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Alcohol Marketing and Youth Drinking: Is There a Causal Relationship, and Why Does It Matter? 酒类营销与青少年饮酒:是否存在因果关系,为什么重要?
Q1 Medicine Pub Date : 2020-02-21 DOI: 10.15288/jsads.2020.s19.5
J. Sargent, Samantha Cukier, T. Babor
JAMES D. SARGENT, m.D.,a,* SAMANTHA CUKIER, pH.D., m.B.a.,b & THOMAS F. BABOR, pH.D., m.p.H.c aC. Everett Koop Institute, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire bThe Ottawa Hospital Research Institute, Centre for Journalology, Clinical Epidemiology Program, Ottawa, Ontario, Canada cDepartment of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut
JAMES D. SARGENT, m.d.,a,* SAMANTHA CUKIER, pH.D., m.B.a,b和THOMAS F. BABOR, ph .p. h.c. aC. Everett Koop研究所,达特茅斯Geisel医学院,黎巴嫩,新罕布什尔州;渥太华医院研究所,新闻中心,临床流行病学项目,加拿大安大略省;康涅狄格大学医学院,法明顿,康涅狄格州
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引用次数: 16
Youth Cognitive Responses to Alcohol Promotional Messaging: A Systematic Review 青少年对酒精促销信息的认知反应:一项系统综述
Q1 Medicine Pub Date : 2020-02-21 DOI: 10.15288/jsads.2020.s19.26
Elizabeth R Henehan, Ansley E Joannes, Liam Greaney, Susan Knoll, Q. W. Wong, Craig S Ross
Objective: This review examines the research of the effects of alcohol advertising on the cognitive mechanisms that precede underage alcohol use. Method: Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we reviewed 22 studies (1988–2016) selected from 22,040 articles. The final sample assessed cognitive responses of youth younger than the legal purchase age who were exposed to alcohol advertisements from television or magazines. Results: The studies were predominantly cross-sectional (59.1%), used convenience sampling (63.6%), had 74 to 3,521 participants, and were from six countries. The most common methods and applied theories for assessing advertising effects on cognitions were linear methods based on priming and modeling theories, and structural equation modeling based on information-processing models. Overall, advertising content appealed to youth, particularly advertisements that emphasized lifestyles of drinkers rather than the product quality. Youth exposed to alcohol advertisements were more likely to associate positive and arousing effects with alcohol, and in some studies effects were modified by sex, alcohol use, and age. Residual confounding and selection bias were a concern in the majority of studies. Conclusions: Exposure to alcohol advertising may affect underage perceptions of risks and rewards of alcohol use. Nevertheless, the ability to draw causal conclusions is limited because of study designs. Future studies should use nonlinear methods to assess the association between advertising and cognitions and avoid measuring alcohol advertising as a uniform and dose-response exposure among diverse populations. Future research would be strengthened by applying consistent theoretical frameworks, improving control for confounding bias, and using validated cognitive outcome measures.
目的:本文综述了酒精广告对未成年人饮酒前认知机制的影响。方法:使用PRISMA(首选报告项目用于系统评价和荟萃分析)指南,我们从22,040篇文章中选择了22项研究(1988-2016)。最后的样本评估了低于法定购买年龄的年轻人在看电视或杂志上的酒精广告时的认知反应。结果:研究以横断面为主(59.1%),采用方便抽样(63.6%),参与者74至3521人,来自6个国家。广告认知效应评估最常用的方法和应用理论是基于启动和建模理论的线性方法和基于信息处理模型的结构方程模型。总的来说,广告内容对年轻人很有吸引力,尤其是那些强调饮酒者的生活方式而不是产品质量的广告。接触酒精广告的青少年更有可能将酒精的积极和兴奋作用与酒精联系起来,在一些研究中,这种效果会因性别、酒精使用和年龄而改变。残留混淆和选择偏差是大多数研究关注的问题。结论:接触酒精广告可能会影响未成年人对饮酒风险和回报的认知。然而,由于研究设计,得出因果结论的能力是有限的。未来的研究应使用非线性方法来评估广告与认知之间的关系,并避免将酒精广告作为不同人群中统一的剂量反应暴露来测量。未来的研究将通过应用一致的理论框架,改善对混杂偏差的控制,以及使用经过验证的认知结果测量来加强。
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引用次数: 11
The Alcohol Marketing Landscape: Alcohol Industry Size, Structure, Strategies, and Public Health Responses 酒类营销前景:酒类产业规模、结构、策略和公共卫生对策
Q1 Medicine Pub Date : 2020-02-21 DOI: 10.15288/jsads.2020.s19.13
D. Jernigan, Craig S Ross
