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Gender Informed or Gender Ignored? Opportunities for Gender Transformative Approaches in Brief Alcohol Interventions on College Campuses.

ABSTRACT: Brief alcohol interventions are an effective strategy for reducing harmful and risky alcohol use and misuse. Many effective brief alcohol interventions include information and advice about an individual's alcohol use, changing their use, and assistance in developing strategies and goals to help reduce their use. Emerging research suggests that brief interventions can also be expanded to address multiple health outcomes; recognizing that the flexible nature of these approaches can be helpful in tailoring information to specific population groups. This scoping review synthesizes evidence on the inclusion of sex and gender in brief alcohol interventions on college campuses, highlighting available evidence on gender responsiveness in these interventions. Furthermore, this scoping review offers strategies on how brief alcohol interventions can be gender transformative, thereby enhancing the effectiveness of brief alcohol interventions as harm reduction and prevention strategies, and in promoting gender equity.

SUBMITTER: Wolfson L

PROVIDER: S-EPMC7014134 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Gender Informed or Gender Ignored? Opportunities for Gender Transformative Approaches in Brief Alcohol Interventions on College Campuses.

Wolfson Lindsay L Stinson Julie J Poole Nancy N

International journal of environmental research and public health 20200107 2

Brief alcohol interventions are an effective strategy for reducing harmful and risky alcohol use and misuse. Many effective brief alcohol interventions include information and advice about an individual's alcohol use, changing their use, and assistance in developing strategies and goals to help reduce their use. Emerging research suggests that brief interventions can also be expanded to address multiple health outcomes; recognizing that the flexible nature of these approaches can be helpful in t ...[more]

PMID: 31936091

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Project description:BACKGROUND:Community-based programs in rural low-and middle-income country settings are well-placed to conduct gender transformative activities that aid program sustainability and catalyse wider social change, such as reducing gender inequities that in turn improve health outcomes. The Anchal program is a drowning prevention intervention for children aged 1-5?years old in rural Bangladesh. It provides community crèche-based supervision delivered by local trained paid-female volunteers. We aimed to identify the influence of the Anchal program on gender norms and behaviours in the community context, and the effects these had on program delivery and men and women's outcomes. METHODS:Qualitative in-depth interviews, focus group discussions and observations were conducted with program beneficiaries and providers. Gender outcomes were analysed using FHI 360's Gender Integration Framework. RESULTS:The Anchal program was found to be a gender accommodating program as it catered for communities' gender-based roles and constraints but did not actively seek to change underlying beliefs, perceptions and norms that led to these. The program in some cases enhanced the independence and status of female community staff. This changed perceptions of communities towards acceptable levels of physical mobility and community involvement for women. Conversely, gender affected program delivery by reducing the ability of female supervisory staff to engage with male community leaders. The double burden of wage and household labour carried by local female staff also limited performance and progression. Gender-based constraints on staff performance, attrition and community engagement affected efficiency of program delivery and sustainability. CONCLUSIONS:The Anchal program both adapted to and shaped community gender norms and roles. The program has well-established relationships in the community and can be leveraged to implement gender transformative activities to improve gender-based equity. Health programs can broaden their impacts and target social determinants of health like gender equity to increase program sustainability and promote equitable health outcomes.

Project description:BackgroundColleges in the United States are determining how to operate safely amid the coronavirus disease 2019 (COVID-19) pandemic.ObjectiveTo examine the clinical outcomes, cost, and cost-effectiveness of COVID-19 mitigation strategies on college campuses.DesignThe Clinical and Economic Analysis of COVID-19 interventions (CEACOV) model, a dynamic microsimulation model, was used to examine alternative mitigation strategies. The CEACOV model tracks infections accrued by students and faculty, accounting for community transmissions.Data sourcesData from published literature were used to obtain parameters related to COVID-19 and contact-hours.Target populationUndergraduate students and faculty at U.S. colleges.Time horizonOne semester (105 days).PerspectiveModified societal.InterventionCOVID-19 mitigation strategies, including social distancing, masks, and routine laboratory screening.Outcome measuresInfections among students and faculty per 5000 students and per 1000 faculty, isolation days, tests, costs, cost per infection prevented, and cost per quality-adjusted life-year (QALY).Results of base-case analysisAmong students, mitigation strategies reduced COVID-19 cases from 3746 with no mitigation to 493 with extensive social distancing and masks, and further to 151 when laboratory testing was added among asymptomatic persons every 3 days. Among faculty, these values were 164, 28, and 25 cases, respectively. Costs ranged from about $0.4 million for minimal social distancing to about $0.9 million to $2.1 million for strategies involving laboratory testing ($10 per test), depending on testing frequency. Extensive social distancing with masks cost $170 per infection prevented ($49 200 per QALY) compared with masks alone. Adding routine laboratory testing increased cost per infection prevented to between $2010 and $17 210 (cost per QALY gained, $811 400 to $2 804 600).Results of sensitivity analysisResults were most sensitive to test costs.LimitationData are from multiple sources.ConclusionExtensive social distancing with a mandatory mask-wearing policy can prevent most COVID-19 cases on college campuses and is very cost-effective. Routine laboratory testing would prevent 96% of infections and require low-cost tests to be economically attractive.Primary funding sourceNational Institutes of Health.

Project description:IntroductionAdolescent pregnancy is defined as pregnancy at the age of 19 or below. Pregnancy and childbirth complications are the most significant cause of death among 15-19-year-old girls. Several studies have indicated that inequitable gender norms can increase the vulnerability of adolescent girls, including violence exposure, early marriage, and adolescent pregnancy. To address these disparities, gender transformative approaches aim to challenge and transform restrictive gender norms, roles, and relations through targeted interventions, promoting progressive changes. This realist review aims to synthesise existing evidence from a broad range of data sources to understand how, why, for whom, and in what contexts gender transformative approaches succeed in reducing adolescent pregnancy in low- and middle-income countries.Method and analysisWe employ a five-step realist synthesis approach: (1) clarify the scope of review and assessment of published literature, (2) development of initial programme theories, (3) systematic search for evidence, (4) development of refined programme theories, and (5) expert feedback and dissemination of results. This protocol presents the results of the first three steps and provides details of the next steps. We extracted data from 18 studies and outlined eight initial programme theories on how gender transformative approaches targeting adolescent pregnancy work in the first three steps. These steps were guided by experts in the field of sexual and reproductive health, implementation science, and realist methodology. As a next step, we will systematically search evidence from electronic databases and grey literature to identify additional studies eligible to refine the initial programme theories. Finally, we will propose refined programme theories that explain how gender transformative approaches work, why, for whom, and under which circumstances.Ethics and disseminationEthics approval is not required because the included studies are published articles and other policy and intervention reports. Key results will be shared with the broader audience via academic papers in open-access journals, conferences, and policy recommendations. The protocol for this realist review is registered in PROSPERO (CRD42023398293).

Dataset Information

Gender Informed or Gender Ignored? Opportunities for Gender Transformative Approaches in Brief Alcohol Interventions on College Campuses.

Publications

Gender Informed or Gender Ignored? Opportunities for Gender Transformative Approaches in Brief Alcohol Interventions on College Campuses.

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