Background
Methods
Design
Selection of municipalities
Municipality | Alcohol measure ranking | ||||||
---|---|---|---|---|---|---|---|
Name | Mean age of onset | Ever drinking | Regular drinking | Weekly drinking | Heavy episodic drinking | Heavy weekly drinking | Total ranking |
Four municipalities with weaker declines in youth alcohol consumption | |||||||
1W | 5 | 1 | 4 | 5 | 2 | 2 | 19 |
2W | 6 | 2 | 3 | 2 | 3 | 8 | 24 |
3W | 2 | 6 | 5 | 3 | 8 | 14 | 38 |
4W | 11 | 13 | 2 | 4 | 9 | 9 | 48 |
Six municipalities with stronger declines in youth alcohol consumption | |||||||
5S | 1 | 17 | 13 | 16 | 7 | 5 | 59 |
6S | 12 | 5 | 11 | 12 | 13 | 11 | 64 |
7S | 13 | 8 | 14 | 15 | 11 | 3 | 64 |
8S | 14 | 11 | 10 | 8 | 12 | 12 | 67 |
9S | 10 | 14 | 6 | 9 | 14 | 15 | 68 |
10S | 16 | 16 | 8 | 13 | 16 | 17 | 86 |
Alcohol policies
Questions
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How effective integrated alcohol policies should manifest themselves
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1. In preparation of this interview, I sent you a document containing a summary of the intended alcohol policies in municipality X (2007–2011). Are these interventions actually implemented? Are there interventions missing? Can you supplement? | |
2. What was the reason for municipality X to decide whether or not to focus on alcohol policies? | |
3. Why do you think that municipality X chose this package of alcohol interventions? | |
How effective integrated alcohol policies can be realized and which influential factors play a role
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4. Who was the initiator of alcohol policies in municipality X? | |
5. What was the support for alcohol policies within municipality X? | |
6. What (specific or additional) resources did municipality X have when developing alcohol policies? | |
7. Did municipality X collaborate with other sectors than Public Health when developing alcohol policies? If yes, with whom and what was the role of these partners? | |
8. What was the specific role of the regional Public Health Service when developing alcohol policies in municipality X? | |
9. What are in your opinion important barriers and facilitators when implementing alcohol policies? Can you give examples from your own experiences? | |
10. What other things happened in municipality X, next to the discussed alcohol policies, that could have influenced changes in youth alcohol consumption? | |
Main codes
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Sub codes
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Initiation | Start of development process |
Collaboration | Regional alcohol prevention project |
Local working group | |
Development | Alcohol policies |
Policy document | |
Public Health Service | Leading role |
Municipal board | Politics |
Council | |
Mayor | |
Alderman | |
Civil servant | |
Resources | Money |
Time | |
Involved actors | Policy sectors |
External actors | |
Context | |
Alcohol intervention plan | |
Media | |
Alcohol interventions | Target group |
Setting | |
Determinants |
Data collection
Analyses
Results
Package of alcohol interventions
Municipalities with weaker declines | Municipalities with stronger declines | |
---|---|---|
Educational strategies |
Target group: Adolescents
Setting: At primary and secondary schools |
Target group: Adolescents; Parents Setting: At primary and secondary schools; At sports clubs; During events; On the street; In bars |
Non-educational strategies |
Regulation: Writing of regulatory policy
Enforcement: Mystery shoppers in sports clubs, bars, and supermarkets from the regional alcohol prevention project; Enforcement by the Drug and Food administration initiated from the regional alcohol prevention project; Juvenile delinquent trajectories after being arrested when drunk | |
Media strategies |
Negative media attention (for example in newspaper) about negative consequences of Happy Hours; Levels of alcohol consumption; Offenses of regulations
Positive media attention about covenants with sports clubs or bars |
A: “Yes, you will see this in what has been achieved. Those are all educational activities.” Q: “But in different contexts?” A: “Yes, in different contexts and they were of course working on writing regulatory policies and such, they have been doing that.” Q: “Yes, so certain things were in a developing phase?” A: “Yes, absolutely. But really enforcement, no … that is not performed.” [8S]
A: “And then there was a club [sports club] that closed a covenant [on regulations], which was broadly reported in the media.” [8S]A: “But it was the case that the newspaper reported violations [of regulations] found somewhere in the municipality.” [7S]
Indicated reasons to implement alcohol interventions
