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Special Issue "Alcohol and Health"

Special Issue Editors

Guest Editor
Prof. Dr. Eileen Kaner

Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
Website | E-Mail
Interests: alcohol; behavioural interventions; health inequalities; life course
Guest Editor
Dr. Amy O'Donnell

Institute of Health and Society, Newcastle Unviersity, Newcastle upon Tyne, UK
Website | E-Mail
Interests: alcohol interventions; implementation science; primary health care
Guest Editor
Prof. Dr. Peter Anderson

Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
Website | E-Mail
Interests: alcohol policy; alcohol epidemiology; primary health care; public health

Special Issue Information

Dear Colleagues,

Alcohol is the sixth leading global risk-factor for morbidity and premature death. The adverse health, social, and economic effects of excessive alcohol consumption are experienced not only by individual drinkers, but also often by other people in their immediate environment. Whilst the health impacts of risky dinking are felt across societies, some vulnerable groups are particularly affected including: Younger people, mainly due to the increased risk of alcohol-related injuries; the children of heavy drinking parents who can experience family disruption, child abuse and neglect; socio-economically deprived, minority ethnic groups and/or marginalised people who may not have the resources to buffer the effects of alcohol; and older individuals who develop co-morbidities, including mental health problems, that can require changes to patterns of drinking built up over many years. This complex, multilevel health and social care challenge demands a complex multilevel prevention and treatment response: A need reflected in  international policy guidelines, such as the World Health Organisation’s Global strategy to reduce harmful use of alcohol. Indeed, there is a large and robust evidence base to support a range of preventative strategies, from brief interventions to reduce problematic drinking, to pricing and taxation measures that help reduce overall consumption. However, much of this evidence is not put into practice and we wish to understand why. We would like to receive high quality primary research or reviews from around the world that reveal key evidence gaps covering under-researched groups or settings, under-specified intervention issues and key implementation challenges at both a practice and policy level. We also welcome work that highlights innovative approaches to reduce alcohol-related harms including community level actions, technological advancements and legislative levers to promote policy-level intervention.

Prof. Dr. Eileen Kaner
Dr Amy O'Donnell
Prof. Dr. Peter Anderson
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Alcohol interventions
  • Prevention
  • Equity
  • Alcohol policy
  • Social and contextual harm

Published Papers (9 papers)