Objective: The purpose of this study is to inform public health efforts to reduce alcohol-related harm by describing the alcohol marketing landscape. We review the size, structure, and strategies of both the U.S. national and global alcohol industries and their principal marketing activities and expenditures and provide a summary of public health responses. Method: Primary data were obtained from advertising and alcohol industry market research firms and were supplemented by searches of peer-reviewed literature, business press, and online databases on global business and trade. Results: Worldwide, alcohol sales totaled more than $1.5 trillion in 2017. Control of alcoholic beverage production and marketing is concentrated globally in the hands of a small number of firms. The oligopoly structure of the producing industry helps to generate high profits per dollar invested relative to other industries, which in turn fund marketing expenditures that function as barriers to entry by other firms. Advertising expenditures are high and advertising is widespread. Stakeholder marketing and corporate social responsibility campaigns assist in maintaining a policy environment conducive to extensive alcohol marketing activity. The most common regulatory response has been alcohol industry self-regulation; statutory public health responses have made little progress in recent years and have lagged behind industry innovation in digital and social marketing. Conclusions: Alcohol marketing is widespread globally and a structural element of the alcoholic beverage industry. Given the level of alcohol-related harm worldwide, global and regional recommendations and best practices should be used to guide policy makers in effective regulation of alcohol marketing.
目的:本研究的目的是通过描述酒精营销环境,为公共卫生工作提供信息,以减少酒精相关的危害。我们回顾了美国国内和全球酒精行业的规模、结构和策略,以及他们的主要营销活动和支出,并提供了一份公共卫生反应的摘要。方法:主要数据来自广告和酒类行业市场研究公司,并辅以同行评议文献、商业报刊和全球商业和贸易在线数据库。结果:2017年,全球酒类销售总额超过1.5万亿美元。酒精饮料的生产和销售控制集中在全球少数几家公司手中。生产行业的寡头垄断结构有助于产生相对于其他行业的每美元投资的高利润,这反过来又为营销支出提供资金,作为其他公司进入的障碍。广告费用很高,广告很普遍。利益相关者营销和企业社会责任运动有助于维持有利于广泛开展酒类营销活动的政策环境。最常见的监管反应是酒类行业的自我监管;近年来,法定的公共卫生应对措施进展甚微,并且落后于数字和社会营销方面的行业创新。结论:酒精营销在全球范围内广泛存在,是酒精饮料行业的一个结构性因素。鉴于全世界与酒精有关的危害程度,应采用全球和区域建议和最佳做法来指导决策者有效监管酒精销售。
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引用次数: 45
Alcohol Marketing and Adolescent and Young Adult Alcohol Use Behaviors: A Systematic Review of Cross-Sectional Studies 酒精营销与青少年酒精使用行为:横断面研究的系统回顾
Q1 Medicine Pub Date : 2020-02-21 DOI: 10.15288/jsads.2020.s19.42
Laura J. Finan, Sharon Lipperman-Kreda, J. Grube, Anna Balassone, Emily Kaner
Objective: This article provides a systematic review of cross-sectional research examining associations between exposure to alcohol marketing and alcohol use behaviors among adolescents and young adults. Method: Literature searches of eight electronic databases were carried out in February 2017. Searches were not limited by date, language, country, or peer-review status. After abstract and full-text screening for eligibility and study quality, 38 studies that examined the relationship between alcohol marketing and alcohol use behaviors were selected for inclusion. Results: Across alcohol use outcomes, various types of marketing exposure, and different media sources, our findings suggest that cross-sectional evidence indicating a positive relationship between alcohol marketing exposure and alcohol use behaviors among adolescents and young adults was greater than negative or null evidence. In other words, cross-sectional evidence supported that alcohol marketing exposure was associated with young peoples’ alcohol use behaviors. In general, relationships for alcohol promotion (e.g., alcohol-sponsored events) and owning alcohol-related merchandise exposures were more consistently positive than for other advertising exposures. These positive associations were observed across the past four decades, in countries across continents, and with small and large samples. Conclusions: Despite issues of measurement and construct clarity within this body of literature, this review suggests that exposure to alcohol industry marketing may be important for understanding and reducing young peoples’ alcohol use behavior. Future policies aimed at regulating alcohol marketing to a greater extent may have important short- and long-term public health implications for reducing underage or problematic alcohol use among youth.
