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Artikelen (chronologisch)

1. De Bruijn, A. (2008). No reason for optimism: the expected impact of commitment in the European Commission's Alcohol and Health Forum. Addiction, 103 (10), 1588-1592.

Background: Europe is the heaviest-drinking region in the world, more than 2.5 times the rest of the world's average.
The Comission's conclusion: The cornerstone for the European Commission's action to decrease the alcohol-related harm of this consumption and the main emphasis for its work is the Alcohol and Health Forum, with its Task Forces on Marketing Communication and Youth-Specific Aspects of Alcohol. The Forum, which was launched in June 2007, aims to provide a common platform for all interested stakeholders. Forum members are invited to make commitments to reduce alcohol-related harm, in the form of a monitored and evaluated action plan. By 29 February 2008, 79 commitments have been provided by the members of the Forum.
Aprraisal of the initiative: Taking into account the limited information available, the proposed commitments indicate few evidence-based approaches. A large majority of the summaries do not, or only slightly, address the relevance of their commitment and give no evidence of why their proposed action is important in reducing alcohol-related harm. Even fewer commitments mention indicators of effectiveness of the proposed actions or propose to evaluate the effectiveness of the proposed actions.
Conclusion: While most economic operators in the Forum have resources to undertake actions which could be highly effective, they commit principally to educational programmes which have been found to be mainly ineffective. This, and the neglect of existing legislation, do not give reason for optimism on the impact of the proposed commitments.
http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2008.02319.x/abstract

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2. Anderson, P., De Bruijn, A., Angus, K., Gordon, R. & Hastings, G. (2009). Impact of Alcohol Advertising and Media Exposure on Adolescent Alcohol Use: A Systematic Review of Longitudinal Studies. Alcohol and alcoholism, 44,(3), 1-15.

Aims: To assess the impact of alcohol advertising and media exposure on future adolescent alcohol use. Methods: We searched MEDLINE, the Cochrane Library, Sociological Abstracts, and PsycLIT, from 1990 to September 2008, supplemented with
searches of Google scholar, hand searches of key journals and reference lists of identified papers and key publications for more recent publications.We selected longitudinal studies that assessed individuals’ exposure to commercial communications and media and alcohol drinking behaviour at baseline, and assessed alcohol drinking behaviour at follow-up. Participants were adolescents aged 18 years or younger or below the legal drinking age of the country of origin of the study, whichever was the higher.
Results: Thirteen longitudinal studies that followed up a total of over 38,000 young people met inclusion criteria. The studies measured exposure to advertising and promotion in a variety of ways, including estimates of the volume of media and advertising exposure, ownership of branded merchandise, recall and receptivity, and one study on expenditure on advertisements. Follow-up ranged from 8 to 96 months. One study reported outcomes at multiple time-points, 3, 5, and 8 years. Seven studies provided data on initiation of alcohol use amongst non-drinkers, three studies on maintenance and frequency of drinking amongst baseline drinkers, and seven studies on alcohol use of the total sample of non-drinkers and drinkers at baseline. Twelve of the thirteen studies concluded an impact of exposure on subsequent alcohol use, including initiation of drinking and heavier drinking amongst existing drinkers, with a dose response relationship in all studies that reported such exposure and analysis. There was variation in the strength of association, and the degree to which potential confounders were controlled for. The thirteenth study, which tested the impact of outdoor advertising placed near schools failed to detect an impact on alcohol use, but found an impact on intentions to use.
Conclusions: Longitudinal studies consistently suggest that exposure to media and commercial communications on alcohol is associated with the likelihood that adolescents will start to drink alcohol, and with increased drinking amongst baseline drinkers. Based on the strength of this association, the consistency of findings across numerous observational studies, temporality of exposure and drinking behaviours observed, dose-response relationships, as well as the theoretical plausibility regarding the impact of media exposure and commercial communications, we conclude that alcohol advertising and promotion increases the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol.
http://alcalc.oxfordjournals.org/content/early/2009/01/14/alcalc.agn115.short

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3. Van der Wulp, N.Y., Hoving, E.F., De Vries, H., & Van Dalen, W.E. (2010). Alcohol en zwangerschap: De eerste resultaten van een interventiestudie. Tijdschrift voor Verloskundigen, 35, 22-27.

