Alcohol use and abuse among rural Zimbabwean adults: a test of a community-level intervention
Open accessAbstract
Background Understanding what factors contribute to alcohol abuse in resource-poor countries is important given its adverse health consequences. Past research shows that social peers influence substance abuse, suggesting that the social environment may be an effective target for reducing alcohol abuse across a population. This study investigates the determinants of alcohol use and abuse in rural Zimbabwe and tests a community popular opinion leader (CPOL) community-based intervention partly directed at reducing alcohol abuse.Methods Tests were conducted on the impact of the CPOL intervention on alcohol use patterns across communities in rural Zimbabwe over three waves from 2003 to 2007, including community- and individual-level tests using data based on in-person interviews of adult men and women (ages 18-30; N=5543). Data were analyzed using paired-sample t-tests, as well as logistic and ordinary least-squares regression with random effects.Results Higher drinking (any use, more frequent use, greater quantity, and/or frequent drunkenness) was generally associated with being male, older, not married, more highly educated, of Shona ethnicity, away from home frequently, employed, having no religious affiliation, or living in areas with a higher crude death rate or lower population density. Over the study period, significant declines in alcohol use and abuse were found in intervention and control sites at relatively equal levels.Conclusions Although no support was found for the effectiveness of the CPOL study in reducing alcohol abuse, Zimbabwe is similar to other countries in the impact of socio-demographic and cultural factors on alcohol use and abuse.
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A majority of the health promotion and education studies that found no effect were either not adequately powered to detect the alcohol-related outcome or were compared to another intervention rather than a control.
“Meanwhile, a majority of the studies that found no effect of their interventions either were not adequately powered to detect the alcohol-related outcome [23,43] or were compared to another intervention rather than a control, thus potentially obscuring some potential reduction in harm [95].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [43]
Of the health promotion and education RCTs, 2 were based in the workplace, 5 in the community, 6 in schools, and 7 in clinics, of which 1 focused on women sex workers.
“Of these, 2 were based in the workplace [26,38], 5 in the community [23,37,43,84], 6 in schools [33,40,65,85,86], and 7 in clinics [39,55–57], of which 1 was focused on women sex workers [95].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [43]
The 14 RCTs evaluating medications looked at naltrexone (3), ondansetron (1), gabapentin (1), disulfiram (5), and topiramate (2).
“The 14 RCTs evaluating medications looked at naltrexone (3) [22,24,32], ondansetron (1) [43], gabapentin (1) [51], disulfiram (5) [46–50], and topiramate (2) [32,62].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [43]
The majority of health promotion and education programs addressed alcohol use in the context of HIV/AIDS prevention and risk reduction.
“The majority of programs addressed alcohol use in the context of HIV/AIDS prevention and risk reduction [38–40,43,56,57,95].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [43]
Cubbins and colleagues found significant alcohol reduction in both the intervention and control groups, but no difference between the groups.
“Cubbins and colleagues evaluated a community-level intervention in which popular community individuals relayed education through casual conversations and found significant alcohol reduction in both the intervention and control groups, but no difference between the groups [43].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [43]
The RCTs evaluating naltrexone and ondansetron found limited impact on abstinence, number of heavy drinking days or number of abstinent days, and abstinence.
“The RCTs evaluating naltrexone and ondansetron found limited impact on abstinence, number of heavy drinking days or number of abstinent days [22,24,32], and abstinence [43].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [43]
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- Authors
- Cubbins, L. A., Kasprzyk, D., Montano, D., Jordan, L. P., & Woelk, G.
- Affiliations
- Battelle (US)
- University of Southampton (GB)
- Elizabeth Glaser Pediatric AIDS Foundation (US)
- Corresponding author
- Cubbins, Lisa A.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 124
- Issue
- 3
- Pages
- 333-339
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC3383920
- OpenAlex
- W1994848271
- Cited by
- 26
- References
- 41
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2022: 4 · 2021: 2 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 5 · 2013: 1
- FWCI
- 0.24
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- alcohol consumption, alcohol abuse, community-based intervention, social influence, rural Zimbabwe, determinants of alcohol use, sociodemographic factors, cultural factors, intervention effectiveness, young adults
- MeSH terms
- Adolescent, Adult, Alcohol Drinking, Alcoholic Intoxication, Alcoholism, Female, Humans, Male, Risk Factors, Rural Population, Zimbabwe
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