目的:本文提供了一个系统的回顾横断面研究的关系暴露于酒精营销和酒精使用行为的青少年和年轻人。方法:检索2017年2月8个电子数据库的文献。搜索不受日期、语言、国家或同行评审状态的限制。在对资格和研究质量进行摘要和全文筛选后,选择了38项研究来检查酒精营销和酒精使用行为之间的关系。结果:在酒精使用结果、不同类型的营销暴露和不同的媒体来源中,我们的研究结果表明,在青少年和年轻人中,表明酒精营销暴露与酒精使用行为之间存在正相关的横截面证据大于负面或无效证据。换句话说,横截面证据支持酒精营销暴露与年轻人的酒精使用行为有关。总的来说,酒精促销(例如,酒精赞助的活动)与拥有与酒精有关的商品曝光的关系比其他广告曝光更为一致。在过去的四十年中,在各大洲的国家,在大小样本中都观察到了这些积极的联系。结论:尽管在本文献中存在测量和结构清晰度的问题,但本综述表明,接触酒精行业营销可能对理解和减少年轻人的酒精使用行为很重要。未来旨在更大程度上管制酒类销售的政策可能对减少青少年中未成年人或有问题的酒精使用产生重要的短期和长期公共健康影响。
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引用次数: 35
Similarities Between Alcohol and Tobacco Advertising Exposure and Adolescent Use of Each of These Substances 烟酒广告与青少年使用烟酒广告之间的相似性
Q1 Medicine Pub Date : 2020-02-21 DOI: 10.15288/jsads.2020.s19.97
M. Weitzman, Lily Lee
Objective: Underage alcohol use is a major public health problem and substantial corporate money supports alcohol advertising across multiple venues. A diverse research literature demonstrates that adolescent exposure to such advertising is associated with drinking attitudes and behavior, but no scientific body has determined these associations to be causal. The objective of this study was to assess the association between alcohol advertising and teen drinking in the context of the “Analogy” criterion of the Bradford Hill criteria and consider a determination that the association between exposure to alcohol advertising and alcohol use is causal. Method: This study was a narrative review on the association between adolescent exposure to alcohol advertising and subsequent alcohol use in the context of domains utilized in the Surgeon General’s 2012 Report, Preventing Tobacco Use Among Youth and Young Adults, which concluded, “Advertising and promotional activities by tobacco companies have been shown to cause the onset and continuation of smoking among adolescents and young adults.” Results: In every aspect compared (i.e., adolescent knowledge; attitudes toward; initiation of use; continuation of use; mediums of advertisement; the use of mascots, celebrities, and themes; and frequency and density of advertisements and retailers), the findings for both tobacco and alcohol and their association with exposure to advertising are analogous. Conclusions: Application of the Analogy criterion of the Bradford Hill criteria comparing alcohol and tobacco supports a judgment that the association between exposure to alcohol advertising and increased adolescent knowledge, attitudes toward, initiation, and continuation of alcohol use are causal in nature.
目的:未成年人饮酒是主要的公共卫生问题,大量公司资金支持在多个场所进行酒精广告。各种各样的研究文献表明,青少年接触此类广告与饮酒态度和行为有关,但没有科学机构确定这些联系是因果关系。本研究的目的是在Bradford Hill标准的“类比”标准的背景下评估酒精广告与青少年饮酒之间的关系,并考虑确定接触酒精广告与饮酒之间的关系是因果关系。方法:本研究是在2012年外科医生报告《防止青少年和年轻人吸烟》中使用的领域背景下,对青少年接触酒精广告与随后饮酒之间的关系进行叙述性审查,该报告得出结论:“烟草公司的广告和促销活动已被证明会导致青少年和年轻人吸烟的开始和持续。”结果:各方面比较(即青少年知识;的态度;开始使用;继续使用;广告媒介;吉祥物、名人和主题的使用;广告和零售商的频率和密度),烟草和酒精及其与广告接触的关系的研究结果是类似的。结论:应用比较酒精和烟草的Bradford Hill标准的类比标准支持这样一种判断,即接触酒精广告与青少年对酒精的知识、态度、开始和继续使用之间的联系本质上是因果关系。
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引用次数: 14
Why Research Should Pay Attention to Effects of Marketization of Addiction Treatment Systems. 为什么研究应关注戒毒系统市场化的影响?
Q1 Medicine Pub Date : 2019-01-01 DOI: 10.15288/jsads.2019.s18.31
Jessica Storbjörk, Kerstin Stenius