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Research

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Open AccessArticle Mapping Patterns and Trends in the Spatial Availability of Alcohol Using Low-Level Geographic Data: A Case Study in England 2003–2013
Int. J. Environ. Res. Public Health 2017, 14(4), 406; doi:10.3390/ijerph14040406
Received: 18 January 2017 / Revised: 28 March 2017 / Accepted: 10 April 2017 / Published: 12 April 2017
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Abstract
Much literature examines the relationship between the spatial availability of alcohol and alcohol-related harm. This study aims to address an important gap in this evidence by using detailed outlet data to examine recent temporal trends in the sociodemographic distribution of spatial availability for
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Much literature examines the relationship between the spatial availability of alcohol and alcohol-related harm. This study aims to address an important gap in this evidence by using detailed outlet data to examine recent temporal trends in the sociodemographic distribution of spatial availability for different types of alcohol outlet in England. Descriptive analysis of measures of alcohol outlet density and proximity using extremely high resolution market research data stratified by outlet type and quintiles of area-level deprivation from 2003, 2007, 2010 and 2013 was undertaken and hierarchical linear growth models fitted to explore the significance of socioeconomic differences. We find that overall availability of alcohol changed very little from 2003 to 2013 (density +1.6%), but this conceals conflicting trends by outlet type and area-level deprivation. Mean on-trade density has decreased substantially (−2.2 outlets within 1 km (Inter-Quartile Range (IQR) −3–0), although access to restaurants has increased (+1.0 outlets (IQR 0–1)), while off-trade access has risen substantially (+2.4 outlets (IQR 0–3)). Availability is highest in the most deprived areas (p < 0.0001) although these areas have also seen the greatest falls in on-trade outlet availability (p < 0.0001). This study underlines the importance of using detailed, low-level geographic data to understand patterns and trends in the spatial availability of alcohol. There are significant variations in these trends by outlet type and deprivation level which may have important implications for health inequalities and public health policy. Full article
(This article belongs to the Special Issue Alcohol and Health)
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Open AccessArticle Are Brief Alcohol Interventions Adequately Embedded in UK Primary Care? A Qualitative Study Utilising Normalisation Process Theory
Int. J. Environ. Res. Public Health 2017, 14(4), 350; doi:10.3390/ijerph14040350
Received: 30 January 2017 / Revised: 21 March 2017 / Accepted: 24 March 2017 / Published: 28 March 2017
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Abstract
Despite substantial evidence for their effectiveness, the adoption of alcohol screening and brief interventions (ASBI) in routine primary care remains inconsistent. Financial incentive schemes were introduced in England between 2008 and 2015 to encourage their delivery. We used Normalisation Process Theory-informed interviews to
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Despite substantial evidence for their effectiveness, the adoption of alcohol screening and brief interventions (ASBI) in routine primary care remains inconsistent. Financial incentive schemes were introduced in England between 2008 and 2015 to encourage their delivery. We used Normalisation Process Theory-informed interviews to understand the barriers and facilitators experienced by 14 general practitioners (GPs) as they implemented ASBI during this period. We found multiple factors shaped provision. GPs were broadly cognisant and supportive of preventative alcohol interventions (coherence) but this did not necessarily translate into personal investment in their delivery (cognitive participation). This lack of investment shaped how GPs operationalised such “work” in day-to-day practice (collective action), with ASBI mostly delegated to nurses, and GPs reverting to “business as usual” in their management and treatment of problem drinking (reflexive monitoring). We conclude there has been limited progress towards the goal of an effectively embedded preventative alcohol care pathway in English primary care. Future policy should consider screening strategies that prioritise patients with conditions with a recognised link with excessive alcohol consumption, and which promote more efficient identification of the most problematic drinkers. Improved GP training to build skills and awareness of evidence-based ASBI tools could also help embed best practice over time. Full article
(This article belongs to the Special Issue Alcohol and Health)
Open AccessArticle Implementing a Public Health Objective for Alcohol Premises Licensing in Scotland: A Qualitative Study of Strategies, Values, and Perceptions of Evidence
Int. J. Environ. Res. Public Health 2017, 14(3), 221; doi:10.3390/ijerph14030221
Received: 31 December 2016 / Revised: 16 February 2017 / Accepted: 21 February 2017 / Published: 23 February 2017
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Abstract
The public health objective for alcohol premises licensing, established in Scotland in 2005, is unique globally. We explored how public health practitioners engaged with the licensing system following this change, and what helped or hindered their efforts. Semi-structured interviews were conducted with 13
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The public health objective for alcohol premises licensing, established in Scotland in 2005, is unique globally. We explored how public health practitioners engaged with the licensing system following this change, and what helped or hindered their efforts. Semi-structured interviews were conducted with 13 public health actors, audio-recorded, and analysed using an inductive framework approach. Many interviewees viewed the new objective as synonymous with reducing population-level alcohol consumption; however, this view was not always shared by licensing actors, some of whom did not accept public health as a legitimate goal of licensing, or prioritised economic development instead. Some interviewees were surprised that the public health evidence they presented to licensing boards did not result in their hoped-for outcomes; they reported that licensing officials did not always understand or value health data or statistical evidence. While some tried to give “impartial” advice to licensing boards, this was not always easy; others were clear that their role was one of “winning hearts and minds” through relationship-building with licensing actors over time. Notwithstanding the introduction of the public health objective, there remain significant, and political, challenges in orienting local premises licensing boards towards decisions to reduce the availability of alcohol in Scotland. Full article
(This article belongs to the Special Issue Alcohol and Health)
Open AccessArticle The Feasibility of Embedding Data Collection into the Routine Service Delivery of a Multi-Component Program for High-Risk Young People