Achtergrond: Alcoholgebruik tijdens de zwangerschap kan levenslange schadelijke gevolgen hebben. Om prenataal alcoholgebruik te voorkomen ontwikkelen STAP en de Universiteit Maastricht een alcohol preventie programma voor zwangere vrouwen. Hiervoor is een eerste verkennend kwalitatief onderzoek onder zwangere vrouwen uitgevoerd.
Doel: Het doel van dit onderzoek is te achterhalen of er verschillen zijn in bewustzijn, motivatie en gedrag tussen zwangere vrouwen die wel alcohol drinken en die geen alcohol drinken.
Methode: Er zijn semi-gestructureerde diepte-interviews afgenomen met 18 zwangere vrouwen.
Resultaten: De vrouwen die alcohol dronken tijdens hun zwangerschap, dronken vóór de zwangerschap meer en vaker alcohol, waren zich minder bewust van de risico’s van alcoholgebruik en ervoeren vaker moeilijke situaties om geen alcohol te drinken dan de vrouwen die geen alcohol dronken tijdens de zwangerschap.
Conclusie: Zwangere vrouwen die alcohol drinken verschilden van niet-drinkende zwangere vrouwen in bewustzijn, motivatie en gedrag. Bij het ontwikkelen van een programma om alcoholgebruik tijdens de zwangerschap terug te dringen moet hiermee rekening gehouden worden. Bij de verdere ontwikkeling van het alcohol preventie programma spelen verloskundigen een belangrijke rol.
http://www.kennispoort-verloskunde.nl/alcohol-en-zwangerschap.aspx

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4. Ross, C.S., De Bruijn, A. and Jernigan, D. (2013) Do time restrictions on alcohol advertising reduce youth exposure? Journal of Public Affairs 13/1 pp 123–129.

Summary: Regulators may attempt to reduce youth exposure to alcohol advertising by restricting times during which alcohol ads may be aired on television or radio. The Netherlands introduced such a policy and found that teenage advertising exposure increased following the time restrictions. This study uses simulation analysis and a comprehensive database of television alcohol advertising to demonstrate that time restrictions are likely to reduce advertising exposure to the youngest viewers while increasing exposure for the high-risk teenage population.
http://onlinelibrary.wiley.com/doi/10.1002/pa.1452/abstract

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5. Van der Wulp, N.Y, Hoving, C. & De Vries, H.(2013) A qualitative investigation of alcohol use advice during pregnancy: Experiences of Dutch midwives, pregnant women and their partners.
Midwifery Nov;29(11):e89-98.

Objective: Two studies aimed to explore the advice Dutch midwives give and the information Dutch pregnant women and partners of pregnant women receive about alcohol consumption in pregnancy.
Design: Study 1 included individual semi-structured interviews with midwives. Study 2 involved focus groups and individual semi-structured interviews with pregnant women and partners. Interview content was based on the I-Change Model.
Setting: Study 1 was conducted nation-wide. Study 2 was conducted in the central and southern regions of the Netherlands.
Participants: 10 midwives in study 1. 25 pregnant women and nine partners in study 2.
Measurements and findings: Study 1 showed that midwives intended to advise complete abstinence, although this advice was mostly given when women indicated to consume alcohol. Midwives reported to lack good screening skills and sufficient knowledge about the mechanisms and consequences of antenatal alcohol use and did not involve partners in their alcohol advice. In study 2 the views of pregnant women and partners were congruent to the findings reported in study 1. In addition, pregnant women and partners considered midwives as an important source of information on alcohol in pregnancy. Partners were interested in the subject, had a liberal view on antenatal alcohol use and felt ignored by midwives and websites. Pregnant women indicated to receive conflicting alcohol advice from their health professionals.
Key conclusions: midwives’ alcohol advice requires improvement with regard to screening, knowledge about mechanisms and consequences of antenatal alcohol use and the involvement of the partners in alcohol advice during pregnancy.
http://www.midwiferyjournal.com/article/S0266-6138%2812%2900221-5/abstract

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6. Van der Wulp, N.Y., Hoving, C. & De Vries, H. (2014) Dutch midwives' experiences with implementing health counselling to prevent prenatal alcohol use. Journal of Clinical Nursing.

Aims and objectives:To explore midwives’ experiences with the implementation of a brief health counselling intervention to prevent prenatal alcohol use.
Background: Low levels of prenatal alcohol exposure can cause adverse neurobehavioural effects in children (Sayal et al. 2007). Still, around 35–50% of Dutch, pregnant women use alcohol (Health Council of the Netherlands 2005). Brief interventions are effective in reducing prenatal alcohol use (Stade et al. 2009), but information regarding facilitators and barriers to implementation of these interventions by health professionals such as midwives is not available. The present study investigated midwives’ experiences with implementing health counselling to prevent prenatal alcohol use.
Design: Semi-structured telephone interviews were conducted with all midwives who had participated in a trial assessing the effect of a brief health counselling intervention to prevent prenatal alcohol use (n = 14). The intervention was delivered from February–December 2011.
Results:
• Midwives appreciated a clearly structured, comprehensive intervention to prevent prenatal alcohol use.
• Most midwives had not implemented the intervention correctly, including three successive counselling sessions, as they believed their clients did not need repetitive counselling.
• The implementation of the intervention can be improved when midwives are convinced of the importance of an intervention to prevent prenatal alcohol use, for example, by providing clear data on pregnant women’s alcohol use.
http://onlinelibrary.wiley.com/doi/10.1111/jocn.12525/abstract

