Dynamic simulation modelling of policy responses to reduce alcohol-related harms: rationale and procedure for a participatory approach

Abstract

Development of effective policy responses to address complex public health problems can be challenged by a lack of clarity about the interaction of risk factors driving the problem, differing views of stakeholders on the most appropriate and effective intervention approaches, a lack of evidence to support commonly implemented and acceptable intervention approaches, and a lack of acceptance of effective interventions. Consequently, political considerations, community advocacy and industry lobbying can contribute to a hotly contested debate about the most appropriate course of action; this can hinder consensus and give rise to policy resistance. The problem of alcohol misuse and its associated harms in New South Wales (NSW), Australia, provides a relevant example of such challenges. Dynamic simulation modelling is increasingly being valued by the health sector as a robust tool to support decision making to address complex problems. It allows policy makers to ask 'what-if' questions and test the potential impacts of different policy scenarios over time, before solutions are implemented in the real world. Participatory approaches to modelling enable researchers, policy makers, program planners, practitioners and consumer representatives to collaborate with expert modellers to ensure that models are transparent, incorporate diverse evidence and perspectives, are better aligned to the decision-support needs of policy makers, and can facilitate consensus building for action. This paper outlines a procedure for embedding stakeholder engagement and consensus building in the development of dynamic simulation models that can guide the development of effective, coordinated and acceptable policy responses to complex public health problems, such as alcohol-related harms in NSW.

Impacts of licensed premises trading hour policies on alcohol‐related harms

“…The model structure, parameterisation and the participatory approach used and its development are described in detail elsewhere 19, 30. Briefly, model development was undertaken using a participatory stakeholder engagement and consensus building approach.…”

“…An agent-based model of alcohol consumption behaviour was developed to explore the impact of different licensed venue trading hour policy scenarios on acute harms over time [30]. The model structure, parameterisation and the participatory approach used and its development are described in detail elsewhere [19,30]. Briefly, model development was undertaken using a participatory stakeholder engagement and consensus building approach.…”

“…Briefly, model development was undertaken using a participatory stakeholder engagement and consensus building approach. Stakeholders involved were academics, policy experts, clinicians, health service providers, program planners and health economists [19]. The model was designed to simulate 3.6 million individuals and was calibrated to approximate population statistics of the state of New South Wales, Australia from 2011 to 2016 and then to project output estimates from January 1 st 2017 to December 31 st 2021 when simulating the baseline and intervention scenarios.…”

“…However, the primary purpose of the model was to provide decision support capability by estimating the overall comparative impacts of different policy scenarios over time against the baseline rather than providing highly precise estimates of outcome indicators. A strength of the study, and a key innovation in the application of simulation models to public health settings, is the explicit engagement of key stakeholders in the design and development of the simulation modelling tool [16,[19][20][21]. The participatory approach assisted with transparent negotiation and consensus building around the most acceptable policy options in the context of previous, and sometimes contentious, empirical evidence.…”

“…Participatory approaches to the development of such models and their use are recommended to ensure transparency and accountability for model parameters, estimates, assumptions, data sources and model outputs [19,20]. Participatory model development also serves to engage stakeholders and potential end-usersimproving communication and garnering broader support for collaborative action based on model outputs [21][22][23][24][25].…”