Porthé Victoria, García-Subirats Irene, Ariza Carles, Villalbí Joan Ramón, Bartroli Montse, Júarez Olga, Díez Elia
Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Avenida Monforte de Lemos, 3-5 (Pabellón 11. Planta 0), 28029, Madrid, Spain.
Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain.
J Community Health. 2021 Jun;46(3):565-576. doi: 10.1007/s10900-020-00898-6.
Alcohol consumption was associated with 3 million deaths worldwide in 2016. Although community action has proven to be effective and has become a priority area of the global strategy to reduce alcohol consumption, there is a gap in the knowledge of community interventions to reduce alcohol use among adults. This study aims to analyze the evidence on effective community-based interventions to reduce alcohol consumption and harm among adults and to identify their components and underlying theories. Search strategy involved five databases (January 2000-March 2020). We included multicomponent, evaluated, and community interventions addressing to adults in urban settings of high-income countries. Furthermore, two conceptual frameworks were adapted to identify the social determinants of alcohol related harms and modifiable factors through community interventions. The initial search yielded 164 articles. The final sample included eight primary studies. Six of them were effective and shared three components (community mobilization; law enforcement and media campaigns), they combined approaches at individual and environmental levels addressing structural determinants of health and some cultural aspects related to consumption. Health outcomes focused mainly on reducing consumption, modifying patterns and acute effects on health. Few studies addressed social problems arising from harmful consumption. This review has identified several effective community-based interventions to reduce harmful use of alcohol among adults as well as some mechanisms and theories supporting them. It also provides a framework to guide new designs, with potential evidence of factors, as well as possible combinations of methods to improve health at community level across different settings and contexts.
2016年，全球范围内与饮酒相关的死亡人数达300万。尽管社区行动已被证明是有效的，并且已成为全球减少酒精消费战略的一个优先领域，但在减少成年人酒精使用的社区干预措施方面，仍存在知识差距。本研究旨在分析关于减少成年人酒精消费和危害的有效社区干预措施的证据，并确定其组成部分和潜在理论。检索策略涉及五个数据库（2000年1月至2020年3月）。我们纳入了针对高收入国家城市地区成年人的多成分、经过评估的社区干预措施。此外，还采用了两个概念框架来确定与酒精相关危害的社会决定因素以及通过社区干预可改变的因素。初步检索得到164篇文章。最终样本包括八项主要研究。其中六项有效且共有三个组成部分（社区动员、执法和媒体宣传活动），它们在个体和环境层面结合了方法，以解决健康的结构决定因素以及一些与消费相关的文化方面。健康结果主要集中在减少消费、改变模式以及对健康的急性影响。很少有研究涉及有害消费引发的社会问题。本综述确定了几种有效的基于社区的干预措施，以减少成年人有害饮酒行为，以及一些支持这些措施的机制和理论。它还提供了一个框架来指导新的设计，包括可能的影响因素证据以及在不同环境和背景下改善社区层面健康的方法组合。
