National Alcohol Strategy 2000-2003
Full text version

Date of publication: March 2001This is the full text online version of this document. You can also download this publication in PDF format.

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Part Six: The Monitoring Framework

Although the National Drug Policy identifies areas to be targeted for improvement, it neither specifies the extent of improvement expected, nor how progress will be measured or monitored. These shortcomings were addressed in a 1999 report prepared for the Inter-Agency Committee on Drugs (Ministry of Health and Alcohol Advisory Council 1999). The report:

• suggested specific quantitative and qualitative indicators for monitoring progress towards the National Drug Policy’s desired outcomes

• offered supporting evidence and rationale for the chosen indicators’ appropriateness and value

• gave the baseline data for the indicators chosen, along with some reference to the data already gathered that are relevant to the indicators

• discussed the availability of data to enable monitoring over time

• suggested improvements to data collection to enable more effective monitoring

• proposed both quantitative and qualitative targets where appropriate.

Targets and indicators

The tables that follow present a summary of the alcohol-related targets and indicators from the IACD report, some of which have been slightly adapted for present purposes.

The tables use the following format:

• Priorities: alcohol-related priorities for action identified in the National Drug Policy

• Outcomes: the desired outcomes specified for each priority in the National Drug Policy

• Targets: quantified outcomes to be achieved within specified times

• Indicators: yardsticks to measure progress towards outcomes

• Data sources: datasets used to identify indicators and provide a basis for measuring progress

• Responsibility for monitoring and reporting: IACD agency responsible for monitoring and reporting on progress

• Comment: information, drawn largely from the IACD report, on the limitations of the monitoring framework for each outcome.

Outcome 1: Government staff and agencies General acceptance by government staff of harm minimisation as an effective approach to reducing alcohol-related harm; and ongoing co-operation and collaboration amongst agencies involved in alcohol issues. Targets Indicators Data source Responsibility for monitoring/reporting See comment Number of IACD meetings National Drug Policy reporting structure All IACD agencies Six-monthly reporting Comment: Development of a target is not considered appropriate to this outcome as meetings and reporting are process results and will not of themselves contribute to the priority. Data sources will be generated by IACD agency participation.

Outcome 2: Community involvement Increased involvement of the community and particular subgroups within the community in reducing alcohol-related harm. Targets by 2003 Indicators Data source Responsibility for monitoring/reporting See comment Service delivery contracts let to non-government organisations in relation to harm minimisation National Drug Policy reporting structure All IACD agencies Funding levels that community agencies and non-government organisations receive in association with Policy outcomes IACD agencies' six-monthly reporting on community involvement in reducing harm within their sector IACD agencies' six-monthly reporting on the degree and nature of contact and consultation with non-government organisations and the community Comment: Development of a target is not considered appropriate to this outcome as the nature of involvement and consultation is of as much importance as, if not more than the quantity. Data on service delivery contracts let to non-government organisations exist but would need to be analysed to enable recording against the indicators. Data on contact and consultation with non-government organisations and the wider community have not yet been collected.

Outcome 3: School policies and education More effective school policies and education in the school setting about healthy attitudes and practices for alcohol use. Targets by 2003 Indicators Data source Responsibility for monitoring/reporting See comment A higher proportion of schools have drug education policies and programmes that take into account relevant aspects of Drug Education: A Guide for Principals and Boards of Trustees (Ministry of Education 2000) Surveys and monitoring evaluation data developed form the Drug Education Development Programme Ministry of Education More evidence that teachers understand the principles of effecitve drug education, and models of good practice, and that this understanding is demonstrated in drug education programmes delivered in schools A higher proportion of schools provide their students (at least those in years 1-10) with opportunities to achieve drug education goals that are consistent with the national Health and Physical Education Curriculum Comment: Insufficient data are available to set targets.