Objective: Researchers generally assume that addiction treatment systems can be viewed as entities and planned with the citizens' best interests in mind. We argue that another steering principle, the market logic, has permeated many Western World treatment systems but is neglected in research. We demonstrate how it may affect system-level planning, service provision, and the service users.

Method: We draw on an ongoing Swedish study, with some Nordic references, using several data sources: (1) public statistics on treatment expenditures and purchases; (2) interviews with service users (n = 36) and their service providers (n = 23) on different market features; (3) an observation of a large public procurement process concluding framework agreements based on competitive tendering; (4) interviews with officials involved with steering of the system and procurement (n = 16); (5) a workshop on procurement in the Nordic countries (n = 11 participants); and (6) 77 interviews with professionals, managers, and elected representatives.

Results: We outline seven propositions that call for further research attention: public procurement, as regulated in the European Union, is not suitable for addiction treatment; marketization challenges democracy, equity, needs assessment, and treatment planning; marketization causes new accountability problems and idle monitoring; marketization causes fragmentation and obstructs coordination and continuity of care; marketization causes unification of services and favors big bureaucratically sophisticated providers; treatment professionals' values are downplayed when a mistrust-based market logic replaces a trust- and needs-based logic; and marketization marginalizes treatment professionals and service users by limiting discretion.

Conclusions: Findings point toward the importance of acknowledging and mitigating market principles in treatment systems to safeguard needs assessments and planning that serve the interests of the service users and the public.

