Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
Addiction. 2021 Sep;116(9):2260-2288. doi: 10.1111/add.15341. Epub 2021 Jan 14.
A complex systems perspective has been advocated to explore multi-faceted factors influencing public health issues, including alcohol consumption and associated harms. This scoping review aimed to identify studies that applied a complex systems perspective to alcohol consumption and the prevention of alcohol-related harms in order to summarize their characteristics and identify evidence gaps.
Studies published between January 2000 and September 2020 in English were located by searching for terms synonymous with 'complex systems' and 'alcohol' in the Scopus, MEDLINE, Web of Science and Embase databases, and through handsearching and reference screening of included studies. Data were extracted on each study's aim, country, population, alcohol topic, system levels, funding, theory, methods, data sources, time-frames, system modifications and type of findings produced.
Eighty-seven individual studies and three systematic reviews were identified, the majority of which were conducted in the United States or Australia in the general population, university students or adolescents. Studies explored types and patterns of consumption behaviour and the local environments in which alcohol is consumed. Most studies focused on individual and local interactions and influences, with fewer examples exploring the relationships between these and regional, national and international subsystems. The body of literature is methodologically diverse and includes theory-led approaches, dynamic simulation models and social network analyses. The systematic reviews focused on primary network studies.
The use of a complex systems perspective has provided a variety of ways of conceptualizing and analyzing alcohol use and harm prevention efforts, but its focus ultimately has remained on predominantly individual- and/or local-level systems. A complex systems perspective represents an opportunity to address this gap by also considering the vertical dimensions that constrain, shape and influence alcohol consumption and related harms, but the literature to date has not fully captured this potential.
为了探索影响公共卫生问题（包括饮酒及相关危害）的多方面因素，人们提倡采用复杂系统视角。本研究旨在确定运用复杂系统视角研究饮酒与预防酒精相关危害的相关文献，以总结其特点并确定证据空白。
通过在 Scopus、MEDLINE、Web of Science 和 Embase 数据库中搜索与“复杂系统”和“酒精”同义的术语，以及通过纳入研究的手工检索和参考文献筛选，查找 2000 年 1 月至 2020 年 9 月期间发表的英文文献。提取每个研究的目的、国家、人群、酒精主题、系统层次、资金、理论、方法、数据来源、时间框架、系统修改和得出的发现类型等信息。
确定了 87 项单独的研究和 3 项系统评价，其中大多数在美国或澳大利亚进行，研究对象为普通人群、大学生或青少年。研究探索了消费行为的类型和模式以及饮酒的当地环境。大多数研究侧重于个体和当地的相互作用和影响，而较少的研究则探索了这些关系与区域、国家和国际子系统之间的关系。该文献的方法多种多样，包括理论导向的方法、动态模拟模型和社会网络分析。系统评价主要关注原始网络研究。
运用复杂系统视角提供了多种概念化和分析饮酒和预防危害工作的方法，但最终重点仍然是主要的个体和/或地方系统。复杂系统视角提供了一个机会，可以通过考虑限制、塑造和影响饮酒和相关危害的垂直维度来解决这一差距，但迄今为止，文献尚未充分利用这一潜力。