Int. J. Environ. Res. Public Health 2017, 14(2), 208; doi:10.3390/ijerph14020208
Received: 16 November 2016 / Revised: 14 February 2017 / Accepted: 15 February 2017 / Published: 20 February 2017
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Abstract
Background: There is little evidence about how to improve outcomes for high-risk young people, of whom Indigenous young people are disproportionately represented, due to few evaluation studies of interventions. One way to increase the evidence is to have researchers and service providers collaborate
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Background: There is little evidence about how to improve outcomes for high-risk young people, of whom Indigenous young people are disproportionately represented, due to few evaluation studies of interventions. One way to increase the evidence is to have researchers and service providers collaborate to embed evaluation into the routine delivery of services, so program delivery and evaluation occur simultaneously. This study aims to demonstrate the feasibility of integrating best-evidence measures into the routine data collection processes of a service for high-risk young people, and identify the number and nature of risk factors experienced by participants. Methods: The youth service is a rural based NGO comprised of multiple program components: (i) engagement activities; (ii) case management; (iii) diversionary activities; (iv) personal development; and (v) learning and skills. A best-evidence assessment tool was developed by staff and researchers and embedded into the service’s existing intake procedure. Assessment items were organised into demographic characteristics and four domains of risk: education and employment; health and wellbeing; substance use; and crime. Descriptive data are presented and summary risk variables were created for each domain of risk. A count of these summary variables represented the number of co-occurring risks experienced by each participant. The feasibility of this process was determined by the proportion of participants who completed the intake assessment and provided research consent. Results: This study shows 85% of participants completed the assessment tool demonstrating that data on participant risk factors can feasibly be collected by embedding a best-evidence assessment tool into the routine data collection processes of a service. The most prevalent risk factors were school absence, unemployment, suicide ideation, mental distress, substance use, low levels of physical activity, low health service utilisation, and involvement in crime or with the juvenile justice system. All but one participant experienced at least two co-occurring domains of risk, and the majority of participants (58%) experienced co-occurring risk across four domains. Conclusions: This is the first study to demonstrate that best-evidence measures can feasibly be embedded into the routine data collection processes of a service for high-risk young people. This process allows services to tailor their activities to the most prevalent risks experienced by participants, and monitor these risks over time. Replication of this process in other services would improve the quality of services, facilitate more high quality evaluations of services, and contribute evidence on how to improve outcomes for high-risk young people. Full article
(This article belongs to the Special Issue Alcohol and Health)
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Open AccessArticle Attitudes and Learning through Practice Are Key to Delivering Brief Interventions for Heavy Drinking in Primary Health Care: Analyses from the ODHIN Five Country Cluster Randomized Factorial Trial
Int. J. Environ. Res. Public Health 2017, 14(2), 121; doi:10.3390/ijerph14020121
Received: 6 December 2016 / Revised: 18 January 2017 / Accepted: 20 January 2017 / Published: 26 January 2017
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Abstract
In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health
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In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs) in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion of consulting adult patients (age 18+ years) who screened positive and were given advice to reduce their alcohol consumption (intervention activity). We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers’ screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity. Full article
(This article belongs to the Special Issue Alcohol and Health)
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Open AccessArticle Support Vector Machine Classification of Drunk Driving Behaviour
Int. J. Environ. Res. Public Health 2017, 14(1), 108; doi:10.3390/ijerph14010108
Received: 10 November 2016 / Revised: 11 January 2017 / Accepted: 13 January 2017 / Published: 23 January 2017
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Abstract
Alcohol is the root cause of numerous traffic accidents due to its pharmacological action on the human central nervous system. This study conducted a detection process to distinguish drunk driving from normal driving under simulated driving conditions. The classification was performed by a
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Alcohol is the root cause of numerous traffic accidents due to its pharmacological action on the human central nervous system. This study conducted a detection process to distinguish drunk driving from normal driving under simulated driving conditions. The classification was performed by a support vector machine (SVM) classifier trained to distinguish between these two classes by integrating both driving performance and physiological measurements. In addition, principal component analysis was conducted to rank the weights of the features. The standard deviation of R–R intervals (SDNN), the root mean square value of the difference of the adjacent R–R interval series (RMSSD), low frequency (LF), high frequency (HF), the ratio of the low and high frequencies (LF/HF), and average blink duration were the highest weighted features in the study. The results show that SVM classification can successfully distinguish drunk driving from normal driving with an accuracy of 70%. The driving performance data and the physiological measurements reported by this paper combined with air-alcohol concentration could be integrated using the support vector regression classification method to establish a better early warning model, thereby improving vehicle safety. Full article
(This article belongs to the Special Issue Alcohol and Health)
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Open AccessArticle Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts
Int. J. Environ. Res. Public Health 2017, 14(1), 75; doi:10.3390/ijerph14010075
Received: 6 December 2016 / Revised: 4 January 2017 / Accepted: 10 January 2017 / Published: 12 January 2017
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Abstract
This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts
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This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries. Full article
(This article belongs to the Special Issue Alcohol and Health)

