Reducing alcohol-related harm and social disorder in a university community: a framework for evaluation

Cousins, Kimberley; Connor, Jennie; Kypri, Kypros

doi:10.1136/ip.2010.027961

Cited by 6 publications

(3 citation statements)

References 31 publications

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“…‘Campus Watch has undergone many changes, both structural and functional, since it was introduced in 2007; its evolution has not been guided by an overarching design and modifications have occurred for reasons that have not always been well documented.’ [27]…”

Section: Resultsmentioning

confidence: 99%

Challenges to evaluating complex interventions: a content analysis of published papers

2013

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BackgroundThere is continuing interest among practitioners, policymakers and researchers in the evaluation of complex interventions stemming from the need to further develop the evidence base on the effectiveness of healthcare and public health interventions, and an awareness that evaluation becomes more challenging if interventions are complex.We undertook an analysis of published journal articles in order to identify aspects of complexity described by writers, the fields in which complex interventions are being evaluated and the challenges experienced in design, implementation and evaluation. This paper outlines the findings of this documentary analysis.MethodsThe PubMed electronic database was searched for the ten year period, January 2002 to December 2011, using the term “complex intervention*” in the title and/or abstract of a paper. We extracted text from papers to a table and carried out a thematic analysis to identify authors’ descriptions of challenges faced in developing, implementing and evaluating complex interventions.ResultsThe search resulted in a sample of 221 papers of which full text of 216 was obtained and 207 were included in the analysis. The 207 papers broadly cover clinical, public health and methodological topics. Challenges described included the content and standardisation of interventions, the impact of the people involved (staff and patients), the organisational context of implementation, the development of outcome measures, and evaluation.ConclusionsOur analysis of these papers suggests that more detailed reporting of information on outcomes, context and intervention is required for complex interventions. Future revisions to reporting guidelines for both primary and secondary research may need to take aspects of complexity into account to enhance their value to both researchers and users of research.

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Section: Resultsmentioning

confidence: 99%

Challenges to evaluating complex interventions: a content analysis of published papers

2013

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“…A recent study following devolution in Kenya, describes the convergence of gender with disability and poverty, in hindering disabled women from accessing skilled delivery, despite the presence of the free maternity programme [20]. Gender-based violence was commonly discussed by photovoice participants, who were adolescents who had dropped out from full-time education, living in an informal settlement with high levels of poverty and alcohol misuse in the surrounding community, in keeping with risk factors for GBV as identified through previous studies in Kenya and globally [35, 36]. ‘Invisible power’ is exercised by the powerful in society to shape the aspirations, expectations and desires of the least powerful.…”

Section: Gender and Agementioning

confidence: 99%

Applying an intersectionality lens to examine health for vulnerable individuals following devolution in Kenya

McCollum

Taegtmeyer

Otiso

et al. 2019

Int J Equity Health

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BackgroundPower imbalances are a key driver of avoidable, unfair and unjust differences in health. Devolution shifts the balance of power in health systems. Intersectionality approaches can provide a ‘lens’ for analysing how power relations contribute to complex and multiple forms of health advantage and disadvantage. These approaches have not to date been widely used to analyse health systems reforms. While the stated objectives of devolution often include improved equity, efficiency and community participation, past evidence demonstrates that that there is a need to create space and capacity for people to transform existing power relations these within specific contexts.MethodsWe carried out a qualitative study between March 2015 and April 2016, involving 269 key informant and in-depth interviews from across the health system in ten counties, 14 focus group discussions with community members in two of these counties and photovoice participatory research with nine young people. We adopted an intersectionality lens to reveal how power relations intersect to produce vulnerabilities for specific groups in specific contexts, and to identify examples of the tacit knowledge about these vulnerabilities held by priority-setting stakeholders, in the wake of the introduction of devolution reforms in Kenya.ResultsOur study identified a range of ways in which longstanding social forces and discriminations limit the power and agency individuals can exercise, but are mediated by their unique circumstances at a given point in their life. These are the social determinants of health, influencing an individual’s exposure to risk of ill health from their living environment, their work, or their social context, including social norms relating to their gender, age, geographical residence or socio-economic status. While a range of policy measures have been introduced to encourage participation by typically ‘unheard voices’, devolution processes have yet to adequately challenge the social norms, and intersecting power relations which contribute to discrimination and marginalisation.ConclusionsIf key actors in devolved decision-making structures are to ensure progress towards universal health coverage, there is need for intersectoral policy action to address social determinants, promote equity and identify ways to challenge and shift power imbalances in priority-setting processes.

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“…The University of Otago is one of eight universities in New Zealand (population 4.7 million). Located in Dunedin (population 120,000), and the majority of Otago students live in residential colleges and shared houses surrounding the campus in North Dunedin [ 19 ]. Between 2006 and 2009, in response to growing concern about disorderly behaviour [ 20 , 21 , 22 , 23 , 24 ], the university implemented several initiatives.…”

Section: Introductionmentioning

confidence: 99%

Hazardous Drinking among Students over a Decade of University Policy Change: Controlled Before-and-After Evaluation

Kypri

Maclennan

Cousins

et al. 2018

IJERPH

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Background: Responding to high levels of alcohol-related harm among students, a New Zealand university deployed a security and liaison service, strengthened the Student Code of Conduct, increased its input on the operation of alcohol outlets near campus, and banned alcohol advertising on campus. We estimated the change in the prevalence of alcohol consumption patterns among students at the university compared with other universities. Methods: We conducted a controlled before-and-after study with surveys in residential colleges at the target university in 2004 and 2014, and in random samples of students at the target university and three control universities in 2005 and 2013. The primary outcome was the prevalence of recent intoxication, while we analysed drinking per se and drinking in selected locations to investigate mechanisms of change. Results: The 7-day prevalence of intoxication decreased from 45% in 2004 to 33% in 2014 (absolute difference: 12%; 95% CI: 7% to 17%) among students living in residential colleges, and from 40% in 2005 to 26% in 2013 (absolute difference: 14%; 95% CI: 8% to 20%) in the wider student body of the intervention university. The intervention effect estimate, representing the change at the intervention university adjusted for change at other universities (aOR = 1.30; 95% CI: 0.89 to 1.90), was consistent with a benefit of intervention but was not statistically significant (p = 0.17). Conclusion: In this period of alcohol policy reform, drinking to intoxication decreased substantially in the targeted student population. Policy reforms and coincidental environmental changes may each have contributed to these reductions.

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Reducing alcohol-related harm and social disorder in a university community: a framework for evaluation

Abstract: Regression analyses will be used to examine changes in the intervention site relative to changes in the control areas.

Cited by 6 publications

References 31 publications

Challenges to evaluating complex interventions: a content analysis of published papers

Challenges to evaluating complex interventions: a content analysis of published papers

Applying an intersectionality lens to examine health for vulnerable individuals following devolution in Kenya

Hazardous Drinking among Students over a Decade of University Policy Change: Controlled Before-and-After Evaluation

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