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7. Van der Wulp, N., Hoving, C., & de Vries, H. (2014). Partner's Influences and Other Correlates of Prenatal Alcohol Use. Maternal and Child Health Journal, 1-9.

Abstract: To investigate the influence of partners on alcohol consumption in pregnant women within the context of other factors. A Dutch nationwide online cross-sectional study among 158 pregnant women and their partners was conducted. To identify correlates of prenatal alcohol use, including perceived and reported partner norm (i.e. partner’s belief regarding acceptability of prenatal alcohol use), partner modeling (i.e. partner’s alcohol use during the woman’s pregnancy) and partner support (i.e. partner’s help in abstaining from alcohol during pregnancy), independent sample T-tests and Chi square tests were conducted. Correlation analyses tested the relationship between perceived and reported partner influence. Multivariate logistic hierarchical regression analyses tested the independent impact of partner’s perceived and reported influence next to other correlates from the I-Change Model.
Pregnant women who consumed alcohol perceived a weaker partner norm (p\0.001) and less partner modeling (p\0.05), with the partner reporting a weaker norm (p\0.001), more drinking days per week (p\0.05) and weaker support (p\0.05). Perceived and reported partner norm, modeling and support were positively related (respectively p\0.01, p\0.01 and p\0.05). The multivariate analyses demonstrated that pregnant women with a higher education who perceived lower severity of harm due to prenatal alcohol use and a weaker partner norm were more likely to use alcohol (R2 = 0.42). This study demonstrated that perceived partner norm was the most critical of the constructs of perceived and reported partner influences in explaining prenatal alcohol use.
http://dx.doi.org/10.1007/s10995-014-1592-y

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8. Van der Wulp, N.Y., Hoving, C., Van Dalen, W.E., Eijmael, K.& De Vries, H. (2014)Preventing prenatal alcohol use via health counseling by midwives and internet-based computer tailored feedback; a randomized controlled trial. Journal of Medical Internet Research.

Background: Effective interventions are needed to reduce neurobehavioral impairments in children due to prenatal alcohol use. Currently, health counseling (HC) interventions have shown inconsistent results to reduce prenatal alcohol. Thus, more research using HC is needed to gain more knowledge about the effectiveness of this type of intervention on the reduction of prenatal alcohol use. An alternative and promising strategy is computer tailoring (CT). However, to date, no study has shown the effectiveness of this intervention modus in reducing prenatal alcohol use.
Objectives: To test the effectiveness of HC and CT on stopping and reducing prenatal alcohol use in a Dutch sample of pregnant women using alcohol.
Methods: Sixty Dutch midwifery practices, randomly assigned to one of three conditions, recruited 135 HC, 116 CT and 142 Usual Care (UC) respondents from February to September 2011. HC respondents received counseling from their midwife according to a HC protocol, which consisted of seven steps, addressed in three feedback sessions. CT respondents received usual care from their midwife and three CT feedback letters via the Internet. UC respondents received routine alcohol care from their midwife. After three and six months, we assessed the effect of the interventions on alcohol use.
Results: Multilevel multiple logistic regression analyses showed that CT respondents more often stopped using alcohol compared to UC respondents six months after baseline (respectively 78% versus 55%; p= .04). Multilevel multiple linear regression analyses showed that CT respondents (M = 0.35 units per week; SD = 0.31) with average (P = .007) or lower (P < .001) alcohol use before pregnancy or with average (P = .03) or lower (P = .002) social support more strongly reduced their alcohol use six months after baseline compared to UC respondents (M = 0.48; SD = 0.54). Six months after baseline, 72% of the HC respondents had stopped using alcohol. This 17% difference with the UC group was not significant.
Conclusions: This is the first study showing that CT can be effective to reduce prenatal alcohol use; HC did not effectively reduce prenatal alcohol use. Future researchers developing a HC intervention to reduce prenatal alcohol use are recommended to invest more in recruitment of pregnant women and implementation by health care providers. As pregnant women are reluctant to disclose their alcohol use to health professionals and CT preserves a person’s anonymity, the present effective CT intervention is recommended as an attractive intervention for pregnant women using alcohol.
Trial Registration: Dutch Trial Register NTR 2058 (Archived by WebCite at webcitation).