Review

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Open AccessReview Parental Supply of Alcohol in Childhood and Risky Drinking in Adolescence: Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2017, 14(3), 287; doi:10.3390/ijerph14030287
Received: 28 January 2017 / Accepted: 2 March 2017 / Published: 9 March 2017
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Abstract
Whether parental supply of alcohol affects the likelihood of later adolescent risky drinking remains unclear. We conducted a systematic review and meta-analysis to synthesize findings from longitudinal studies investigating this association. We searched eight electronic databases up to 10 September 2016 for relevant
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Whether parental supply of alcohol affects the likelihood of later adolescent risky drinking remains unclear. We conducted a systematic review and meta-analysis to synthesize findings from longitudinal studies investigating this association. We searched eight electronic databases up to 10 September 2016 for relevant terms and included only original English language peer-reviewed journal articles with a prospective design. Two reviewers independently screened articles, extracted data and assessed risk of bias. Seven articles met inclusion criteria, six of which used analytic methods allowing for meta-analysis. In all seven studies, the follow-up period was ≥12 months and attrition ranged from 3% to 15%. Parental supply of alcohol was associated with subsequent risky drinking (odds ratio = 2.00, 95% confidence interval = 1.72, 2.32); however, there was substantial risk of confounding bias and publication bias. In all studies, measurement of exposure was problematic given the lack of distinction between parental supply of sips of alcohol versus whole drinks. In conclusion, parental supply of alcohol in childhood is associated with an increased likelihood of risky drinking later in adolescence. However, methodological limitations preclude a causal inference. More robust longitudinal studies are needed, with particular attention to distinguishing sips from whole drinks, measurement of likely confounders, and multivariable adjustment. Full article
(This article belongs to the Special Issue Alcohol and Health)
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Other

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Open AccessOpinion Harmful Use of Alcohol: A Shadow over Sub-Saharan Africa in Need of Workable Solutions
Int. J. Environ. Res. Public Health 2017, 14(4), 346; doi:10.3390/ijerph14040346
Received: 31 December 2016 / Revised: 22 March 2017 / Accepted: 23 March 2017 / Published: 27 March 2017
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Abstract
Alcohol consumption and alcohol-attributable burden of disease in Africa are expected to rise in the near future, yet. increasing alcohol-related harm receives little attention from policymakers and from the population in general. Even where new legislation is proposed it is rarely enacted into
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Alcohol consumption and alcohol-attributable burden of disease in Africa are expected to rise in the near future, yet. increasing alcohol-related harm receives little attention from policymakers and from the population in general. Even where new legislation is proposed it is rarely enacted into law. Being at the center of social and cultural activities in many countries, alcohol’s negative role in society and contribution to countries’ burden of disease are rarely questioned. After the momentum created by the adoption in 2010 of the WHO Global Strategy and the WHO Regional Strategy (for Africa) to Reduce the Harmful Use of Alcohol, and the WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases, in 2013, little seems to have been done to address the increasing use of alcohol, its associated burden and the new challenges that derive from the growing influence of the alcohol industry in Africa. In this review, we argue that to have a positive impact on the health of African populations, action addressing specific features of alcohol policy in the continent is needed, namely focusing on particularities linked to alcohol availability, like unrecorded and illicit production, outlet licensing, the expansion of formal production, marketing initiatives and taxation policies. Full article
(This article belongs to the Special Issue Alcohol and Health)

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