Alcohol management plans in Aboriginal and Torres Strait Islander (Indigenous) Australian communities in Queensland: community residents have experienced favourable impacts but also suffered unfavourable ones

BMC Public Health

Research Article

Robyn McDermott¹  David Martin²  Alan R. Clough³  Caryn West⁴  Simon Towle⁵  Katrina Bird⁵  Bronwyn Honorato⁵  Michelle S. Fitts⁵  Jan A. Robertson⁵  Christopher M. Doran⁶  Adrian Miller⁷  Anthony Shakeshaft⁸  Robert Sanson-Fisher⁹  Stephen A. Margolis^1,10  Valmae Ypinazar^1,10 

[1] Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, 4870, Cairns, QLD, Australia;College of Arts and Social Sciences, Australian National University, Canberra, Australia;Community-based Health Promotion and Prevention Studies Group, Australian Institute of Tropical Health and Medicine, James Cook University, 4870, Cairns, QLD, Australia;Division of Tropical Health and Medicine, College of Healthcare Sciences, James Cook University, Cairns, QLD, Australia;Division of Tropical Health and Medicine, College of Public Health, Medical & Veterinary Sciences, James Cook University, Cairns, QLD, Australia;Health Economics, Central Queensland University, 4000, Brisbane, QLD, Australia;Indigenous Research Unit, Griffith University, 4111, Nathan, QLD, Australia;National Drug and Alcohol Research Centre, University of New South Wales, 2052, Sydney, NSW, Australia;School of Medicine and Public Health (Public Health), University of Newcastle, 2000, Sydney, NSW, Australia;School of Medicine, Griffith University, 4111, Nathan, QLD, Australia;

关键词: Alcohol;    Indigenous;    Aboriginal and Torres Strait Islander;    Australian;    Legal intervention;    Evaluation;   

DOI  :  10.1186/s12889-016-3995-8

 received in 2016-09-21, accepted in 2016-12-23,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn Australia, ‘Alcohol Management Plans’ (AMPs) provide the policy infrastructure for State and Commonwealth Governments to address problematic alcohol use among Aboriginal and Torres Strait Islanders. We report community residents’ experiences of AMPs in 10 of Queensland’s 15 remote Indigenous communities.MethodsThis cross-sectional study used a two-stage sampling strategy: N = 1211; 588 (48%) males, 623 (52%) females aged ≥18 years in 10 communities. Seven propositions about ‘favourable’ impacts and seven about ‘unfavourable’ impacts were developed from semi-structured interviews. For each proposition, one-sample tests of proportions examined participant agreement and multivariable binary logistic regressions assessed influences of gender, age (18–24, 25–44, 45–64, ≥65 years), residence (≥6 years), current drinking and Indigenous status. Confirmatory factor analyses estimated scale reliability (ρ), item loadings and covariances.ResultsSlim majorities agreed that: AMPs reduced violence (53%, p = 0.024); community a better place to live (54%, 0.012); and children were safer (56%, p < 0.001). More agreed that: school attendance improved (66%, p < 0.001); and awareness of alcohol’s harms increased (71%, p < 0.001). Participants were equivocal about improved personal safety (53%, p = 0.097) and reduced violence against women (49%, p = 0.362). The seven ‘favourable’ items reliably summarized participants’ experiences of reduced violence and improved community amenity (ρ = 0.90).Stronger agreement was found for six ‘unfavourable’ items: alcohol availability not reduced (58%, p < 0.001); drinking not reduced (56%, p < 0.001)); cannabis use increased (69%, p < 0.001); more binge drinking (73%, p < 0.001); discrimination experienced (77%, p < 0.001); increased fines, convictions and criminal records for breaching restrictions (90%, p < 0.001). Participants were equivocal (51% agreed, p = 0.365) that police could enforce restrictions effectively. ‘Unfavourable’ items were not reliably reflected in one group (ρ = 0.48) but in: i) alcohol availability and consumption not reduced and ii) criminalization and discrimination.In logistic regressions, longer-term (≥ 6 years) residents more likely agreed that violence against women had reduced and that personal safety had improved but also that criminalization and binge drinking had increased. Younger people disagreed that their community was a better place to live and strongly agreed about discrimination. Current drinkers’ views differed little from the sample overall.ConclusionsThe present Government review provides an opportunity to reinforce ‘favourable’ outcomes while targeting: illicit alcohol, treatment and diversion services and reconciliation of criminalization and discrimination issues.

【 授权许可】

CC BY   
© The Author(s). 2017