This literature review is part of ‘Le Ala’, a community action research project led by Pacific peoples. Its findings and recommendations are intended to guide the development of a community intervention(s) aimed at reducing alcohol-related harm among Pacific peoples in New Zealand.
The purpose of Le Ala is to find a practical, community-based approach to intervening on alcohol problems among New Zealand’s Pacific peoples.
This literature search aimed to identify current alcohol-related interventions (in both Pacific and other communities), identify any gaps and place the Le Ala intervention project in the context of a credible field of study. Overseas literature was chosen for its relevance to ethnic and indigenous communities, covering strategies from primary prevention in schools to whole-community involvement.
The search began by reviewing historical information, to understand the relationship between Pacific peoples and alcohol before Pacific settlement in New Zealand. It then identified key information that could be considered in developing a solution-focused intervention. For example, a search of the latest epidemiological data found that alcohol consumption is now endemic in Pacific communities in New Zealand. What was once the domain of older men is rapidly being usurped by young people (including women).
The most common of a wide range of New Zealand based interventions (past and present) fell into the broad category of ‘mainstream’ – that is, they were unmodified or adapted programmes from District Health Board (DHB) providers. These interventions operated at the ‘treatment’ end of the intervention spectrum for people already identified as having problems. Unfortunately, much of this literature was descriptive rather than evidence-based.
The search revealed pockets of local innovation e.g. performance (such as dance, theatre, drama, public speaking and music) as a healthpromotion strategy, and school- and church-based interventions. However, these did not focus specifically on alcohol.
The literature review also aimed to canvass potential methods for developing an innovative solution to actual and potential alcoholrelated problems in the Pacific community in New Zealand.
It recognised that any intervention has to be meaningful to the people with whom it is being used – and, out of the many qualitative methodologies available, identified that ‘narrative’ approaches best achieve this (for more detail, see page 40). Narrative approaches enable communities to be involved in developing and ‘owning’ interventions designed specifically for them (rather than taking a ‘one size fits all’ approach). Examples include the Te Whanau Cadillac programme for Maori youth (see page 37) and the Northern Territory of Australia’s ‘Strengthening and Supporting Community Action’ project (see page 45). Key features of successful ‘narrative’ programmes include:
- indigenous community control, good governance, social accountability and commitment from
- community leaders
- a clear set of principles and a plan and strategy, including a realistic timeframe
- clearly defined management structures and strong managerial leadership and support
- appropriate staff (including native language speakers where relevant) and staff development and
- holistic, multi-strategy, flexible interventions
- intra - and inter-agency collaboration
- effective reporting , monitoring and evaluation procedures
- adequate resources.