目的:研究人员普遍认为,戒毒治疗系统可以被视为实体,并以公民的最大利益为出发点进行规划。我们认为,另一个指导原则--市场逻辑--已经渗透到西方世界的许多戒毒系统中,但在研究中却被忽视了。我们将展示它如何影响系统层面的规划、服务提供以及服务使用者:方法:我们借鉴了瑞典正在进行的一项研究,并参考了北欧的一些研究,使用了几种数据来源:(1) 有关治疗支出和采购的公共统计数据;(2) 就不同市场特征对服务使用者(36 人)及其服务提供者(23 人)进行的访谈;(3) 对基于竞争性招标签订框架协议的大型公共采购过程进行的观察;(4) 对参与指导系统和采购的官员(16 人)进行的访谈;(5) 北欧国家采购研讨会(11 人参加);以及 (6) 对专业人士、管理人员和民选代表进行的 77 次访谈:结果:我们概述了需要进一步研究关注的七个命题:结果:我们概述了七项命题,需要进一步的研究关注:欧盟规定的公共采购不适合戒毒治疗;市场化挑战民主、公平、需求评估和治疗规划;市场化导致新的问责问题和监督闲置;市场化导致支离破碎,阻碍护理的协调性和连续性;市场化导致服务的统一,有利于官僚化的大型供应商;当基于不信任的市场逻辑取代基于信任和需求的逻辑时,治疗专业人员的价值被淡化;市场化通过限制自由裁量权使治疗专业人员和服务使用者边缘化。结论:研究结果表明,在治疗系统中承认并减轻市场原则的重要性,以确保需求评估和规划符合服务使用者和公众的利益。
{"title":"Why Research Should Pay Attention to Effects of Marketization of Addiction Treatment Systems.","authors":"Jessica Storbjörk, Kerstin Stenius","doi":"10.15288/jsads.2019.s18.31","DOIUrl":"10.15288/jsads.2019.s18.31","url":null,"abstract":"<p><strong>Objective: </strong>Researchers generally assume that addiction treatment systems can be viewed as entities and planned with the citizens' best interests in mind. We argue that another steering principle, the market logic, has permeated many Western World treatment systems but is neglected in research. We demonstrate how it may affect system-level planning, service provision, and the service users.</p><p><strong>Method: </strong>We draw on an ongoing Swedish study, with some Nordic references, using several data sources: (1) public statistics on treatment expenditures and purchases; (2) interviews with service users (n = 36) and their service providers (n = 23) on different market features; (3) an observation of a large public procurement process concluding framework agreements based on competitive tendering; (4) interviews with officials involved with steering of the system and procurement (n = 16); (5) a workshop on procurement in the Nordic countries (n = 11 participants); and (6) 77 interviews with professionals, managers, and elected representatives.</p><p><strong>Results: </strong>We outline seven propositions that call for further research attention: public procurement, as regulated in the European Union, is not suitable for addiction treatment; marketization challenges democracy, equity, needs assessment, and treatment planning; marketization causes new accountability problems and idle monitoring; marketization causes fragmentation and obstructs coordination and continuity of care; marketization causes unification of services and favors big bureaucratically sophisticated providers; treatment professionals' values are downplayed when a mistrust-based market logic replaces a trust- and needs-based logic; and marketization marginalizes treatment professionals and service users by limiting discretion.</p><p><strong>Conclusions: </strong>Findings point toward the importance of acknowledging and mitigating market principles in treatment systems to safeguard needs assessments and planning that serve the interests of the service users and the public.</p>","PeriodicalId":17103,"journal":{"name":"Journal of Studies on Alcohol and Drugs. Supplement","volume":" ","pages":"31-39"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36896262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Mixed-Methods Evaluation of the Implementation of a Performance Measurement System for South Africa’s Substance Use Treatment Services 南非药物使用治疗服务绩效评估系统实施的混合方法评估
Q1 Medicine Pub Date : 2019-01-01 DOI: 10.15288/jsads.2019.s18.131
B. Myers, P. P. Williams, R. Govender, R. Manderscheid, J. R. Koch
Objective: Minimal knowledge exists on the factors that affect implementation of performance measurement systems, particularly in low- and middle-income countries (LMICs). To address this, we describe the implementation of a performance measurement system for South Africa’s substance abuse treatment services known as the Service Quality Measures (SQM) initiative. Method: We conducted a mixed-methods evaluation of system implementation. We surveyed 81 providers about the extent of system implementation within their agencies and the factors that facilitated implementation. We conducted 26 in-depth interviews of providers’ perceived barriers and facilitators to implementation. Results: The overall penetration of this system was high. Almost all providers viewed the system as feasible to implement, acceptable, appropriate for use in their context, and useful for guiding service improvements. However, the extent of implementation varied significantly across sites (p < .05). Leadership support (p < .05) was associated with increased implementation in multivariable analyses. Providers reflected that high rates of patient attrition, variability