The hidden harm: alcohol’s impact on children and families

Examines the prevalence and effects of heavy drinking on families and children, and the extent to which they persisted or changed over time. Summary The 2015 study examined the prevalence and effects of heavy drinking on families and children, and the extent to which they persisted or changed over time. It paints a concerning picture of the prevalence of alcohol-related family and domestic violence in Australia, shedding new light on a hidden dimension of alcohol harms that occurs largely behind closed doors. Key findings The hidden harm draws on two national surveys of alcohol’s harm to others, service system data and qualitative interviews with families, providing for the first time a detailed and valuable insight into the magnitude of the problem and the large numbers of Australian children who are being put at risk. In 2011 there were 29,684 police-reported incidents of alcohol-related domestic violence in Australia, and that’s just in the four states and territories where this data is available. Children are being verbally abused, left in unsupervised or unsafe situations, physically hurt or exposed to domestic violence because of others’ drinking. Many were also witnessing verbal or physical conflict, drinking or inappropriate behaviour. Over a million children (22 per cent of all Australian children) are estimated to be affected in some way by the drinking of others (2008). 142,582 children were substantially affected (2008), and more than 10,000 Australian children are in the child protection system because of a carers drinking (2006-07)

Single-dose BNT162b2 vaccine protects against asymptomatic SARS-CoV-2 infection

The BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) is being utilised internationally for mass COVID-19 vaccination. Evidence of single-dose protection against symptomatic disease has encouraged some countries to opt for delayed booster doses of BNT162b2, but the effect of this strategy on rates of asymptomatic SARS-CoV-2 infection remains unknown. We previously demonstrated frequent pauci- and asymptomatic SARS-CoV-2 infection amongst healthcare workers (HCWs) during the UK’s first wave of the COVID-19 pandemic, using a comprehensive PCR-based HCW screening programme (Rivett et al., 2020; Jones et al., 2020). Here, we evaluate the effect of first-dose BNT162b2 vaccination on test positivity rates and find a fourfold reduction in asymptomatic infection amongst HCWs ≥12 days post-vaccination. These data provide real-world evidence of short-term protection against asymptomatic SARS-CoV-2 infection following a single dose of BNT162b2 vaccine, suggesting that mass first-dose vaccination will reduce SARS-CoV-2 transmission, as well as the burden of COVID-19 disease

Strategies associated with low‐risk drinking: a population‐based study

Abstract Objective: To examine the relative frequency of use of seven strategies to moderate drinking (SMD) among low‐risk and risky drinkers. Methods: Cross‐sectional data from the 2013 National Drug Strategy Household Survey was used. The analytical sample included 11,462 Australians aged 18–64 who had consumed alcohol in the previous year. Logistic regression was used. Results: Analyses indicated a curvilinear relationship between use of SMD and alcohol consumption. Across the seven SMD, constant use of a strategy, compared with never using a strategy, was associated with low‐risk drinking. Never using a strategy, compared with using one rarely, was also associated with low‐risk drinking. When used occasionally, strategies that implied less alcohol consumed per hour (e.g. refuse unwanted drinks) increased the likelihood of low‐risk drinking, whereas less direct strategies (e.g. counting drinks) increased the likelihood of risky drinking. Conclusions: Adult Australians who drink at low levels use a range of strategies to moderate their alcohol consumption. Overall, consistent use of one or more SMD was associated with low‐risk drinking patterns. Implications: Public health responses to risky drinking may be enhanced by promoting the consistent use of SMD as a way to reduce overall alcohol consumption

Factors contributing to the sustainability of alcohol and other drug interventions in Australian community health settings

This study identifies factors that support the sustainability of interventions implemented to enhance responses to alcohol and other drug misuse in Australian community health settings. Eight completed projects that had received time-limited funding were sampled to reflect a mix of project types, contexts and success in meeting funding objectives. Projects were investigated using a case study approach involving thematic analysis. Project records were analysed and interviews were conducted with stakeholders to identify intervention elements that continued after funding ceased, and factors that supported this sustainability. Key factors identified were: embedding changes in the operations of the agency; filling a critical gap in the sector; building support from key individuals and agencies; and planning realistically for future ownership. We argue that complexity theory provides a framework to understand both the context-bound nature of intervention sustainability and differences within the literature as to how sustainability is typologised. Each factor associated with intervention sustainability identified in this study reflects an astute understanding of project context and a capacity to adapt. These factors could assist people designing interventions with time-limited funding to maximise ongoing impact of interventions. They should optimally be implemented within an overall approach of flexibility and sensitivity to context

The hidden harm: alcohol’s impact on children and families.

