Department of Psychology, Sociology and Politics, Collegiate Crescent, Sheffield Hallam University, Sheffield S10 2BP, United Kingdom; Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, LondonWC1H 9SH, United Kingdom.
Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, LondonWC1H 9SH, United Kingdom.
Int J Drug Policy. 2020 Nov;85:102909. doi: 10.1016/j.drugpo.2020.102909. Epub 2020 Aug 27.
Engaging the community in decisions-making is recognised as important for improving public health, and is recommended in global alcohol strategies, and in national policies on controlling alcohol availability. Yet there is little understanding of how to engage communities to influence decision-making to help reduce alcohol-related harms. We sought to identify and understand mechanisms of community engagement in decision-making concerning the local alcohol environment in England.
We conducted case studies in three local government areas in England in 2018, purposively selected for examples of community engagement in decisions affecting the local alcohol environment. We conducted 20 semi-structured interviews with residents, workers, local politicians and local government practitioners, and analysed documents linked to engagement and alcohol decision-making.
Four rationales for engaging the community in decision-making affecting the alcohol environment were identified: i) as part of statutory decision-making processes; ii) to develop new policies; iii) as representation on committees; and iv) occurring through relationship building. Many of the examples related to alcohol licensing processes, but also local economy and community safety decision-making. The impact of community inputs on decisions was often not clear, but there were a few instances of engagement influencing the process and outcome of decision-making relating to the alcohol environment.
While influencing statutory licensing decision-making is challenging, community experiences of alcohol-related harms can be valuable 'evidence' to support new licensing policies. Informal relationship-building between communities and local government is also beneficial for sharing information about alcohol-related harms and to facilitate future engagement. However, care must be taken to balance the different interests among diverse community actors relating to the local alcohol environment, and extra support is needed for those with least capacity to engage but who face more burden of alcohol-related harms, to avoid compounding existing inequalities.
让社区参与决策被认为对于改善公共卫生非常重要，这在全球酒精战略以及控制酒精供应的国家政策中都得到了推荐。然而，对于如何让社区参与影响决策以帮助减少与酒精相关的伤害，我们知之甚少。我们试图确定并理解社区参与有关英格兰当地酒精环境的决策制定的机制。
我们于 2018 年在英格兰的三个地方政府区域进行了案例研究，这些区域是根据对当地酒精环境有影响的决策中社区参与的例子有目的地选择的。我们对居民、工人、当地政治家和地方政府从业人员进行了 20 次半结构化访谈，并分析了与参与和酒精决策相关的文件。
确定了社区参与影响酒精环境的决策的四个理由：i）作为法定决策过程的一部分；ii）制定新政策；iii）作为委员会代表；iv）通过建立关系。许多例子与酒精许可程序有关，但也涉及当地经济和社区安全决策。社区投入对决策的影响往往不明确，但有一些例子表明，参与影响了与酒精环境有关的决策过程和结果。
虽然影响法定许可决策具有挑战性，但与酒精相关的伤害有关的社区经验可以作为支持新许可政策的有价值的“证据”。社区和地方政府之间的非正式关系建立对于分享有关酒精相关伤害的信息和促进未来的参与也很有益。然而，必须注意平衡与当地酒精环境有关的不同社区行为者之间的不同利益，并且需要为那些参与能力最弱但面临更多与酒精相关的伤害负担的人提供额外的支持，以避免加剧现有的不平等现象。