Outcome 4: Workplace injury and productivity Reduction in injury and loss of productivity in the workplace, linked to the use of alcohol. Targets by 2003 Indicators Data sources Responsibility for monitoring/reporting See comment See comment Occupational Safety and Health Service does not collect data on the use of alcohol and illicit drugs Ministry of Health/Alcohol Advisory Council Comment: Insufficient data are available to set targets. No indicators are proposed due to lack of relevant datasets. The Ministry of Health and Alcohol Advisory Council have been allocated provisional responsibility for monitoring/reporting because the Occupational Safety and Health Service is not a member of the IACD.

Outcome 5: Treatment Improved range, quality and accessibility of treatment options for people with alcohol problems. Targets by 2003 Indicators Data sources Responsibility for monitoring/reporting See comment See comment Data not yet available. The Ministry of Health is implementing a reporting framework for mental health providers and a categorisation programme for mental health services, which should yield datasets over time Ministry of Health Comment: Until indicators are finalised, targets cannot be set. Indicators will need to be developed from data collected by the Ministry of Health through its reporting framework for mental health providers. Those data are now being systematically collected, and it is expected they will be available soon.

Outcome 6: Expertise of health workers Improved expertise of health workers in the alcohol field. Targets by 2003 Indicators Data sources Responsibility for monitoring/reporting See comment Proportion of alcohol and drug treatment workers with postgraduate qualifications Workforce surveys Alcohol Advisory Council Improved alcohol and drug competency scores achieved by medical students as they progress through undergraduate training Evaluation of undergraduate medical education Number of students completing postgraduate and undergraduate papers Training instituion records Comment: Indicators identified, but targets not yet set as data has only been collected for a short time. The emphasis in the indicators on clincially oriented education and training reflects the current absence of relevant workforce development opportunities for those working in the public health sector.

Outcome 1: Responsible drinking levels Increase in the proportion of the population who do not exceed maximum responsible drinking levels. Targets by 2003 Indicators Data sources Responsibility for monitoring/reporting From 21% to 18% of males; and from 8% to 6% for females Proportion of drinkers who exceed maximum responsible drinking levels on an occasion at least weekly: 6 standard drinks for males 4 standard drinks for females Alcohol and Public Health Research Unit national surveys on drinking Alcohol Advsory Council From 27% to 25% at 10 litres; from 12% to 10% at 20 litres Proportion of drinkers whose annual consumption exceeds: 10 litres of absolute alcohol/year 20 litres of absolute alcohol/year Comment: It is an open question at this stage is whether the survey samples should be kept at 14-65 years and defining 'adult' drinkers as those aged 15+ (in line with Statistics New Zealand data and other sources); or whether 'adult' drinkers should be defined as those aged 18+, to allow more sensitive evaluation of the lowering of the legal drinking age. These questions will require further consideration by IACD agencies.

Outcome 2: Alcohol and pregnancy Reduction in the prevalence of drinking among pregnant women and women planning pregnancy. Targets by 2003 Indicators Data sources Responsibility for monitoring/reporting See comment See comment Ministry of Health/Alcohol Advisory Council Comment: Indicators/targets cannot be identified until baseline data are generated. However, the Ministry of Health and Alcohol Advisory Council propose to work with the Alcohol and Public Health Research Unit to include questions regarding alcohol and pregnancy in future surveys.

Outcome 3: Drinking and young people Reduction in the prevalence of binge drinking and other harmful drinking patterns amongst young people, including young Maori and young Pacific peoples. Targets by 2003 Indicators Data sources Responsibility for monitoring/reporting From 18% to 15% for males; and from 7% to 5% for females From 36% to 30% for males; and from 28% to 25% for females Proportion of drinkers aged 14-17 years who, on one occasion at least weekly, exceed: 6 standard drinks for males 4 standard drinks for females Proportion of drinkers aged 18-19 years who, on one occasion at least weekly, exceed: 6 standard drinks for males 4 standard drinks for females Proportion of drinkers under 18 years who report experiencing 5 or more negative consequences from their own drinking Proportion of drivers under 18 years who exceed prescribed breath/blood alcohol levels Proportion of drivers under 18 involved in alcohol-related road crashes Alcohol and Public Health Research Unit national surveys on drinking Land Transport Safety Authority datasets Alcohol Advisory Council Land Transport Safety Authority Comment: Indicators/targets have been drawn from available survey data as the most suitable measures. It has not yet been possible to develop robust indicators/targets in relation to young Maori and young Pacific peoples.