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Implementing alcohol and other drug interventions effectively : How does location matter?

Objective: To identify enabler and barrier mechanisms that impact project implementation, from a review of 127 completed projects intended to reduce harms associated with problematic alcohol and licit drug use in Australia. Design: Data comprised archival material (proposals, reports). A coding framework was developed from the literature and a sample of projects; two researchers developed and refined the framework. Open coding was used to identify factors impacting implementation, followed by pattern coding to identify underlying mechanisms. Sample: Project categories were developed from funding orientation and main activities projects were: enhancing organizational systems and processes (39), training and workforce development (18), community education and prevention (37) and client engagement and treatment (33). Thirty-five projects (28%) were in non-capital city locations. Results: Nine enabler and ten barrier mechanisms were identified, for example, ‘project planning and design’ and ‘wider service system challenges’. Three enabler mechanisms were more likely to be identified for non-capital city projects; ‘external communication and relationships’ (83% vs 70%), ‘sensitivity to service users and settings’ (49% vs 40%) and ‘funding and resourcing’ (40% vs 35%). Most barrier mechanisms were identified for a higher proportion of non-capital city projects, particularly ‘identifying and retaining personnel’ (54% vs 34%), ‘engaging communities and partners’ (46% vs 26%) and ‘organizational governance and capacity’ (29% vs 5%). Conclusions: Project implementation in non-capital city locations requires particular attention to project planning and design, staffing and organizational well-being. Policy initiatives and planning proposals might consider enabler mechanisms along with strategies to minimize barrier mechanisms to support successful implementation

Factors that enable and hinder the implementation of projects in the alcohol and other drug field

Abstract Objective: Few studies systematically explore elements of successful project implementation across a range of alcohol and other drug (AOD) activities. This paper provides an evidence base to inform project implementation in the AOD field. Approach: We accessed records for 127 completed projects funded by the Alcohol, Education and Rehabilitation Foundation from 2002 to 2008. An adapted realist synthesis methodology enabled us to develop categories of enablers and barriers to successful project implementation, and to identify factors statistically associated with successful project implementation, defined as meeting all funding objectives. Thematic analysis of eight case study projects allowed detailed exploration of findings. Results: Nine enabler and 10 barrier categories were identified. Those most frequently reported as both barriers and enablers concerned partnerships with external agencies and communities, staffing and project design. Conclusion: Achieving supportive relationships with partner agencies and communities, employing skilled staff and implementing consumer or participant input mechanisms were statistically associated with successful project implementation. Implications: The framework described here will support development of evidence‐based project funding guidelines and project performance indicators. The study provides evidence that investing project hours and resources to develop robust relationships with project partners and communities, implementing mechanisms for consumer or participant input and attracting skilled staff are legitimate and important activities, not just in themselves but because they potentially influence achievement of project funding objectives

Factors contributing to the sustainability of alcohol and other drug interventions in Australian community health settings

This study identifies factors that support the sustainability of interventions implemented to enhance responses to alcohol and other drug misuse in Australian community health settings. Eight completed projects that had received time-limited funding were sampled to reflect a mix of project types, contexts and success in meeting funding objectives. Projects were investigated using a case study approach involving thematic analysis. Project records were analysed and interviews were conducted with stakeholders to identify intervention elements that continued after funding ceased, and factors that supported this sustainability. Key factors identified were: embedding changes in the operations of the agency; filling a critical gap in the sector; building support from key individuals and agencies; and planning realistically for future ownership. We argue that complexity theory provides a framework to understand both the context-bound nature of intervention sustainability and differences within the literature as to how sustainability is typologised. Each factor associated with intervention sustainability identified in this study reflects an astute understanding of project context and a capacity to adapt. These factors could assist people designing interventions with time-limited funding to maximise ongoing impact of interventions. They should optimally be implemented within an overall approach of flexibility and sensitivity to context