Technical Paper 3:
Preventing Alcohol-related harm in Australia: a window of opportunity

4.1 - Current activity

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Considerable activity aiming to prevent alcohol-related harm is currently under way in Australia. The extent to which the considerable preventative desire and activity (planned or under way) is likely to be effective, and how well this activity reflects an evidence-based approach, is considered in the next section of this paper. In general, the measures that are most often called for by community members tend to be the least effective, while the most effective measures are the least popular and are thus probably the most difficult for governments to introduce, usually requiring strong leadership and well-planned implementation.

What is prevention in this area?

The stated aim of Australia’s current National Drug Strategy is to ‘prevent the uptake and minimise the harmful effects of drug use in Australian society’. Known as ‘harm minimisation’, this approach has been defined as encompassing:
  • Supply reduction strategies designed to restrict the harmful supply of drugs
  • Demand reduction strategies designed to prevent the uptake of harmful drug use
  • Harm reduction strategies to reduce drug-related harm for individuals and communities.
The approach of harm minimisation, while complex and requiring continuing support from public advocates, is based on scientific evidence and underpins the definition of prevention adopted for the review of alcohol-related interventions in this paper. It can encompass universal as well as targeted interventions (both selective: particular high-risk sub-populations; and indicated: those with emerging problems).

Though not explored in detail in this paper, the concept of the prevention paradox assists in understanding prevention approaches in the areas of public health and public safety. This approach suggests that more (net) harm may be prevented through universal interventions – focusing on the majority who are less seriously involved in harmful alcohol/drug use, rather than through interventions that only target the smaller proportion of high-risk users.
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What works in alcohol-related prevention?

The following discussion is informed by recent reviews of the available research evidence. This includes:
  • the World Health Organization’s (WHO) international review of alcohol-related research and
    public policy[13]
  • a recent Australian research monograph on the prevention of substance use, risk and harm[7]
  • a recent update of the latter, with a focus on prevention interventions targeting adolescents.[41]
Other recent reviews have also been drawn upon, to a lesser extent, including Stockwell 2004,[42] Loxley et al. 2005[7, 43] and NDRI 2007.[36]

The conclusions reached in the WHO report[13] with regard to the respective strengths and weaknesses of different types of interventions, according to the available international research evidence, are summarised in Table 6. Included in this table are Australian-authored evaluations of the equivalent interventions provided by Loxley et al.[7] and Toumbourou et al.[41] The scales used to rate the interventions by the respective authors are summarised in Table 5 below.

Table 5: Key to the rating scales shown in Table 6


Rating

Evidence of effectiveness

Breadth of research support

Test across cultures

Australian evaluation

Rating - Evidence of effectiveness (Lack of effectiveness), Breadth of research support (No studies undertaken), Test across cultures (Not tested), Australian evaluation (Limited investigation)

Lack of effectiveness

No studies undertaken

Not tested

Limited investigation

Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)

Limited effectiveness

1 well-designed study completed

Tested in 1 country

Evidence for implementation

Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)

Moderate effectiveness

2–4 studies completed

Tested in 2–4 countries

Evidence for outcome effectiveness

Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)

High degree of effectiveness

5+ studies completed

Tested in 5+ countries

Evidence for effective dissemination

Rating - Evidence of effectiveness (No evidence available), Australian evaluation (N/A)

No evidence available



N/A

Australian evaluation (Warrants further research)




Warrants further research

Australian evaluation (Evidence is contra-indicative)




Evidence is contra-indicative
This rating scale applies to the WHO’s international review [13] and Australian reviews.[14].
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Of the 39 interventions listed in Table 6, at least half of these are universal (targeted at the whole population) and approximately half are targeted at high-risk groups. The international review by Babor et al. concludes that interventions targeting the whole population generally have higher effectiveness ratings and are less costly to implement and maintain, on average, than those targeting high-risk groups.[13] In general, the types of interventions that are considered most effective according to the ratings are, in order:
  1. Regulating physical availability
  2. Taxation and pricing
  3. Drink-driving countermeasures
  4. Treatment and early intervention
The types of interventions for which there is somewhat less evidence of effectiveness are, in order:
  1. Altering the drinking context
  2. Regulating promotion
  3. Education and persuasion
There are differences in the ratings of some interventions between the international review[13] and the Australian review.[7] (for example, the treatment of alcohol problems and mass media campaigns). Also, importantly, it should be recognised that although the effectiveness of some interventions do not rate highly, in some cases this may be due to the limited research evidence that is available to inform the rating (for example, advertising content controls).

