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LOCAL ALCOHOL POLICY PAKKAproject: A Study of effectiveness of local alcohol policy

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Title: LOCAL ALCOHOL POLICY PAKKAproject: A Study of effectiveness of local alcohol policy


1
LOCAL ALCOHOL POLICYPAKKA-project A Study of
effectiveness of local alcohol policy
  • Katariina Warpenius
  • International Conference on Effective Approaches
    to Tackle Alcohol Related Problems in Local
    Communities
  • Riga, Latvia, 12-13 March 2007

2
Local alcohol policy (PAKKA) project
(2004-2007/09)
  • Project leader Marja Holmila
  • Two regions Hämeenlinna and Jyväskylä
  • Pakka-project emphasizes the drinking
    environment and focuses on the supply of alcohol
    by enforcing the age-limits of purchase (18
    years) and preventing sales to drunken customers.
  • Aims Teen-agers and young adults drink less and
    the age of first drink goes up, drunkenness and
    related harms will be reduced

3
International experience
  • Community action projects to prevent alcohol and
    other drug problems have gained popularity and
    importance in the past 20-30 years.
  • The work shares a common heritage with community
    prevention concerning other health problems, for
    instance heart- and cardiovascular diseases.
  • Collective risk is reduced through interventions
    affecting community processes and structures that
    influence alcohol use, targeting communities
    rather than individuals.

4
Choosing effective strategies scientific evidence
  • Several attempts have been made to summarise the
    information from the expanding evaluation
    literature. (Babor et al 2003 Edwards et al
    1996 Andréasson 2002 Heather et Stockwell
    2004.)
  • Previous community-based prevention studies have
    shown that these projects can produce
    scientifically measured outcomes. (Andréasson et
    al 2000 Casswell et al 1999 Giesbrecht et al
    1990, Holder et al 1997 Holmila 1997 Holder
    2000 Homel Clalrk 1994 Wagenaar et al 2000
    Wallin et al 2005)

5
Effective methods Regulating physical
availability
  • The location and easiness of purchase have an
    effect on how much alcohol is consumed and how
    many harms it causes
  • Examples of methods minimum age of purchase,
    density of outlets, hours of sales
  • - To ban selling alcohol in festivals that are
    favoured by teen-agers

6
Effective methods Changing the drinking
situation
  • Examples of methods
  • To enforce regulations in selling alcohol to
    drunken customers in restaurants, or keeping the
    restaurants open late at night
  • To train the restaurant personnel to prevent
    violence and disorder
  • To ban drinking in traffic and at work-place

7
Effective methods media-advocacy community
mobilization
  • Works best when campaigns are combined with
    surveillance and implementation of laws
  • Media or other forms of information giving e.g.
    professional training, information campaigns is
    needed to support alcohol policy measures
  • Local opinion climate is decisive in determining
    which kinds of policies will be feasible
  • Community mobilization Implementation and
    enforcement of alcohol policies take place on the
    local level

8
Effective methods systematic multi-method
approach
  • - Separate policies are not as effective as
    systematic multi-method approaches
  • -It is useful to coordinate different campaigns
    and approaches
  • - The recommended strategy for local communities
    is to combine community mobilization with various
    types of environmental strategies focused on the
    supply of alcoholic beverages and the drinking
    situation

9
Developing responsible sales of alcohol work
carried out in PAKKA-regions
  • Finnish law prohibits selling alcohol to those
    under the age of 18 and those who are clearly
    intoxicated
  • Strengthening the surveillance of liquor licence
    authorities and the police
  • Co-operation with the shops and restaurants
    joint task groups and seminars
  • Training of responsible alcohol sales
  • Influencing the public opinion gaining support
    for prevention among the citizens, decision makes
    and civil servants
  • Coordination of different types of action

10
Preliminary results from PAKKA
  • The effects of local alcohol policy are studied
    using various kinds of data
  • Purchase trials
  • Population and school-based surveys
  • Key-person interviews
  • Register data on harms related to alcohol
  • Process documentation and media analyses
  • Process of feedback between the researchers,
    the community organizers and the local
    alcohol markets

11
PAKKA causal model for restaurant component
  • Process documentation
  • Training of servers and shopkeepers,
    surveillance, public discussion, working together
    with the students
  • Intermediate outcomes The frequency of alcohol
    service to intoxicated patrons
  • Final outcomes Drunkenness and risky
    behaviour when drunk Alcohol-related acute
    harms