in willingness to implement the system, and limited capacity for interpreting performance feedback affected the extent of system implementation. Conclusions: It is feasible to implement a performance measurement system in LMICs if the system is acceptable, appropriate, and useful to providers. To ensure the utility of this system for treatment service strengthening, system implementation must be optimized. Efforts to enhance target population coverage, strengthen leadership support for performance measurement, and build capacity for performance feedback utilization may enhance the implementation of this performance measurement system. Objectifs : Peu de connaissance existe sur les facteurs influençant l’implantation d’un système de mesure du rendement, particulièrement dans les pays à revenu faible et intermédiaire (PRFI). Pour aborder cette question, nous décrivons l’implantation d’un système de mesure du rendement des services de traitement en toxicomanie d’Afrique du Sud, connu sous le nom du projet de Mesures de la qualité du service (MQS). Méthode : Nous avons mené une évaluation d’implantation du système à l’aide d’une méthode mixte. Nous avons interrogé 81 pourvoyeurs de services sur l’ampleur de l’implantation du système dans leur agence et les facteurs qui ont facilité l’implantation. Nous avons mené 26 entrevues approfondies sur les perceptions des pourvoyeurs concernant les obstacles et les facilitateurs de l’implantation. Résultats : L’appropriation générale de ce système était élevée. Presque tous les pourvoyeurs voyaient la faisabilité d’implantation du système et le considéraient comme étant acceptable, approprié à leur contexte et utile pour guider l’amélioration des services. Cependant, l’ampleur de l’implantation variait de façon significative à travers les sites (p < ,05). Le soutien de la direc
目标:对影响绩效评估系统实施的因素知之甚少,特别是在低收入和中等收入国家(LMICs)。为了解决这个问题,我们描述了南非药物滥用治疗服务的绩效衡量系统的实施,该系统被称为服务质量措施(SQM)倡议。方法:采用混合方法对系统实施情况进行评价。我们调查了81个供应商关于他们机构内系统实施的程度和促进实施的因素。我们进行了26次深入访谈,以了解供应商在实施过程中遇到的障碍和促进因素。结果:该系统整体渗透率高。几乎所有的提供者都认为该系统是可行的、可接受的、适合在其环境中使用的,并且对指导服务改进是有用的。然而,不同地点的实施程度差异显著(p < 0.05)。在多变量分析中,领导支持(p < 0.05)与提高执行力相关。提供者反映,患者的高流失率、实施该系统的意愿变化以及解释绩效反馈的能力有限影响了系统实施的程度。结论:在低收入国家实施绩效评估系统是可行的,如果该系统是可接受的,适当的,并且对提供者有用。为确保该制度对加强治疗服务的效用,必须优化制度实施。努力提高目标人口覆盖率,加强领导对绩效评估的支持,以及建立绩效反馈利用的能力,可以促进这一绩效评估系统的实施。目的:存在一些影响经济发展的因素,特别是影响经济发展的因素,特别是影响经济发展的因素,特别是影响经济发展的因素,特别是影响经济发展的因素,特别是影响经济发展的因素。就国外的其他问题而言,《关于服务质量和服务质量的措施的实施方案》、《关于服务质量和服务质量的措施的实施方案》、《关于服务质量和服务质量的措施的实施方案》、《关于服务质量和服务质量的措施的实施方案》。msamthode: Nous avons menmenes une samuvaling d 'implantation du system system ? ? i ' 'aide ' d 'une msamothode mix。Nous avons调查了81名调查对象,调查对象为系统植入服务的提供者,调查对象为系统植入服务的提供者,调查对象为系统植入服务的提供者。现在,avons menewer26家企业对投资者的看法产生了深刻的影响,他们关注的是植入的障碍和便利因素。rs: L 'appropriation gsamnsamacrale de ce system system: sims: sims: sims: sims: sims: sims: sims: sims: sims: sims: sims: sims: sims: sims: sims: sims: sims。Presque - tous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous - sous独立的,l 'ampleur de l '着床变异在不同部位有显著差异(p <,05)。Le soutien de la direction (p <,05)分析了多变量的变异变异。这两个词的意思都是:1 . volontise d 'implanter le system <e:1>; 2 . volontise d 'implanter le system <e:1>; 3 . volontise d 'implanter le system <e:1>; 3 . capacit<e:1>限制;3 . interpracement; 3 . imactroment; 3 . impact: 1 . ampleur de l 'implantation du system <e:1>。结论:在系统测试过程中,系统测试是可行的,系统测试是可接受的,是适当的,是有效的。Pour veiller - ce que ce system - <e:1> soit not not not not not not not not not not not not not not not not not not not not not not not not not not not not not not not not not not not not。在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力,在人口统计方面的努力。目的:探讨<s:1>经济因素分析(unconconciimiento mínimo sobre loses - emas de medición - del - desempeño),特别是研究(unconconciciento mínimo de los sistemas de medición - del - desempeño),以及(unconconciciento países de ingressos bajos y medios, PIMB)。Para abordaresto (Para abordaresto),描述了implementación关于系统的信息medición关于服务的信息收集的信息Sudáfrica关于物质的信息收集的信息Sudáfrica关于服务的媒体的信息收集的信息(MCS)。msametos:实现una evaluación de msametos mixtos de la implementación del sistema。1 .通过工厂和设施管理机构的系统和设施管理机构的系统和设施管理机构的系统和设施管理机构的系统和设施管理机构的平衡。Llevamos和cabo的26个企业家在深刻的soberas barreras percibidas穷人证明了他们的facilitadores para la implementación。结果:La penetración total de este sistema fue alta。Casi - todo是指系统兼容的、可实现的、可接受的、可使用的、在特定环境下可使用的服务。
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引用次数: 8
Estimation of Needs for Addiction Services: A Youth Model. 成瘾服务需求的估计:一个青少年模型。
Q1 Medicine Pub Date : 2019-01-01
Joël Tremblay, Karine Bertrand, Nadine Blanchette-Martin, Brian Rush, Annie-Claude Savard, Nadia L'Espérance, Geneviève Demers-Lessard, Rosalie Genois