A: “Well that was picked up more from the nuisance enforcement.” Q: “Exactly, because of youth nuisance in nightlife areas.” A: “Yes.” [10S]A: “… but that it [number of underage adolescents that got drinks in alcohol outlets] was reported in the newspaper, that was interesting.” Q: “Media attention, yes.” A: “And then, then municipalities would also say: ‘And how many in our municipality?' And they did not hear this, but it has been very much agenda-setting, I think, and awareness.” [7S and 9S]A: “… it was that alcohol train which came broadly in the news, because it was again demolished…” [8S]
A: “[No] We [municipality] are just performing the best [regarding youth alcohol consumption] of the entire region … and we [municipality] have other problems.” [9S]A: “[Yes] Well, I think mainly the numbers [on youth alcohol consumption] from the youth health monitor.” [5S]
A: “As far as I can recall, the municipality has not scored very negative compared to the region, but is it more betting on national priorities.” [2W]
Collaboration between different sectors
Collaboration at the regional level
A: “[Inside] Because they [the regional project] had those three working groups, they [the regional project] also had people in the working group regulations, not from the regional Public Health Service so to speak, but from municipalities that had something to do with regulations.” [7S]Q: “[Outside] And here [written document] it is stated: for further elaboration and implementation of action plans, key partners, such as police, prosecution office, Food and Drug Administration, municipal welfare, and the council working group ‘Catering industry’ policy plan, were explicitly involved.” A: “Exactly.” [8S]
A: “It was difficult to … to really … I think to get that on the agenda of … of the ‘harder’ side [i.e., sectors other than public health] let’s say within the municipality. The ‘harder’ sectors …” [4W]
Collaboration at the municipal level
A: “… well, maybe communication, but no collaboration.” [10S]A: “… especially at the authorization and enforcement side internally in the municipality. That the link was not judged to be logical … that it [authority and enforcement] would have to do something with health: Why? Very much that compartmentalised actually, that has changed but was present then.” [4W]
A: “… and they also wanted to reduce youth nuisance, and from there, so actually not from public health but from enforcement and safety, that local working group originated and the local working group was integral.” [6S]
Leadership
Q: “And, let’s see. Yes, the collaboration with other policy sectors was hardly present. And with external actors and policy implementers it was present during development but the step thereafter did not take place?” A: “Yes, that did not take place, no. I think this has nothing to do with bad collaboration relations, but purely with the leading role from the municipality.” [3W]
A: “And there were a few recommendations from which the municipality could pick out what went wrong. That was, amongst other things, that the leading role was not taken enough…” [9S]
A1: “Because they [aldermen from other municipalities] were very active and this municipality actually did nothing. They went along with the regional alcohol prevention project.” A2: “Many municipalities thought: ‘Well, we participate in the regional alcohol prevention project, so we have alcohol prevention, that is arranged’.” [7S]
Q: “And why did that [local working group/integrated alcohol policy] succeed in this municipality?” A: “They [municipality] initiated this [local working group/integrated alcohol policy] themselves, you see. We [regional Public Health Service] did not have to push them [municipality].” [8S]
A: “It [implementation of interventions] really comes from us and that is also the case for all other interventions.” [5S]A: “… but those staff [of the regional Public Health Service] were also trying to stimulate the council official: ‘Come, let's establish a working group, let's do something’.” [7S and 9S]
Influential factors
A: “Just effort, people, council officials. Availability of money. Just time and hours. … yes, I [policy advisor] noticed this in everything. Also, they [municipality] really wanted to have a leading position.” [8S]Q: “So they [municipality] reserved a budget on their own to…” A: “Yes, and in addition they had money that they isolated/extracted from the regional alcohol prevention project.” [6S]
A: “I always say: ‘Person X [policy advisor of municipality 5S], you breath alcohol’. This person knows everything about alcohol and for ages this person’s focus is on alcohol.” [1W]
A: “… during the year, budget cuts were necessary, there was a shortage in money, so the budget of public health was removed …” [3W]A: “That is actually due to very practical reasons, namely time constraints of the council official that had to write this [implementation plan]." [4W]A: “It is constantly someone else who sits over there [in the municipal board]. It is just very determinative … It all costs energy, ultimately, what [energy] you put in this you cannot put into the content.” [1W]