Outcome 4: Alcohol and road crashes Reduction in the rate of road crashes involving of road crashes involving drivers who have consumed alcohol beyond prescribed blood alcohol content levels. Targets by 2003 Indicators Data sources Responsibility for monitoring/reporting A reduction in the proportion of deceased drivers over the legal alcohol limit at the time of the crash, to 25% or less for 2000/01 Proportion of fatal road crashes where driver alcohol was involved Proportion of road crashes resulting in injury where driver alcohol was involved Land Transport Safety Authority datasets on alcohol-related fatalities and crashes Land Transport Safety Authority

Outcome 5: Maori, alcohol and road crashes Reduction in the rate of Maori death and injury caused by alcohol-related motor vehicle crashes. Targets by 2003 Indicators Data sources Responsibility for monitoring/reporting See comment Proportion of Maori drinkers who exceed maximum responsible drinking levels on one occasion at least weekly: 6 standard drinks for males 4 standard drinks for females Proportion of Maori drinkers whose annual consumption exceeds: 10 litres of absolute alcohol/year 20 litres of absolute alcohol/year Proportion of Maori drivers who exceed prescribed breath/blood alcohol levels Proportion os Maori drivers involved in alcohol-related road crashes Maori booster sample from Alcohol and Public Health Research Unit national surveys on drinking Land Transport Safety Authority datasets Alcohol Advisory Council Land Transport Safety Authority Comment: Insufficient data available to set targets. Although ethnicity data is not routinely collected by the Land Transport Safety Authority at present, there is an expectation that such data will become available over time.

Outcome 6: Alcohol-related crimes Reduction in the rate of alcohol-related crimes, including criminal assaults and public order offences. Targets by 2003 Indicators Data sources Responsibility for monitoring/reporting From 10% to 5% From 5% to 3% Proportion of males surveyed who report being assaulted by someone who had been drinking Proportion of females surveyed who report ebing assaulted by someone who had been drinking Proporation of domestic violence indicents attended where alcohol involvement was noted Proportion of offences where alcohol was a factor when charges were laid Number of prosecutions taken against license holders as a proportion of all licences Number of infringement notices issued for Sale of Liquor Act offences Alcohol and Public Health Research Unit national surveys on drinking POL 400 forms and national police reports Police charge sheet data for offences Police offence data and Liquor Licensing Authority statistics Police infringement notice datasets Police Police/Liquor Licensing Authority Police Comment: Insufficient data available to set targets, except for those crime-related indicators derived from national surveys conducted by the Alcohol and Public Health Research Unit.

Outcome 7: Alcohol-related drownings and injuries Reduction in the rate of alcohol-related drownings and other alcohol-related injuries. Targets by 2003 Indicators Data sources Responsibility for monitoring/reporting A reduction in the proportion of alcohol-related drownings to 15% of all drownings Proportion of drownings that are alcohol-related Proportion of hospitalisations involving external injury where alcohol was present Water Safety New Zealand database New Zealand Health Information Service hospitalisation data Ministry of Health/Alcohol Advisory Council Ministry of Health Comment: Indicators are drawn from official datasets of Water Safety New Zealand and New Zealand Health Information Service. Analysis of time-series data is required before hospitalisation target can be set. Note also that hospitalisation data provide only a partial picture of alcohol-related injuries.

Reporting

The IACD report on indicators proposes that:

• as part of its six-monthly reporting requirement to the Ministerial Committee on Drug Policy, the IACD should produce an annual update against the indicators

• the updates form part of IACD’s second (August) report for each year

• the reporting on indicators should begin in 2000.

