Exploring gendered differences among polish migrants in the UK in problematic drinking and pathways into and through alcohol treatment.

Few studies have focused on the gendered differences amongst Polish migrants in their use of alcohol or access to treatment services. This study explored the divergent pathways through alcohol use, misuse and treatment access in a group of Polish migrants in London. Using an intersectionality framework we examine the ways that social attitudes toward gender in both communities and access to services related to migrant status and class are experienced. With a view to informing treatment services we discuss how a better understanding of these pathways, and the factors likely to influence them, can be used to address challenges experienced by Polish migrant women with problematic alcohol use.

Patterns in Reduction or Cessation of Drinking in Australia (2001-2013) and Motivation for Change.

AIMS: This paper examines: (a) change over time (2001-2013) in recently reducing or ceasing drinking in the Australian population and (b) the reasons given for reducing or ceasing drinking in the most recent survey (2013); stratified by sex and age group. SHORT SUMMARY: Rates of reducing and ceasing drinking increased between 2001 and 2013 in Australia. Young people were more likely to modify drinking due to lifestyle and enjoyment reasons; older groups were more likely to report health reasons. These trends contribute to the broader context of declining alcohol consumption in Australia. METHODS: Data are from five waves of the National Drug Strategy Household Survey (N = 119,397). Logistic regression models with interaction terms were used to identify a shift in sex or age over time in predicting reduction or cessation of drinking and to predict motivations for reducing or ceasing drinking by sex and age. RESULTS: Reports of recently reducing the quantity or frequency of drinking increased from 2001 to 2007 and remained stable between 2007 and 2013. There was a steady increase in the number of Australians reporting recently ceasing drinking from 2001 to 2013, with a significant effect for age (younger groups more likely than older groups to cease drinking in the past two waves). Reasons for reducing or ceasing drinking varied by age, with older people more likely to report health reasons and younger people more likely to report lifestyle reasons or enjoyment. CONCLUSION: Increases over time in reports of reduction or cessation of drinking due to health, lifestyle, social and enjoyment reasons suggest that the social position of alcohol in Australia may be shifting, particularly among young people.

The role of training in IBA implementation beyond primary health care settings in the UK.

There has been a considerable drive to encourage a wide range of professional groups to incorporate alcohol screening (or identification) and brief advice (IBA) into their everyday practice. This article aims to examine the role of training in promoting IBA delivery in contexts outside primary care and other health settings. The data are drawn mainly from a structured online survey supplemented by illustrative material from nine qualitative interviews and insights from an expert workshop. Findings support the results from other research that issues relating to role relevance and role security continue to act as barriers to professional change. Furthermore, issues of organisational commitment and organisational barriers are insufficiently addressed in strategy to promote wider use of IBA. The article concludes that development of appropriate training for alcohol IBA needs to take account of the role of IBA within a complex interactive system of related services and help seeking pathways and consider how training can contribute to changing both professional attitudes and behaviours and organisational approaches to implementing and sustaining IBA in everyday professional practice.

Delivering alcohol Identification and Brief Advice (IBA) in housing settings: A step too far or opening doors?

Within the UK, there is a drive to encourage the delivery of alcohol screening (or identification) and brief advice (IBA) in a range of contexts beyond primary care and hospitals where the evidence is strongest. However, the evidence base for effectiveness in non-health contexts is not currently established. This paper considers the case of housing provided by social landlords, drawing on two research studies which were conducted concurrently. One study examined the feasibility of delivering alcohol IBA in housing settings and the other the role of training in delivering IBA in non-health contexts including housing. This paper draws mainly on the qualitative data collected for both studies to examine the appropriateness and feasibility of delivering IBA in a range of social housing settings by the housing workforce. Findings suggest that while it is feasible to deliver IBA in housing settings, there are similar challenges and barriers to those already identified in relation to primary care. These include issues around role inadequacy, role legitimacy and the lack of support to work with people with alcohol problems. Results indicate that the potential may lie in focusing training efforts on specific roles to deliver IBA rather than it being expected of all staff.

The alcohol improvement programme: evaluation of an initiative to address alcohol-related health harm in England.

AIMS: The evaluation aimed to assess the impact of The Alcohol Improvement Programme (AIP). This was a UK Department of Health initiative (April 2008-March 2011) aiming to contribute to the reduction of alcohol-related harm as measured by a reduction in the rate of increase in alcohol-related hospital admissions (ARHAs). METHODS: The evaluation (March 2010-September 2011) used a mix of qualitative and quantitative methods to assess the impact of the AIP on ARHAs, to describe and assess the process of implementation, and to identify elements of the programme which might serve as a 'legacy' for the future. RESULTS: There was no evidence that the AIP had an impact on reducing the rise in the rate of ARHAs. The AIP was successfully delivered, increased the priority given to alcohol-related harm on local policy agendas and strengthened the infrastructure for the delivery of interventions. CONCLUSION: Although there was no measurable short-term impact on the rise in the rate of ARHAs, the AIP helped to set up a strategic response and a delivery infrastructure as a first, necessary step in working towards that goal. There are a number of valuable elements in the AIP which should be retained and repackaged to fit into new policy contexts.

