social resources and by reason of background and deprivation are inhibited from seeking help for their alcoholism. Consequently a direct in-person outreach approach is required in order to effect treatment. The milieu is rife with physical and psychological threats to occupants. These present unique challenges to the community alcoholism counselor who, as a member of an interdisciplinary community mental health treatment team, seeks to intervene. Counselor is viewed by client as an intruder in the environment. Breaking the isolation in which the client is immersed and developing a bond with him becomes the most immediate and most difficult of the several tasks facing the counselor.

Treatment of strategies in an urban Indian alcoholism program.

her complicated because of difficulty in defining the nature, or even the size, of the problem. Research literature concerning the definition, etiology, dynamics, assessment and treatment of alcoholism among American Indians is abundant but of unequal quaL ity and questionable usefulness. No single agency or organization collects or has access to information on alcohol use among native peoples. Only on the Pine Ridge and Makah Reservations has an epidemiological survey of an entire tribal population been made regarding mental health and alcoholism (1). The native peoples of North America are a heterogeneous population with diverse cultures, attitudes and religious persuasions in which alcohol has a number of uses and meanings. In response to this diversity, as well as to the overwhelming need in local Indian communities, over a hundred new Indian-run alcoholism treatment programs have developed since the American Indian SelfDetermination Act of 1975. Few of these programs have reported their treatment approaches or have investigated the effectiveness of tribal-specific treatment of Indian problem drinkers. This paper examines the relationship between treatment approaches used in the Seattle Indian Alcoholism Program and treatment outcome. The program was established by the local Seattle Indian community and is recognized by both Indian and nonIndian community alcoholism treatment agencies as a successful program. This survey may aid other alcoholism treatment programs that are attempting to provide treatment, education and support to Indian alcoholics.

Social ecology: a method for evaluating groups.

The applicability of social ecology as a means to evaluate psychotherapy groups is discussed by means of a case example. A Couples' Growth in a community alcohol treatment programme was used to demonstrate a social ecological approach to the assessment and description of groups. Members' and leaders' perceptions of the group's social environment, as well as perceptions of an ideal group, were determined via a recently developed Group Environment Scale. This assessment pointed to areas of discrepancies, and the results were validated in a "group feedback session". Systematic data on the social ecology of groups will enable clinicians to better evaluate and describe this treatment setting in which behaviour change is being attempted.