The IACD report on indicators further notes that mid-year updates on the outcomes would support a proposed biennial production of a National Drug Statistics Report.

Going beyond the framework

Future research

Indicators for a number of the outcomes listed in this National Alcohol Strategy were identified from, and will be monitored using existing datasets – at least, as long as these datasets continue to be compiled. For other outcomes, however, no dataset appropriate for the purpose of developing indicators currently exists. For example, in the case of alcohol-related injuries, treatment options, and Maori rates of death and injury in alcohol-related road crashes, suitable datasets may be able to be developed from information that is currently being collected. For other outcomes, such as alcohol and pregnancy, it is much more likely that new research will be needed.17

For the most part, the outcomes, which form the basis of the monitoring framework, focus on groups, environments and behaviours known to be associated with alcohol-related harm. However, as society changes it is likely that the nature and causes of alcohol-related harm will change also.

It is expected that the National Drug Policy will be reviewed in 2003. In the meantime, it is important that efforts are not focused solely on the known problems and strategies. Wider monitoring in the form of new research – research that enables emerging problems to be quickly identified, and strategies to be developed and implemented – also needs to be undertaken.

Research identified in Part Two: Key issues

• the contribution of alcohol to deaths, illness and hospitalisations

• the prevalence of co-existing alcohol problems and mental health disorders

• the extent to which alcohol is involved in boating fatalities and other drownings

• New Zealand prevalence of FAS/FAE

• the contribution of alcohol to violence within the family

• the role of alcohol in other types of offending

• the contribution of alcohol to workplace accidents.

As well, more needs to be known about how some groups use alcohol, in particular:

• Maori

• Pacific peoples

• young women

• older people

• people with mental health problems.

Research identified in Part Four: Strategies

• impact of the reduction in the legal drinking age on alcohol-related harm

• impact of the increased availability of alcohol on alcohol-related harm

• impact of devolving further decision-making power to District Licensing Agencies

• impact of marketing and sales strategies on alcohol consumption

• feasibility of recalibrating tax levels to influence drinking patterns and practices

• drinking patterns and practices of people who are same-sex-attracted

• drinking patterns and practices of groups recently settled in New Zealand

• effectiveness of family-based approaches to dealing with alcohol problems

• effectiveness of community development models in reducing alcohol-related harm

• effectiveness of treatment, especially for members of different cultures

• new treatment approaches, such as pharmacotherapies and brief interventions.

Research identified in Part Five: Workforce development

• effectiveness and efficiency of education and training

• relevance and appropriateness of education and training programmes

• barriers to education and training.

Research identified in Part Six: The monitoring framework

• effectiveness of school policies and education in the school setting on healthy attitudes and practices around alcohol

• prevalence of drinking amongst pregnant women and women planning pregnancy

• impact of the use of alcohol on injury and lost productivity in the workplace

• Maori rates of death and injury from alcohol-related road crashes

• the extent of alcohol-related crime.

Co-ordination of information

Government agencies produce and retain vast amounts of information. Much information relating to alcohol use and misuse, and to alcohol-related harm and problems, is collected and collated. Most of this information, however, is stored in databases maintained in relative isolation from one another.

To maximise the usefulness of available information, there needs to be greater co-ordination of data sources. Not only will this approach help avoid costly duplications, but it will help ensure that those addressing alcohol-related harm are readily able to find out what is available, easily access it when required, and select from it the information they need.

The rapidly growing use of the Internet, supported by ever more sophisticated computer technology, has made more information more readily available, and available to a much wider audience, than was previously possible. It is now important to determine how best to utilise these computer-based developments to improve the co-ordination of information and, in so doing, facilitate the application of new information to future efforts to reduce alcohol-related harm.

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17 This need has been foreseen for some time; refer to Public Health Commission 1994.

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Related information

Other Ministry of Health Strategies

Alcohol in New Zealand

National Drug Policy website