Substitution treatment in the era of "recovery": An analysis of stakeholder roles and policy windows in Britain.

Based on documentary analyses and interviews with twenty key informants in 2012, this paper analyses the shift in British drugs policy towards "recovery" from the perspectives of major stakeholders. The processes involved in reopening the debate surrounding the role of substitution treatment and its re-emergence on to the policy agenda are examined. Drawing on Kingdon's work on agenda-setting, the ways in which methadone maintenance was challenged and defended by key stakeholders in the initial phase of policy development and the negotiation of a "recovery" focus as the organizing concept for British drugs policy are explored. Study limitations are noted.

Examining trends in the representation of young people and alcohol in Australian newspapers over twenty years (2000-2019).

BACKGROUND: The news media can reflect and influence public opinion, as well as affect individual practice. In the context of significant changes in alcohol consumption among young people over the past twenty years, we examined Australian newspaper reporting of young people (under 18 years) and alcohol to assess whether there have been changes over time in the content and slant of articles that reflect or elucidate these trends. METHODS: Factiva was used to search newspaper articles from major Australian newspapers over a twenty year period (2000-2019). After screening, two researchers coded 2415 newspaper articles across four key domains: article type, article theme, sources cited and topic slant (e.g. approving, disapproving tone). Change over time across the study period was assessed using joinpoint Poisson regression analyses. RESULTS: There was a significant increase in articles on young people and alcohol between 2000 and 2008, before a corresponding decrease to 2019. Policy or prevention strategies were the most common theme of articles (35.8%), followed by articles reporting on risks or harms associated with alcohol use for young people (18.1%). Researchers were the most common source reported (25.1%), followed by politicians (19.0%). Three quarters of articles (75.9%) had a socially disapproving topic slant, which increased significantly up until 2011, with a corresponding decrease thereafter. CONCLUSION: Attention to, and problematisation of, young people and alcohol increased in the first decade of this millennium which may have acted to sustain or accelerate declining drinking trends. However, this dissipated back to baseline levels in the second decade, which may indicate a lag time in recognition of young people's drinking becoming less of a public health 'problem'.

Declining drinking among adolescents: Are we seeing a denormalisation of drinking and a normalisation of non-drinking?

BACKGROUND: In the early 2000s, alcohol use among young people began to decline in many western countries, especially among adolescents (ages between 12-17 years old). These declines have continued steadily over the past two decades, against the backdrop of much smaller declines among the general population. ARGUMENT: Hypotheses examining individual factors fail adequately to provide the necessary 'big picture' thinking needed to understand declines in adolescent drinking. We use the normalisation thesis to argue that there is strong international evidence for both processes of denormalisation of drinking and normalisation of non-drinking occurring for adolescents in many western countries. CONCLUSIONS: Research on declining adolescent drinking provides evidence of both denormalisation of alcohol consumption and normalisation of non-drinking. This has implications for enabling policy environments more amenable to regulation and increasing the acceptability of non-drinking in social contexts. Normalisation theory (and its various interpretations) provides a useful multi-dimensional tool for understanding declines in adolescent drinking.

The role of Macmillan nurse tutors: an interview study with post-holders.

This article explores the role of Macmillan nurse tutors through in-depth, semi-structured tape-recorded interviews with 22 post-holders, focusing on their responsibilities, institutional affiliations and career aspirations. After full transcription, these qualitative data were subjected to open coding. Many tensions and variations within the role were revealed. However, these tutors appeared to be extremely committed to cancer and palliative care. They were concerned about how their future educational position would be maintained in a changing system of health care and health provision.

Networking health research in Britain: the post-war childhood leukaemia trials.

The treatment of childhood leukaemia is seen as a successful historical example of the operation of the randomized controlled trial and continues to inform contemporary policy making on such trials within health research. This article analyses the scientists' 'story of success' through historical research. It tells us about the organizational and professional structures of such research post-war in the United Kingdom, and examines the history of the cancer clinical trial through this particular example. The story reveals a more complex picture than the 'heroic' one, with key developments in the operation of post-war science, both in terms of its infrastructure and of its scientific networks, not least the rise of co-operative working among clinicians and the growing importance of statisticians in medical research and practice. It also underlines differences between the British and US approaches in which the role of one health system, the National Health Service, helped structure different, initially less intensive, patterns of response.