Implementing an Ideology. A Case Study from Leicestershire, England
Implementing an Ideology. A Case Study from Leicestershire, England
复制标题
实施意识形态。
DOI：
10.1177/145507251002700608
复制
发表时间：
2010
影响因子：
1.7
通讯作者：
D. Cameron
中科院分区：
文献类型：
--
作者：
D. Cameron
在20世纪70年代末，我们为英格兰莱斯特郡（人口85万）建立了一个当时为问题饮酒者提供的高度创新的服务。它是基于一些核心信念，关于酒精问题的人的性质，以及什么对他们有帮助。最值得注意的是，它拒绝“酗酒”的概念，并在任何时候都将客户（“顾客”）视为负责任的，因此能够决定什么对他们有帮助。这是一个以社区为基础的分层服务，以非禁欲为导向，以客户需求为导向。这一干预系统使转诊率迅速上升，有证据表明，与邻近的类似县相比，这一服务可能对与饮酒有关的长期发病率和死亡率产生了积极影响。现有数据相互关联，不完整，但令人鼓舞。邻近各州提供方式的变化以及全国保健和社会服务的行政和结构变化意味着不可能继续以综合形式提供服务，跟踪酒精问题间接指标的变化也变得不可行。自然实验因我们无法控制的因素而终止。尽管如此，该服务仍然存在，尽管以截断的形式存在。它的存在在英国当地酒精服务提供模板的发展中发挥了作用。
In the late 1970s, we established for the county of Leicestershire in England (pop. 850,000) what was then a highly innovative service for problem drinkers. It was based upon a number of core beliefs about the nature of people with alcohol problems and about what would be helpful for them. Most notably it rejected the concept of “alcoholism” and treated the clients (“customers”) at all times as being responsible and therefore able to make decisions about what would be helpful for them. It was a community based tiered service, non-abstinence oriented and client demand led. That system of intervention generated a burgeoning referral rate and there was evidence that compared with neighbouring similar counties, the service may have had a positive impact on the long term morbidity and mortality related to alcohol use. The data available were correlational and incomplete but were encouraging. Changes in the style of provision in the neighbouring counties and administrative and structural changes in health and social services nationally meant that it was not possible to continue the service in its comprehensive form, and tracking changes in the indirect indicators of alcohol problems became unfeasible. The natural experiment was terminated by factors beyond our control. Nonetheless, the service still exists, though in a truncated form. Its presence played a part in the development of the template for local alcohol service provision in Britain.