What makes effective community action to reduce alcoholrelated harm

1
What makes effective community action (to reduce
alcohol-related harm)

• Sally Casswell

2
Acknowledgment of need for change at community
level

• At the heart of Community Action is the
  empowerment of communities, their ownership and
  control of their own endeavours and destinies
  (Ottawa Charter)
• Community (led) development
• Community engagement
• Social entrepreneurs, Social innovation
• how does this relate to community action?

3
What makes effective community action (to reduce
alcohol-related harm)

• A systems approach to implementing effective
  policy at the local level
• Works within a regulatory framework
• Responds to changed circumstances

4
Effective policy to reduce alcohol-related harm

• Restrict alcohol availability (minimum purchase
  age hours, days, density, clustering secondary
  supply)
• Manage the drinking context ( enforcement
  management policy security guards)
• Restrict marketing (global, national but also
  some local on premise and hoardings, price
  promotions and give-aways)
• Drinking Driving countermeasures (RBT sobriety
  checkpoints BAC levels visibility and certainty
  of detection)
• Early intervention (brief advice in range of
  contexts)
• Pricing policy

5
What makes effective community action (to reduce
alcohol-related harm)

• Requires paid co-ordination and networking to
  achieve evidence based objectives and add value
  to existing resource
• Community can be geographical or community of
  interest

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Alcohol Producer/ Marketers
Retail Sector
Reduce alcohol- related harm by implementing
policy and changing local environments
National policy development
Brokerage Evaluation Research
Alcohol CAP Worker NGO Iwi
Pan-Tribal
Funding Agency
7
Waikato Rural Drink Drive Project 1996 - 1999

• Funded by ALAC
• Objective to reduce rural drink driving
• rural dwellers disproportionately high in
  alcohol-related traffic crashes
• Original plan to involve grass roots community
• Seven local committees
• Small grants to apply for
• (Stewart and Conway(2000) Substance Use and
  Misuse)

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Waikato Rural Drink Drive Project 1996 - 1999
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Waikato Rural Drink Drive Project 1996 - 1999

• First Year
• Police increased enforcement CBT
• Booze Buses
• Increased funding
• One community grant given
• One community committee established
• North Waikato Project (meetings of key community
  people, including licensees, public / media
  event, poster and video competition)
• But became inactive
• Second Year . Based on formative evaluation
• Funded collation and timely distribution of last
  drink survey data
• Influence resistant licensees
• deployment of traffic enforcement resources
• Waka Taua Project
• Early Intervention Project

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Waikato Rural Drink Drive Project 1996 - 1999

• Reduction in fatalities (10pm 3am)
• Compulsory Breath Testing (CBT) - 22
• plus media -13
• plus booze buses and community action -27
• Cost benefit analysis of CBT showed benefit to
  government especially from comprehensive package
  (CBT, media, booze buses and community action)
• (Miller et al (2004) Accident Analysis and
  Prevention)
• Development of Alco-link

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Auckland region community action project on youth
drinking

• Co-operation between MoH funded alcohol workers
  in Auckland region .. with formative evaluation
  input
• Objectives
• To reduce social supply to under 18s
• To reduce access to off license purchases by
  under 18s
• To reduce on-licensed premise intoxication of
  under 35s
• To reduce drinking and intoxication in public
  places
• To influence/challenge existing social norms of
  alcohol use

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Pseudo patrons project
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Auckland region community action project on youth
drinking

• Auckland-wide 61 successful purchase without
  I.D.
• Active involvement of key stakeholders (police,
  health sector, local councils)
• Feedback to licensees
• Media publicity
• Community media, Maori media
• Minister of Justice

14
Auckland region community action project on youth
drinking

• Supermarkets
• Supervisor checks
• Licensing Trust
• Policy to ID anyone who looks under 25 years,
  till prompt to ask for ID, Security guards at
  higher risk premises, development of signage,
  internal pseudo-patron survey
• Police
• development of CPOs
• Sales without I.D.
• From 61 success to 56 in 2004 and 41 in 2005

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What makes effective community action (to reduce
alcohol-related harm)

• Set objectives and strategies evidence and local
  knowledge
• Change the environment to change the individual
• Think strategically and involve (only) relevant
  key partners
• Need for overlapping interests, payoff for all
  partners
• Formative evaluation is your (critical) friend
  and evidence is a tool
• Often the most effective initiative involves more
  effective use of existing resources (people paid
  to work on the issue)
• The success of any programme is reliant on the
  commitment of key people
• Be aware of the done to issue, honour your
  partnership commitment (including funders)
• Think sustainable