12
Purchase trials in restaurants Katariina
Warpenius
  • The goal is to evaluate how PAKKA action has
    influenced the restaurants practices how often
    the restaurants sell drinks to drunken customers
    and has PAKKA-action changed these practices?
  • Research setting Pre- post measurement in 2004
    and 2006 in Jyväskylä and its comparison site. In
    2006 the data was gathered also in Hämeenlinna.
  • Method Invisible theatre An actor pretending
    to be clearly drunk attempted to buy a pint of
    beer at the bar. A specialist panel helped to
    choose the most convincing and accurate
    performance

13
Purchase trials in restaurants
  • The test was carried out on Friday and
    Saturday-evenings. It was directed to the service
    personnel, not to the doormen.
  • Sample Premises having a license to serve all
    kinds of alcoholic beverages bars, pubs and
    nightclubs. In 2006 restaurants for dining were
    also included. (94 premises in total in 2004 and
    159 premises in total in 2006)
  • The researcher supervised the trials and filled
    in the follow-up forms describing the environment
    and context of the test.
  • Analysis SPSS, logistic regression analysis
    (Waldin test)

14
Refusal rate () in intervention and control area
in 2004 and 2006
15
Refusal rate () in different types of licensed
premises in intervention area Jyväskylä
16
Refusal rate () in different types of licensed
premises in the control area
17
Refusal rate () according to participation in
RBS-training
18
Law enforcement in intervention and control
areas monitoring visits in fully licensed
premises per year in 2000-2005
19
Conclusions on the restaurant purchase trials
  • The difference between the control area and
    Pakka-intervention area was statistically
    significant.
  • The improved results in bars and pubs can
    probably be explained by the increased law
    enforcement and surveillance.
  • The RBS-training alone did not have an effect on
    the refusal rate.
  • Instead of juridical rules, many bar staff
    members follow informal social norms in their
    service practices. Alcohol service to intoxicated
    patrons was most common at downtown night clubs.

20
Under-age purchase trials in shops, kiosks,
service stations and monopoly shops T. Karlsson,
K. Raitasalo and K. Warpenius
  • The goal was to evaluate the effects of
    PAKKA-action on enforcement of age-limit
    controls how easy is it for the under-aged to
    buy alcohol?
  • Research setting a controlled pre-post
    experiment in 2004 and 2006 in Hämeenlinna and in
    comparison region.
  • Method purchase trials. The purchases were
    carried out by 8 adult, but younger looking
    students (4 girls and 4 boys). They attempted to
    buy a certain amount of wine, long drinks, beer
    or cider without showing an identity card.
  • A specialist panel was used to select the
    students.

21
Under-age purchase trials
  • The experiment was carried out on Wednesdays and
    Thursdays between 16.00-20.00 in shops, kiosks,
    service stations and monopoly shops (35 in total
    in intervention site, about 300 attempts to buy
    alcoholic beverages)
  • A follow-up form was filled and the researchers
    supervised the experiment

22
Refusal rate () in Hämeenlinna and in comparison
site in 2004 and 2006, under-age purchase trials
Lähde Pakka ostokoetutkimus
23
Refusal rates () according to the type of outlet
in Hämeenlinna in 2004 and 2006, under-age
purchase trials
Lähde Pakka ostokoetutkimus
24
How many 15-year olds () considered it easy to
buy beer in Hämeenlinna and the comparison site,
in 2004 and 2006, school survey results
Girls, Hämeenlinna Girls, comparison site Boys,
Hämeenlinna Boys, comparison site
Lähde Stakes -Kouluterveystutkimus
25
Conclusions the under-age purchase trials
  • Enforcement of the under-age control was
    increased both in Hämeenlinna and in the
    comparison region. The results from school survey
    confirm the purchase trials results.
  • Under-age control was most efficient in Alko
    monopoly shops
  • The change between 2004 and 2006 was most
    positive in small shops and kiosk
  • The change between 2004 and 2006 was most
    negative in big markets in Hämeenlinna.

26
Influencing the local alcohol policies
  • On the basis of the experiences gained in PAKKA
    project, we are hopeful that the localities can
    be encouraged to prevent alcohol related harms by
    increasing enforcement of alcohol law and by
    combining this enforcement with training,
    community mobilization, influencing the public
    opinion and by media advocacy.
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