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Background: Considerable attention has been focused on the impact of young people's alcohol use. To address this, schools often implement alcohol and drug education and there are many potential programmes to choose from. Objective: The aim of this study was to identify evidence-based alcohol education programmes for schools. Methods: A systematic review was undertaken of school-based programmes that targeted alcohol within a school setting and included at least one alcohol behaviour or knowledge change outcome. Six-hundred seventy-five abstracts were screened resulting in 454 studies assessed for eligibility, with 70 studies, evaluating 40 individual programmes, included in the final review. Results: Of the 40 programmes, 3 had good evidence of a positive effect. They included CLIMATE Schools (Australia), Project ALERT (USA) and All Stars (USA). Of the others, 4 showed some evidence of positive effect, 1 had no evidence of effect, 29 were inconclusive and 2 showed negative outcomes, such as increases in alcohol use. Although many programmes were evaluated, very few had sufficient evidence to be able to endorse their widespread implementation in schools. Conclusion: Three programmes included in the review had sufficient positive outcomes to be recommended for implementation, and four showed good outcomes in some areas. Schools should consider these results when deciding on introducing alcohol education. Overall, the evidence base is broad but relatively weak and further research is required, focusing on programmes identified as having good or potentially good outcomes.

Noncommunicable diseases (NCDs) kill 40 million people each year and are the cause of 70% of global deaths annually. Proximal risk factors include tobacco use, physical inactivity, the harmful use of alcohol and consumption of unhealthy food, which are shaped by the social and economic conditions of daily life, known as the social and commercial determinants of health. It is well recognised within the global health community that policy coherence across all levels of government at the national and international level is required to address NCDs. To date, however, there has been little coherence between health and trade policy, which directly affects access to unhealthy or healthy commodities. This paper explores policy actors' views of the challenges in achieving coordinated and coherent NCD policy across health and trade sectors. Drawing on interviews (n = 18) with key policy actors and using a policy framework that focuses on ideas, power and the 'deep core' of neoliberalism, we identify the role of competing frames, power asymmetries and interests in constraining policy coherence. We also find differences between NCD risk factor domains. Tobacco control was highlighted as one area of generally successful coherence internationally. In contrast, alcohol and nutrition were identified as areas with little coherence. Industry power, the role of evidence, presence of absence of a treaty, the extent of coordinated advocacy and leadership by intergovernmental organisations were key factors influencing coherence. In light of these constraints, the role of advocacy by non-governmental organisations was highlighted as the key for much-needed policy change. [ABSTRACT FROM AUTHOR]

Lencucha and Thow have highlighted the way in which neo-liberalism is enshrined within institutional mechanisms and conditions the policy environment to shape public policy on non-communicable diseases (NCDs). They critique the strong (but important) focus of public health policy research on corporate interests and influence over NCD policy, and point toward neo-liberal policy paradigms shaping the relationship between the state, market and society as an area for critique and further exploration. They also importantly underline the way in which the neo-liberal policy paradigm shapes the supply of unhealthy goods and argue that health advocates have not engaged enough with supply side issues in critiques of policy debates on NCDs. This is an important consideration especially in the Asia-Pacific where trade and agricultural policies have markedly shaped production and what is being produced within countries. In this commentary, I reflect upon how neoliberalism shapes intersectoral action across trade, development and health within and across institutions. I also consider scope for international civil society to engage in advocacy on NCDs, especially where elusive 'discourse coalitions' influenced by neoliberalism may exist, rather than coordinated 'advocacy coalitions'. [ABSTRACT FROM AUTHOR]

The paper analyses the policy process which enabled the successful adoption of Australia's National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (NATSIHP), which is grounded in an understanding of the Social Determinants of Indigenous Health (SDIH). Ten interviews were conducted with key policy actors directly involved in its development. The theories we used to analyse qualitative data were the Advocacy Coalition Framework, the Multiple Streams Approach, policy framing and critical constructionism. We used a complementary approach to policy analysis. The NATSIHP acknowledges the importance of Aboriginal and Torres Strait Islander (hereafter, Aboriginal) culture and the health effects of racism, and explicitly adopts a human-rights-based approach. This was enabled by a coalition campaigning to 'Close the Gap' (CTG) in health status between Aboriginal and non-Aboriginal Australians. The CTG campaign, and key Aboriginal health networks associated with it, operated as an effective advocacy coalition, and policy entrepreneurs emerged to lead the policy agenda. Thus, Aboriginal health networks were able to successfully contest conventional problem conceptions and policy framings offered by government policy actors and drive a paradigm shift for Aboriginal health to place SDIH at the centre of the NATSIHP policy. Implications of this research for policy theory and for other policy environments are considered along with suggestions for future research. [ABSTRACT FROM AUTHOR]

This article explores the European Union's (EU) role and position on global health, including its role in the World Health Organization (WHO), and the impact of the Lisbon Treaty. Struggles over the implementation of the Lisbon Treaty potentially undermine the EU's ability to speak with one voice and its effectiveness. EU influence is determined by the remit of the EU (defined by competences outlined in the Treaty on the Functioning of the EU, TFEU), as well as the specific rules and procedures of international institutions. Based on empirical research, we considered the role of the EU in global health, via policy and policy coherence across the EU when it came to health matters (including the WHO reform) and through EU representation within multilateral fora. We conclude that the EU is a significant player in global health. It has established global health policy and played a leadership role in negotiating international health agreements. It has had a coordinated voice at the WHO, whilst being less cohesive in other multilateral health fora. Effectiveness of EU representation at the WHO was affected by a number of factors, including Member State's (MS) trust in EU representation and reluctance to cede competence on health matters, lack of EU flexibility in negotiations, lengthy EU coordination processes, MS vying for influence within the EU, and MS rather than EU engagement in behind the scenes and 'soft power' diplomacy. Vertical and horizontal integration within and across the EU also determined EU influence within international organizations. The Lisbon Treaty also had limited impact due to MS and others' concerns about the EU acting on institutional matters. The results are considered in light of the role that global health plays within foreign policy, the multitude of global health actors and prior theory and research on the EU's role in multilateral governance. [ABSTRACT FROM AUTHOR]

This review explored the impact of the COVID-19 pandemic on people with cognitive impairment living in aged care facilities. It also considered policy and organizational responses to COVID-19, and makes recommendations to ameliorate the impact of the pandemic on residents with cognitive impairment in aged care facilities. ProQuest, PubMed, CINAHL, Google Scholar, and Cochrane Central were searched April-May 2022 for peer reviewed articles, and an integrative review of reviews was conducted. Nineteen reviews were identified which referred to people with cognitive impairment living in residential aged care facilities (RACFs) during COVID-19. Negative impacts were highlighted, including COVID-19 related morbidity and mortality, social isolation, and cognitive, mental health and physical decline. Few research articles and policy responses consider people with cognitive impairment in residential aged care. Reviews highlighted that social engagement of residents should be better enabled to reduce the impact of COVID-19. However, residents with cognitive impairment may have inequitable access to communications technology for the purposes of assessment, health care and social engagement, and require more support (along with their families) to access this technology. Greater investment in the residential aged care sector (eg, for workforce and training) is required to address the significant impacts of the COVID-19 pandemic on people with cognitive impairment.