Table 6: Ratings of policy-relevant strategies and interventions

Strategy or interventionEffectivenessBreadth of researchCross-cultural testingCost to implementAustralian evaluation

Regulating physical availability

Total ban on salesRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)HighRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)
Minimum legal purchase ageRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Low
Hours and days of sale restrictionsRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)LowRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)
Restrictions on density of outletsRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)LowAustralian evaluation (Warrants further research)
Staggered closing times for bars and clubsX
Server liabilityRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation) LowRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)
Different availability by alcohol strengthRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation) Low

Taxation and pricing

Alcohol taxesRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)LowRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)
Hypothecated tax to pay for treatment / preventionRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)
Setting floor prices / banning discountingRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)

Drink-driving counter-measures

Sobriety checkpointsRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Moderate
Random breath testingRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)ModerateRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)
Low BAC limitsRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination) Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Low
Administrative licence suspensionRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Moderate
Low BAC for young driversRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)LowRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)
Graduated licensing for novice driversRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Low
Designated drivers and ride servicesRating - Evidence of effectiveness (Lack of effectiveness), Breadth of research support (No studies undertaken), Test across cultures (Not tested), Australian evaluation (Limited investigation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation) Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)ModerateRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)
Ignition interlocksRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)

Treatment and early intervention

Brief intervention in primary health settingsRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)ModerateRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)
Alcohol problems treatmentRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation) Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)HighRating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)
Thiamine supplementationRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)
Workplace interventionsAustralian evaluation (Warrants further research)
Mutual help/self-help attendanceRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Low
Mandatory treatment of repeat drink driversRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Moderate

Altering the drinking context

Bans on serving intoxicated personsRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Moderate
Training staff to prevent intoxication / aggressionRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Moderate Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)
(X if not enforced)
Voluntary codes of bar practiceRating - Evidence of effectiveness (Lack of effectiveness), Breadth of research support (No studies undertaken), Test across cultures (Not tested), Australian evaluation (Limited investigation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Low Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)
(X if not enforced)
Enforcement of on-premises regulations and lawsRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)High
Promoting alcohol-free eventsRating - Evidence of effectiveness (Lack of effectiveness), Breadth of research support (No studies undertaken), Test across cultures (Not tested), Australian evaluation (Limited investigation)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness) Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)High
Community mobilisationRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness) Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)HighRating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)
Plastic or tempered-glass serving containers Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)
Food serviceRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)

Regulating promotion

Advertising bansRating - Evidence of effectiveness (No evidence available), Australian evaluation (N/A)Australian evaluation (Warrants further research)Australian evaluation (Warrants further research)Low
Advertising content controlsRating - Evidence of effectiveness (No evidence available), Australian evaluation (N/A)Australian evaluation (Warrants further research)Australian evaluation (Warrants further research)LowAustralian evaluation (Warrants further research)

Education and persuasion

Alcohol education in schoolsRating - Evidence of effectiveness (Lack of effectiveness), Breadth of research support (No studies undertaken), Test across cultures (Not tested), Australian evaluation (Limited investigation)Rating - Evidence of effectiveness (High degree of effectiveness), Breadth of research support (5+ studies completed), Test across cultures (Tested in 5+ countries), Australian evaluation (Evidence for effective dissemination)Rating - Evidence of effectiveness (Moderate effectiveness), Breadth of research support (2–4 studies completed), Test across cultures (Tested in 2–4 countries), Australian evaluation (Evidence for outcome effectiveness)HighRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)
College student educationRating - Evidence of effectiveness (Lack of effectiveness), Breadth of research support (No studies undertaken), Test across cultures (Not tested), Australian evaluation (Limited investigation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)High
Parent educationRating - Evidence of effectiveness (No evidence available), Australian evaluation (N/A)Australian evaluation (Warrants further research)Australian evaluation (Warrants further research)ModerateAustralian evaluation (Warrants further research)
Public service messages / Mass media campaignsAustralian evaluation (Warrants further research)Australian evaluation (Warrants further research)Australian evaluation (Warrants further research)ModerateRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)
Warning labels / National drinking guidelinesRating - Evidence of effectiveness (Lack of effectiveness), Breadth of research support (No studies undertaken), Test across cultures (Not tested), Australian evaluation (Limited investigation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)Rating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)LowRating - Evidence of effectiveness (Limited effectiveness), Breadth of research support (1 well-designed study completed), Test across cultures (Tested in 1 country), Australian evaluation (Evidence for implementation)

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