How does relevant theory inform a public alcohol policy model?

摘要

This thesis investigates the problems associated with alcohol and solutions to these concerns through a theory based alcohol policy model. Public alcohol policy is challenging to frame in Australia in the context of the policy environment, unclear government agendas, shifting governance structures, and the influence of the alcohol industry on policy direction. To add to these complexities, the current National Alcohol Strategy has done little to reduce the extent and severity of alcohol related harms. A sociocultural focus dominates the Strategy within, predominantly, a harm reduction approach. This emphasis has resulted in issues such as alcohol availability, aggregate consumption and drinker control being inconsistently addressed in strategic actions. In the wake of these omissions, policy advancement is a pressing concern. The thesis determines a way forward for alcohol policy in Australia by analysing research related to alcohol availability and drinker behaviour. Gaps are apparent in the literature. Evidence of an ordered approach to policy development is lacking and relevant theory is not referred to for an alcohol policy model.udTo inform a model for public alcohol policy, an appeal to theory is made. Analysis of population theory and behavioural theory is conducted against key indicators of alcohol associated risk. An integrated approach to alcohol problems and their policy solutions is sought. Availability Theory and the Theory of Planned Behaviour emerge as theories of relevance to alcohol outcomes and alcohol policy. The thesis demonstrates that limiting actual availability and modifying perceived availability are effective ways to lessen population consumption and harms. The importance of strengthening actual behavioural control and modifying perceived behavioural control is likewise confirmed. The thesis establishes the benefits of analysing and applying relevant theory to alcohol policy development. Results of the investigation are presented in a public alcohol policy model The ‘PRACTISE’ Model is the definitive contribution of this thesis to the alcohol research and public policy fields.udFigure 1: The ‘PRACTISE’ Model:udThe Policy ‘Risk appraisal’ of Availability and Control to Increase Strategic Effectiveness (PRACTISE) Model is comprised of a number of components. The Model incorporates the policy aims of limited alcohol availability and stronger behavioural control. Also acknowledged in the Model are the contributions of perceived alcohol availability and perceived behavioural control to the prevention of risk from consumption. The ‘PRACTISE’ Model is a theory based framework and practical way for governments and communities to confront alcohol related harms. A number of Principles are central to the Model, as is a Policy Risk Index. The ‘PRACTISE’ Model, as a scaffold for conceptualising alcohol related risk, informs interventions associated with alcohol. A suite of aims, objectives, goals and strategies support the Model. The Model is a strategic planning tool for policy makers as well as a guide for field practitioners, and is suitable for implementation at national, jurisdictional and community levels. The Model does not contain all the answers; that would be difficult with alcohol. What is provided is a systematic way to achieve more acceptable levels of risk, in order to prevent alcohol associated harms.