Browsing by Author "McCool, J."

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The Alcohol marketing policy environment and adolescent drinking in Sri Lanka: A qualitative exploration of stakeholder perspectives
(Wiley-Blackwell, 2022) Athauda, L.; Peiris-John, R.; McCool, J.; Wickremasinghe, R.; Ameratunga, S.
ABSTRACT: Adolescents continue to be exposed to alcohol marketing, despite the existence of alcohol control policies in Sri Lanka. National-level policies restrict all forms of alcohol advertising, promotions, and sponsorship and sale to minors. The act calls for the need to protect children and adolescents from exposure to the harm of alcohol. This article investigates stakeholders' perceptions of the alcohol marketing policy environment in Sri Lanka, with a specific focus on policies designed to prevent or curtail adolescent drinking. Between May and July 2019, in-depth interviews were conducted with policy stakeholders in Colombo, Sri Lanka. Thematic analysis was conducted on the audio-recorded interviews that were transcribed and translated and imported to NVivo12. Fifteen policy stakeholders from government and nongovernment organizations participated in this study. The overarching theme identified a lukewarm alcohol marketing policy environment. This situation was facilitated by the alcohol industry acting as the vector, an amber light approach towards public health programs, and other factors contributing to the perceived ineffectiveness of the alcohol marketing policy environment. A unified public health approach supported by policy and political commitment may pave the way for better alcohol control in Sri Lanka.
Factors influencing alcohol use among adolescents in South Asia: A Systematic review
(Piscataway, NJ, 2020) Athauda, L.K.; Peiris-John, R.; Ameratunga, S.; McCool, J.; Wickremasinghe, R.
OBJECTIVE: Alcohol is the leading cause of disability-adjusted life years among 15- to 19-year-olds globally; yet, social and structural determinants of alcohol use among adolescents in low- and middle-income countries are largely unknown. Given that a quarter of the global adolescent population lives in South Asia, this systematic review aims to identify factors influencing alcohol use among 10- to 19-year-olds living in South Asia (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka). METHOD: We systematically searched eight databases (SCOPUS, MEDLINE, EMBASE, CINAHL Plus, Cochrane Library, PsycINFO, AMED, EBSCO Host), gray literature, and relevant websites for studies reporting influences at psycho-individual, family, school, peer, neighborhood, or country levels. QATSDD (Quality Assessment Tool for Studies with Diverse Designs) was used for quality assessment. The study protocol was registered with PROSPERO (CRD42017084773). RESULTS: Twenty-three studies were eligible for inclusion. Male gender, age greater than 14 years, depression, religious belief, parental/family members' drinking, reduced parental attention, peer-drinking/pressure/approval, and urban neighborhood were associated with increased risks of adolescent drinking. No information was available from Afghanistan, Bhutan, Bangladesh, Pakistan, and Maldives. There is little evidence available on the determinants at a national (legislature, industry, and media), school, and personality level. CONCLUSIONS: The distal determinants of alcohol use among adolescents living in South Asia are largely unknown. As adolescent drinking behaviors change in response to social media and industry influence, more evidence is needed to reflect the South Asia context.
It’s normal to drink, isn’t it? a qualitative study on factors influencing adolescent drinking in Sri Lanka
(Sri Lanka Medical Association, 2021) Athauda, L.K.; Pereis-John, R.; McCool, J.; Ameratunga, S.; Wickremasinghe, A.R.
Introduction and Objectives In Sri Lanka, adolescent drinking behaviour has been linked to parental, family influence as well as culture and living location. While proximal level social determinants play an important part in influencing adolescent drinking, determinants operating at the distal level have not been discussed adequately. This study aimed to describe the factors influencing adolescent drinking among school going adolescents in the Colombo District. Methods Focus Group Discussions (FGD) were conducted separately for males and females in selected Public Health Midwife (PHM) areas in the Colombo District. A semi structured interview guide facilitated the discussion. Transcripts were translated, transcribed and managed on NVivo 12. Inductive thematic analysis was used to interpret the ideas expressed in the FGDs. Results Fifty adolescents (24 females and 26 males) aged between 16-17 years participated in eight FGDSs. The findings elaborate one overarching theme: it’s normal to drink, isn’t it? Media, culture and society contributed towards building social norms around adolescent drinking. Based on the perception of normalcy around drinking, adolescents were inclined to test their limits and experiment with alcohol, while being influenced by peers. However, they also experienced some restraints, in terms of law, family and culture, which made them question the normalcy around drinking. Conclusion Adolescents engage in social learning, through their distal environment which creates norms and aspirations. Peer engagement facilitates social capital which also contributes towards their decisions to drink. Distal level social determinants are important contributory factors of adolescent alcohol use. Restrictions within this environment may restrict their drinking