Suchergebnisse

This article examines challenges in implementing and sustaining effective alcohol policies and proposes several strategies to counter them. A narrative review was undertaken of recent publications that document challenges in implementing alcohol policies in various contexts. MEDLINE/PubMed were searched for publications in English between 2011 and 2018. Twenty‐five keywords and 25 scholar names were used in the search. From 1,169 hits, 168 full research papers and commentaries were examined. Eight main groups of challenges were identified: interventions of inadequate dose, support, scope, or fidelity; confounding impacts from alcohol industries and other sectors; uneven implementation or inadequate enforcement; popular policies are largely ineffective and effective policies unpopular; policy decision‐making focusing on short‐range perspectives and skewed to favor commercial interests; low awareness of alcohol as a health risk; challenges in getting information on relevant interventions, local data, and insider information; and insufficient capacity or training to implement a policy. Several strategies are offered to counter these challenges: provide evidence to policymakers: conduct assessment and pilot studies; provide enhanced training on alcohol issues and policy implementation; develop allies; promote strong leadership; use media advocacy; engage voices of those impacted by flawed policies; and promote a comprehensive approach.

Alcohol‐related problems are experienced most directly at the local level. There have been significant strides in evaluating locally based alcohol policies and prevention strategies. This article draws from this existing body of research to answer three questions: What is known about effective local interventions and policies? What are the main challenges facing local action on alcohol and how can those challenges be addressed? How can local action on alcohol be sustained? This article reviews evaluated local alcohol interventions and policies, focusing on several countries where these initiatives have been evaluated: for example, Australia, Canada, Finland, New Zealand, Norway, Sweden, and the United States. The positive outcomes associated with community‐based initiatives are summarized and features of successful local action are identified. Although current research finds a number of positive outcomes of local alcohol interventions and policies, a number of challenges of this work remain; these challenges include providing adequate training, resources, and tools for local action; building local resource streams and coalitions to sustain expertise; sustaining long‐term commitment to monitor and evaluate the effects of policies; and addressing the vested interests of community stakeholders in alcohol policy efforts. Lessons learned and recommendations for future community‐based alcohol prevention initiatives are drawn from the findings and challenges of current work.

Difficult social circumstances contribute to numerous problems among Latino youth, which can include risky behaviors, school disengagement, health disparities, and relatively high rates of unintended pregnancy, sexually transmitted diseases, and HIV/AIDS. To promote health and healthy development in spite of exposure to substantial social challenge, it is important to identify factors that contribute to resilience among Latino youth. We examine focus group data from the ¡Encuentro! study (10 youth groups, four parent groups) to learn elements identified by Latino youth and parents that support adolescents in reaching their goals. Honoring principles of community-based participatory research, a community–university analysis team coded data for emerging themes and identified protective factors within Masten's resilience framework. All individual, social, and sociocultural protective factors in Masten's framework were evident, including positive cultural standards, rituals, relationships, and supports. Challenges to resilience specific to Latino youth included prejudice and discrimination related to race/ethnicity and immigration.