Whole-of-community approaches to reducing alcohol-related harm: what do communities think?

Aim: A whole-of-community approach can be defined as a range of intervention strategies simultaneously implemented across a whole community. One possibility for the lack of evidence for the effectiveness of this type of approach to reducing alcohol-related harm is that whole-of-community strategies to date have not examined whether this type of approach, relative to alternative strategies, is acceptable to communities. Methods: The acceptability of a whole-of-community approach and a range of uni-dimensional strategies are examined using 3,017 survey responses from a random sample of 7,985 individuals (aged 18–62) across 20 rural communities in NSW, Australia, as part of a large-scale randomised controlled trial: the Alcohol Action in Rural Communities (AARC) project. Using the Australian Electoral Roll, the sample was selected to reflect specific characteristics (i.e., gender and age) of each participating town as defined in the Australian Bureau of Statistics 2001 census. Results: Relative to other commonly implemented intervention strategies, the whole-of-community approach acceptability rating (85.5%) was statistically significantly greater than increased random breath testing (80.7%), pharmacist information (76.2%) and workplace training (77.0%), and less than increased pub/club compliance (95.8%), high-school programs (96.2%), increased police enforcement (89.5%) and hospital-based advice (88.6%). Intervention acceptability ratings were not associated with exposure to the suggested intervention with two exceptions: those exposed to pub/club compliance provided a lower acceptability rating, while those exposed to workplace training/policies provided a higher acceptability rating. Conclusions: The high level of public support for alcohol interventions and the relatively low exposure to such interventions suggest scope for increasing awareness of intervention activity in communities and implementing a coherent whole-of-community approach