Public health professionals’ perspectives on alcohol public health interventions: a qualitative interview study

Background: In the UK, alcohol-related deaths are increasing and there are also inequalities in alcohol-related health consequences among lower socioeconomic position groups. National and regional governmental organisations in the UK have responsibility for improving public health and reducing health inequalities. However, there is limited research which has explored the experiences of those developing alcohol public health interventions. Therefore, this study had two research questions: What are public health professionals’ experiences and perspectives on the development of public health interventions to reduce alcohol use? How are health inequalities considered in their work?

Methods: Semi-structured interviews were conducted with 16 public health professionals who reported involvement in the development and delivery of alcohol public health interventions, mainly at a local level (e.g., in a local authority public health department). Reflexive thematic analysis was used.

Results: The first theme refers to systemic constraints affecting alcohol public health intervention development. Opinions were varied on whether they had sufficient data access. Some additional data sources were desired (e.g., alcohol-related ambulance callouts) and some data sources were seen as difficult to access (e.g., primary care alcohol risk assessments) due to limited documentation in primary care records. Participants wanted an increased prevention focus (e.g., addressing alcohol licensing, availability, and promotion), but suggested that their capacity for preventative interventions was hindered by national priorities from political decisions and funding restrictions. The second theme refers to alcohol interventions addressing community needs, which includes principles for effective alcohol interventions. Participants highlighted that effective interventions should be delivered within local communities and based on an understanding of the reasons for and influences on their alcohol use. The third theme refers to drivers of inequalities in alcohol harms, in which participants suggested factors such as alcohol-related social norms and stress may be particularly important to target in interventions.

Conclusions: The findings of this study highlight systemic constraints which affect the development process for alcohol public health interventions. Findings also highlight principles for effective community-based alcohol interventions. Proposed factors affecting alcohol-related inequality may represent intervention targets. These insights can be used to improve the intervention development process for alcohol public health interventions, as well as better accounting of health inequalities within such interventions.