Beating the grog: an evaluation of the Tennant Creek liquor licensing restrictions.

OBJECTIVE: To review the effectiveness of, and community attitudes towards, increased restrictions on the availability of alcohol in Tennant Creek. METHOD: Estimates of quarterly per capita consumption of pure alcohol by persons aged > or = 15 years, admissions data from the local hospital, women's refuge and sobering up shelter, and police data on detentions in custody and common offences were compared for the 12 months prior and 24 months subsequent to the introduction of the restrictions. A random sample survey of residents aged > or = 18 years was conducted to ascertain attitudes towards the restrictions. RESULTS: Over the two years following the introduction of the restrictions, there was a reduction of 19.4% in annual per capita consumption of pure alcohol. This was accompanied by declines in: hospital admissions for acute alcohol-related diagnostic related groups; and persons taken into police custody and the proportions of offences reported on Thursdays. A majority of survey respondents was in favour of retaining or strengthening the existing restrictions. CONCLUSIONS: The restrictions were effective in reducing alcohol consumption and acute related harm and had the support of the majority of people in Tennant Creek. On the basis of this evidence, the NT Liquor Commission made a decision to retain them. Restrictions do not provide a simple answer to the problems associated with excessive alcohol consumption. However, they can be an effective part of a broad public health strategy to deal with such problems.

What works? A review of evaluated alcohol misuse interventions among aboriginal Australians.

AIMS: To identify which intervention strategies have been effective in reducing excessive consumption of alcohol, and related harm, among some segments of Australia's Aboriginal population. DESIGN: Items dealing with 'alcohol' and 'evaluation' (27) were identified from the comprehensive electronic data base on Aboriginal alcohol and other drug issues, maintained by Australia's National Centre for Research into the Prevention of Drug Abuse. From these were selected all reports (14) dealing specifically with evaluation of particular intervention projects. These were grouped and systematically reviewed under the broad categories of treatment, health promotion education, acute interventions and supply reduction. FINDINGS: A broad range of intervention strategies has been employed. However, few systematic evaluations have been undertaken and the methodologies employed have been generally insufficient to allow robust generalization. The impact of most interventions appears limited but, in part, this may be a function of inadequate resourcing and programme support. CONCLUSIONS: Despite the limitations of the evaluation reports, several conclusions can be tentatively drawn. It appears there is a need to employ a broader range of treatment models and complementary intervention strategies. Interventions are generally inadequately resourced. There is a suggestion that supply reduction interventions may be effective. Most importantly, there is a pressing need for more rigorous evaluation studies in cooperation with Aboriginal community organizations.

Evaluating government health and substance abuse programs for indigenous peoples: a comparative review.

Most health and substance abuse programs for indigenous peoples in Australia are funded by government. Over the past decade there have been calls for greater accountability in the conduct of these programs. Initial attempts focused on the development of standardised performance indicators, an approach that has been criticised on both political and methodological grounds. Recently, some government agencies have sought to identify culturally appropriate models for the evaluation of programs for indigenous peoples. In a comparative review of the evaluation of indigenous programs in Australia and Canada, conducted for the Western Australian Aboriginal Affairs Department, the authors were not able to identify any generally applicable models. However, this literature review and our own research and experience in working with Aboriginal community organisations have identified some principles that should be an essential part of any attempts to evaluate health and substance abuse programs for indigenous peoples. Underlying these principles is the realisation that evaluation is not a politically or ideologically neutral activity. Theoretical and methodological considerations of the evaluation process must take into account the very real differences between the agendas of indigenous peoples and those who seek to evaluate programs for them.