Qualitative Study on Community and Primary Health Care Involvement on Alcohol and Tobacco Actions in Seven European Countries

Abstract

Alcohol and tobacco use are important determinants of illness and have important country-specific dimensions. It's important to also consider them at community and primary health care (PHC) levels. A collaborative qualitative research (Delphi study and focus groups methodology) was conducted during the process of 10 new countries joining the European Union (EU) and implemented in culturally socio-economically different European countries: four EU (Belgium, Brussels region; Hungary, Pest County; Italy, Friuli Venezia Giulia region; Latvia, Riga region; Slovenia, Ljubljana region) and two Eastern European countries (Bulgaria, Sofia region; Russia, St. Petersburg region). Countries were chosen from the WHO international project according to the criteria noted in the application for EU INCO-COPERNICUS funding. Focus groups were conducted among lay people and PHC professionals in order to identify factors that influence (facilitate and prevent or minimize) PHC management of alcohol- and tobacco use–related problems. A Delphi study was conducted among four different groups in order to develop tasks for instances to be involved in community health policies.

There are some limitations of such a qualitative study; e.g., such studies give ideas that cannot simply be transformed to actions in every country. In order to manage tobacco-and alcohol-related problems a comprehensive community-based approach, that also include PHC teams and policymakers, would be supported in participating countries.

Keywords:

• qualitative research
• community action
• primary health care
• alcohol
• tobacco
• health promotion
• participatory research

Notes

* The term community has become something of a policy buzzword that has been attached to a diverse range of ideas and initiatives. It means various things to a range of individual and systemic stakeholders. “Shared geography,” as an often-regarded simplistic, common denominator, minimizes the range of other “sharing” options, which range from actual objects to beliefs, values, membership in, identification with, association with, from a micro- to a globalized macrolevel. One can oversimplistically categorize three broad types of community intervention models in order to consider the demands and implications of community readiness and community awareness for planned intervention. These include: (1) professional agency networks,(2) community partnerships between professionals and community members, and (3) grass-roots community initiatives. Shiner et al. (2004). Exploring community responses to drugs. Joseph Rowntree Foundation, York, UK (www.jrf.org.uk). Editor's note.