Objective: In the field of health care services, resource allocation is increasingly determined based on a population needs model. Although service needs models have been developed for adults with substance use problems, it would seem inappropriate to apply them indiscriminately to young people.

Method: The method used proposes six steps: (1) targeting the population, (2) estimating the proportion of the population affected by substance misuse and (3) the proportion of youths who should receive services, (4) identifying categories of services, (5) estimating the proportions of youths who should have access to each category of services, and (6) applying the model to real use of services by youths to recalibrate it.

Results: Youths ages 12-17 from the Province of Québec were classified within a tiered model comprising four levels of substance use severity. Youths in need of services varied from 38% (weak response) to 95% (high response) for the highest severity cases. Service categories retained are detoxification/intoxication, outpatient, and residential, with each one being subdivided into four categories. The proportion of youths from each tier who should access categories and subcategories of services varied widely. After a pre-experimentation, the model was adjusted.

Conclusions: The model can be applied in different jurisdictions, with the caution of adjusting prevalence to local reality. Further improvement will be based on more accurate information concerning the path of clients through services, better strategies to reach youths in need of services, and increased knowledge of optimal service categories. Models adapted to low- or moderate-income countries, where the health care system has minimal services in the areas of mental health and addiction, should be developed.

目的:在卫生保健服务领域,资源分配越来越多地基于人口需求模型来确定。虽然已经为有药物使用问题的成年人开发了服务需求模型,但将它们不加区别地应用于年轻人似乎是不合适的。方法:使用的方法提出了六个步骤:(1)以人口为目标,(2)估计受药物滥用影响的人口比例,(3)应该接受服务的青少年比例,(4)确定服务类别,(5)估计应该获得每种服务类别的青少年比例,以及(6)将模型应用于青少年实际使用服务来重新校准它。结果:来自曲海省的12-17岁的青少年被分类在一个分层模型中,包括四个级别的物质使用严重程度。在最严重的情况下,需要服务的青少年从38%(反应弱)到95%(反应高)不等。保留的服务类别是戒毒/中毒、门诊和住院,每一类又细分为四类。每一阶层中应获得类别和子类别服务的青年所占比例差别很大。预实验后,对模型进行调整。结论:该模型可适用于不同的司法管辖区,但需根据当地实际情况调整患病率。进一步的改进将基于更准确地了解服务对象通过服务的途径,更好地为需要服务的青年提供服务的战略,以及增加对最佳服务类别的了解。应制定适合低收入或中等收入国家的模式,因为这些国家的卫生保健系统在精神卫生和成瘾方面的服务很少。
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引用次数: 0
Key Considerations in Planning for Substance Use Treatment: Estimating Treatment Need and Demand 药物使用治疗计划中的关键考虑因素:估计治疗需要和需求
Q1 Medicine Pub Date : 2019-01-01 DOI: 10.15288/jsads.2019.s18.22
A. Ritter, R. Mellor, J. Chalmers, M. Sunderland, K. Lancaster
Objective: Estimates of the extent of treatment need (defined by the presence of a diagnosis for which there is an effective treatment available) and treatment demand (defined as treatment seeking) are essential parts of effective treatment planning, service provision, and treatment funding. This article reviews the existing literature on approaches to estimating need and demand and the use of models to inform such estimation, and then considers the implications for health planners. Method: A thematic review of the literature was undertaken, with a focus on covering the key concepts and research methods that have been used to date. Results: Both need and demand are important estimates in planning for services but contain many difficulties in moving from the theory of measurement to the practicalities of establishing these figures. Furthermore, the simple quantum of need or demand is limited in its usefulness unless it is matched with consideration of different treatment types and their relative intensity, and/or explored as a function of geography and subpopulation. Modeling can assist with establishing more fine-tuned planning estimates, and is able to take into account both client severity and the various treatment types that might be available. Conclusions: Moving from relatively simplistic estimates of need and demand for treatment, this review has shown that although such estimation can inform national or subnational treatment planning, more sophisticated models are required for alcohol and other drug treatment planning. These can help health planners to determine the appropriate amount and mix of treatments for substance use disorders. Objectif : L’estimation de l’ampleur du besoin de traitement, défini par la présence d’un diagnostic pour lequel un traitement efficace est disponible, et la demande de traitement, définie par la recherche de traitement, sont des éléments essentiels à une planification efficace du traitement, à la prestation de service et à son financement. Cet article passe en revue la littérature existante sur les approches pour estimer le besoin et la demande ainsi que l’utilisation de modèles pour documenter une telle estimation, puis considère les implications pour les planificateurs des services de santé. Méthode : Une revue thématique de la littérature a été entreprise en mettant l’accent sur les concepts clés et les méthodes de recherche qui ont été utilisées à ce jour. Résultats : Les estimations des besoins et de la demande sont toutes deux importantes dans la planification des services, mais constituent des défis importants lors du passage de la théorie de la mesure aux aspects plus pratiques de production de ces estimations. Par ailleurs, la simple estimation d’un nombre lié au besoin ou à la demande est limitée, à moins qu’elle ne soit appariée avec différents types de traitement et leur intensité respective, ou explorée avec d’autres facteurs géographiques et de sous-population. La modélisation aide à produire d
此外,需求或需求的简单量子在其效用上是有限的,除非它符合对不同治疗类型及其相对强度的考虑,和/或作为地理和亚人口的函数进行探索。建模可以帮助建立更准确的计划估计,并可以考虑到客户的严重程度和可能可用的各种治疗类型。结论:从相对简单的治疗需求和需求估计,本综述表明,虽然这种估计可以为国家或地方治疗规划提供信息,但酒精和其他药物治疗规划需要更复杂的模型。这些可以帮助健康规划者确定药物使用障碍治疗的适当数量和组合。
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引用次数: 29
Modeling the Potential Impact of Changing Access Rates to Specialist Treatment for Alcohol Dependence for Local Authorities in England: The Specialist Treatment for Alcohol Model (STreAM). 英格兰地方当局酒精依赖专科治疗就诊率变化的潜在影响建模:酒精专业治疗模型(STreAM)。
Q1 Medicine Pub Date : 2019-01-01 DOI: 10.15288/jsads.2019.s18.96
Alan Brennan, Daniel Hill-McManus, Tony Stone, Penny Buykx, Abdallah Ally, Robert E Pryce, Robert Alston, Andrew Jones, Donal Cairns, Tim Millar, Michael Donmall, Tom Phillips, Petra Meier, Colin Drummond

