Unfinished Business or, Why Is It So Difficult to Implement an Evidence-Based Alcohol-Use Intervention Program?

Abstract

Though many evidence-based interventions targeting adolescent alcohol drug use are available, it is unknown if these interventions are put to practice. In this article, we discuss some critical issues associated with the implementation of an evidence-based alcohol prevention program in the Netherlands. Tips that may potentially contribute to a successful implementation of this specific intervention are provided.

Keywords:

• intervention
• implementation
• unfinished business

Notes

¹ Peer review continues to be a consensualized code, or a buzz word, which implies expertise and quality which rarely, if ever, has been adequately demonstrated. Editor's note.

² The reader is reminded that the concepts of “risk (factors),” “vulnerability,” “susceptibility,” as well as “protective factors,” are often noted in the literature, without adequately noting their dimensions (linear, nonlinear; rates of development and decay; anchoring or integration, cessation, etc.), their “demands,” the critical necessary conditions (endogenously as well as exogenously; from a micro to a meso to a macro level) which are necessary for either of them to operate (begin, continue, become anchored and integrate, change as de facto realities change, cease, etc.) or not to and whether their underpinnings are theory-driven, empirically based, individual, and/or systemic stake holder-bound, based upon “principles of faith doctrinaire positions, “personal truths,” historical observation, precedents and traditions that accumulate over time, conventional wisdom, perceptual, and judgmental constraints, “transient public opinion,” or what. This is necessary to consider and to clarify if these terms are not to remain as yet additional shibboleths in a field of many stereotypes, tradition-driven activities, “principles of faith,” stakeholder objectives and institutionalized, anchored flaws which should be “retirered.” Editor's note.

³ The reader is referred to a helpful analysis of the underpinnings of “causality” posited in Hills's criteria for causation which were developed in order to help assist researchers and clinicians determine if risk Factors were causes of a particular disease or outcomes or merely associated. (Hill, A. B. (1965). The environment and disease: associations or causation? Proceedings of the Royal Society of Medicine 58: 295–300.). Editor's note.

⁴ The reader is referred to the thesis by the cyberneticist Heinz Von Foerster who posited that there are two types of questions; legitimate and illegitimate ones. The former are those for which the answer is not known and is, perhaps, even unknowable during a given state of knowledge and technology; for example, the effective control of man's “appetite” for a range of psychoactive substances, whatever their legal status. An illegitimate question is one for which the answer is known, or, at the very least is consensualized enabling the creation of a state of temporary or more permanent query-closure. The quest within a question becomes guaranteed. The asking of illegitimate questions has been, and remains, by and large, the acculturated norm. Heinz Von Foerster, Patricia M. Mora, and Lawrence W. Amiot, “Doomsday; Friday, 13 November, A.D, 2026,” Science, 132, 1960. pp. 1291–1295. The reader is referred to Pablo Neruda's The Book of Questions for a poetic exploration of legitimate questions. Editor's note.

Additional information

Notes on contributors

Ina Koning

Dr. Ina Koning (Utrecht Univerisity, The Netherlands) has extensive experience in intervention development, testing, and implementation targeting adolescents’ substance use. She is an expert in the field of parenting, risk behavior, and intervention research and implementation.

Tom ter Bogt

Prof. Dr. Tom ter Bogt (Utrecht University, The Netherlands) studies popular music and youth culture with a special interest in alcohol and drug use. He is principal investigator in the Health Behavior in School-aged Children study.