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Attendees at the 2018 CDAT Conference had the opportunity to ask live questions during presentations. We received a lot of questions and were not able to answer them all, so please do get in touch if you have anything you would like to discuss with the team. Below are some of the questions and their responses:
Can’t you get caught in the ‘evidence trap’ when trying to be innovative? And are non-evidence based interventions just hard to design and measure, rather than truly not effective?
We often work from an evidence-informed, rather than evidence-based perspective as there may not be previous examples of your specific intervention being successful.
An example of an evidence-informed approach can be found in the Good Sports program. Initially, there was no evidence to support AOD harm reduction via sporting clubs, however, there was evidence to support better control of alcohol sales to prevent alcohol-related harm (i.e. no sales to people under 18, no sales to people who were drunk, service of food). Using this information, the ADF could experiment with a prevention-based intervention on a national level in sporting clubs, and the success of Good Sports now provides the evidence-based information for further work in this space.
Evidence-informed interventions provide an opportunity to collect new evidence in the space you are working in. It is important to consider how you can contribute to the evidence-base in the future – so setting up measurable and specific objectives/outcomes is a good way to build on this.
What have we learned from other countries where drugs have been decriminalised, and how does it benefit us to keep them illegal?
Several countries have decriminalised drug use, including Portugal which has seen little or no increase in drug use, more people with drug problems have entered treatment, while far fewer people are caught up in the prison system due to possession or use of drugs. They are clearly benefits. Why hasn’t Australia done that? This is a political question and one answer is that neither Australian politicians or the public have been convinced that decriminalisation is worthy of pursuing or would work in Australia. That may be due to a fear of the effects of illicit drugs, a belief that drug use is immoral, or dangerous and possibly a belief that the public would not accept a change to the drug law.
How is making alcohol more expensive going to help? We tried this with cigarettes and it doesn’t seem to have worked.
Price has been shown to be a major influence on drinking rates. As the price of alcohol rises, overall consumption declines, and consumption increases when the price decreases. This relationship applies to the heaviest and problematic drinkers who typically purchase the cheapest forms of alcohol.
We are confident that increasing the price of alcohol per standard drink will decrease consumption and decrease the amount of intoxication and the harms especially among heavy drinkers.
An example of this in practice is demonstrated in a recent case study from Canada: In the province of Saskatchewan in 2012, the minimum price of alcohol which it controlled by the liquor authority was increased by 10%. It was followed by decreased consumption of beer by 10.06%; decrease of spirits by 5.87%; decrease in wine by 4.58%; decrease of coolers by 13.2%; decrease of cocktails by 21.3%; decrease in liqueurs by 5.3%, and overall of all alcoholic beverages by a combined 8.43%.
Price increases have also worked with tobacco. Tobacco smoking has plummeted in recent decades and price increase is judged to be the main contributor to that result.
You can find more detailed information on the link between higher price and lower smoking and alcohol rates in the following studies:
How can we ensure that rural areas are included in surveys and toolkits?
Qualitative and quantitative national surveys quoted by Luke, Annie and Geoff in the plenary session like the Household Survey and the Secondary School Students survey are valid reliable data sets which are broadly representative across the nation with clearly described sample sets. Rural and regional populations are fairly included in data collection though there will always be individual variation when looking at particular locations.
Where can we access toolkits such as the one on liquor licensing, and what are the other toolkits available?
Toolkits can be accessed and downloaded from the CDAT area of the ADF website, including the one on Liquor Licensing, as well as toolkits on Using Social Media and Recruiting and Maintaining Volunteers.
How do we do collective impact, particularly without financial resources? Is collaboration for impact about having small communities agree to work with larger communities?
The opportunity for small and large communities to work together on Collective Impact (CI) projects is an option, but not a necessity. The process for setting up CI projects is outlined on the CI Australia website.
What are sources for recent information on short and long-term health effects of alcohol?
These are some sources of recent information on the effects of alcohol:
Alcohol intervention needs the backing of local Koori organisations. Can you provide successful examples of this across NSW and Australia?
You can find many successful examples in the Programs and Projects section of the Australian Indigenous Alcohol and Other Drugs Knowledge Centre
The Aboriginal Health & Medical Research Council is also a good resource as it provides “advice about and endorse[s] arrangements and structures for Aboriginal community control of Aboriginal health and wellbeing related research and evaluation”. They work primarily in NSW and endorsement form that can include letters of support for projects “where Aboriginal community advice and support is sought and where there are appropriate Aboriginal Community Governance measures in place”
Alcohol consumption in 12-17 year-olds dropped to 15%, but guidelines say it should be 0%. What are we doing wrong?
Nothing! No public health program provides instant results and no laws are ever 100% adhered to.
How do we break the cycle of peer pressure and/or peer worship with alcohol consumption?
Creating strong, supportive, and inclusive social environments for young people is important in combatting peer pressure (e.g. sports clubs, dance and theatre clubs, youth centres), as they introduce young people to the idea of social engagement and enjoyment without the influence of substances.
Ensuring that there is strong role modelling by authority figures within these environments is also essential (e.g. sports coaches, community leaders, teachers and parents). Role modelling has been demonstrated as a key way of breaking the cycle of peer pressure and worship associated with alcohol consumption.
For more information on young people and alcohol, follow this link.
What are examples of group program interventions being facilitated within CDAT communities?
There are a number of examples from CDATs across NSW doing and supporting group program interventions, which include Girls @ the Gym – a women/girls group that provides free transport, gym fees, gym gear and education/information to support healthy choices, nutrition and AOD primary prevention messages. This is an ongoing project in a Northern NSW CDAT which has a strong focus on strengthening well-being among women/girls and addresses key AOD protective factors.
Another relevant group intervention would be one of the award winners at the conference who ran the MyFEST Extreme Arts Youth Festival. This was led by local high school’s students and provided youth in the area an outdoor music festival and workshops around cultural dance, drama classes, poetry slam and parkour.
More traditional group intervention programs are also facilitated and funded by numerous CDATs in partnership with organisations like Family Drug Support. Through their Stepping Stone program, many CDATs have been able to set up family support groups in their areas which meet on a fortnightly or monthly basis. This is a group intervention directly targeting parents and relatives of people who have problems with alcohol and other drugs.
I would suggest you download the 2017 Grant Report (can be found on this page, under the heading Projects), which contains a list of all the most recent grants awarded in late 2017 along with a short description/summary of what they are doing throughout the following 12 months. You will undoubtedly find other examples of group interventions but you will also find other types of primary prevention activities which will hopefully inspire both yourself but also others who are reading this.
Can ADF assist to connect CDATs to researchers for specific areas with AOD issues outside national statistics?
Yes, we can. However, we would be better placed to support the translation of research into practice.