Objective: We modeled the impact of changing Specialist Treatment Access Rates to different treatment pathways on the future prevalence of alcohol dependence, treatment outcomes, service capacity, costs, and mortality.

Method: Local Authority numbers and the prevalence of people "potentially in need of assessment for and treatment in specialist services for alcohol dependence" (PINASTFAD) are estimated by mild, moderate, severe, and complex needs. Administrative data were used to estimate the Specialist Treatment Access Rate per PINASTFAD person and classify 22 different treatment pathways. Other model inputs include natural remission, relapse after treatment, service costs, and mortality rates. "What-if" analyses assess changes to Specialist Treatment Access Rates and treatment pathways. Model outputs include the numbers and prevalence of people who are PINASTFAD, numbers treated by 22 pathways, outcomes (successful completion with abstinence, successfully moderated nonproblematic drinking, re-treatment within 6 months, dropout, transfer, custody), mortality rates, capacity requirements (numbers in contact with community services or staying in residential or inpatient places), total treatment costs, and general health care savings. Five scenarios illustrate functionality: (a) no change, (b) achieve access rates at the 70th percentile nationally, (c) increase access by 25%, (d) increase access to Scotland rate, and (e) reduce access by 25%.

Results: At baseline, 14,581 people are PINASTFAD (2.43% of adults) and the Specialist Treatment Access Rate is 10.84%. The 5-year impact of scenarios on PINASTFAD numbers (vs. no change) are (B) reduced by 191 (-1.3%), (C) reduced by 477 (-3.3%), (D) reduced by almost 2,800 (-19.2%), and (E) increased by 533 (+3.6%). The relative impact is similar for other outputs.

Conclusions: Decision makers can estimate the potential impact of changing Specialist Treatment Access Rates for alcohol dependence.

目的我们模拟了不同治疗途径的专科治疗率变化对未来酒精依赖患病率、治疗效果、服务能力、成本和死亡率的影响:按轻度、中度、重度和复杂需求估算地方当局的人数和 "可能需要酒精依赖评估和专家服务治疗"(PINASTFAD)的患病率。管理数据用于估算每个 PINASTFAD 患者的专科治疗获得率,并对 22 种不同的治疗途径进行分类。其他模型输入包括自然缓解、治疗后复发、服务成本和死亡率。"假设 "分析评估专家治疗率和治疗途径的变化。模型输出包括 PINASTFAD 患者的人数和患病率、22 种治疗途径的治疗人数、治疗结果(成功完成治疗并戒酒、成功控制非问题性饮酒、6 个月内重新接受治疗、辍学、转院、监护)、死亡率、治疗能力要求(与社区服务机构联系或住院治疗的人数)、治疗总成本以及一般医疗费用节省情况。五种方案说明了其功能性:(a)无变化,(b)达到全国第 70 百分位数的就诊率,(c)增加 25%的就诊率,(d)增加到苏格兰的就诊率,以及(e)减少 25%的就诊率:基线时,14,581 人患有 PINASTFAD(占成人的 2.43%),专科治疗获得率为 10.84%。各方案对 PINASTFAD 人数的 5 年影响(与不变相比)分别为:(B) 减少 191 人 (-1.3%),(C) 减少 477 人 (-3.3%),(D) 减少近 2,800 人 (-19.2%),(E) 增加 533 人 (+3.6%)。其他产出的相对影响类似:决策者可以估算出改变酒精依赖专科治疗率的潜在影响。
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引用次数: 0
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Journal of Studies on Alcohol and Drugs. Supplement
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