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9. De Bruijn, A., Engels, R., Anderson, P., Bujalski, M., Gosselt, J., Schreckenberg, D., Wohtge, J., De Leeuw, R. (2016). Exposure to Online Alcohol Marketing and Adolescents’ Drinking: A Cross-sectional Study in Four European Countries.Alcohol and Alcoholism .

Aims: The Internet is the leading medium among European adolescents in contemporary times; even more time is spent on the Internet than watching television. This study investigates associations between online alcohol marketing exposure and onset of drinking and binge drinking among adolescents in four European countries.
Method: A total of 9038 students with a mean age of 14.05 (SD 0.82) participated in a school-based survey in Germany, Italy, the Netherlands and Poland. Logistic regression analyses of cross-sectional cross-country survey data were undertaken. Exposure to online alcohol marketing, televised alcohol advertising and ownership of alcohol-branded items was estimated to be controlled for relevant confounders. Onset of drinking and binge drinking in the past 30 days were included in the study as outcome variables.
Results: Adjusted for relevant confounders, higher exposure to (online) alcohol marketing exposure was found to be related to the odds of starting to drink (p < 0.001) and the odds of binge drinking in the past 30 days (p < 0.001). This effect was found to be consistent in all four countries. Active engagement with online alcohol marketing was found to interact more strongly with drinking outcomes than passive exposure to online alcohol marketing.
Conclusions: Youngsters in the four European countries report frequent exposure to online alcohol marketing. The association between this exposure and adolescents’ drinking was robust and seems consistent across national contexts.
DOI: http://dx.doi.org/10.1093/alcalc/agw020

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10. De Bruijn, A., Tanghe, J., de Leeuw, R., Engels, R., Anderson, P., Beccaria, F., Bujalski, M., Celata, C., Gosselt, J., Schreckenberg, D., Słodownik, L., Wothge, J., en Van Dalen, W. (2016) European longitudinal study on the relationship between adolescents’ alcohol marketing exposure and alcohol use. Addiction 111: doi: 10.1111/add.13455

Background and aims: This is the first study to examine the effect of alcohol marketing exposure on adolescents’ drinking in a cross-national context. The aim was to examine reciprocal processes between exposure to a wide range of alcohol marketing types and adolescent drinking, controlled for non-alcohol branded media exposure.
Design: Prospective observational study (11–12- and 14–17-month intervals), using a three-wave autoregressive cross-lagged model.
Setting: School-based sample in 181 state-funded schools in Germany, Italy, Netherlands, Poland.
Participants: A total of 9075 eligible respondents participated in the survey (mean age 14 years, 49.5% male.
Measurements: Adolescents reported their frequency of past-month drinking and binge drinking. Alcohol marketing exposure was measured by a latent variable with 13 items measuring exposure to online alcohol marketing, televised alcohol advertising, alcohol sport sponsorship, music event/festival sponsorship, ownership alcohol-branded promotional items, reception of free samples and exposure to price offers. Confounders were age, gender, education, country, internet use, exposure to non-alcohol sponsored football championships and television programs without alcohol commercials.
Findings: The analyses showed one-directional long-term effects of alcohol marketing exposure on drinking (exposure T1 on drinking T2: β = 0.420 (0.058), P < 0.001, 95% confidence interval (CI) = 0.324–0.515; exposure T2 on drinking T3: β = 0.200 (0.044), P < 0.001, 95% CI = 0.127–0.272; drinking T1 and drinking T2 on exposure: P > 0.05). Similar results were found in the binge drinking model (exposure T1 on binge T2: β = 0.409 (0.054), P < 0.001, 95% CI = 0.320–0.499; exposure T2 on binge T3: β = 0.168 (0.050), P = 0.001, 95% CI = 0.086–0.250; binge T1 and binge T2 on exposure: P > 0.05).
Conclusions: There appears to be a one-way effect of alcohol marketing exposure on adolescents’ alcohol use over time, which cannot be explained by either previous drinking or exposure to non-alcohol-branded marketing.

Boeken

1. Beleid onder invloed door Evert Dekker (red.), 2006
Alcoholpreventiebeleid in Nederland.

2. In de schaduw van de drinker door Willem de Kleijnen, 2008
Elf verhalen uit de omgeving van zware drinkers, opgetekend naar aanleiding van ware gebeurtenissen.

Nederlands Instituut voor Alcoholbeleid STAP
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T: +31 (0)30-6565041
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