Potential unintended consequences | How agencies and structures may interact in unintended ways | Comparative understanding across similar interventions | Consultation with individuals/groups with insights into local contexts and how interventions might operate within them (CICA Project Advisory Group) |
---|---|---|---|
Direct harms | None identified | Lack of depth of knowledge by lay health advisors could result in time delays or inconsistent advice for ‘in-need’ populations [48] | Concerns that volunteers recruited from recovering communities could be at increased risk of relapse of alcohol, drug or mental health problems |
Psychological harms | None identified | Volunteers embedded within communities find it hard to ‘switch off’ [48] | Intervening in licensing could lead to negative reactions from local retailers |
Dissatisfaction and disillusionment of volunteers [49] | |||
Equity harms | Communities most in need are probably the least able to form a strong community group [50, 51] | Motivated individuals becoming health champions are likely to benefit from being a champion more so than those less motivated (who need the potential positive benefits more) [48] | Individual assets within communities excluded from participation due to barriers to recruitment/participation e.g. literacy, criminal record checks, worry about impact on benefits |
Group and social harms | ‘Communities’ chosen to be in charge of alcohol set by experts (normative needs) vs. self-identified communities (felt needs) [49] | Becoming a community champion could result in lack of acceptance by own community resulting in marginalising “do gooders” [48] | None identified |
Current recovery dominated culture within alcohol service provision in UK influences the selection of volunteers from ‘recovery’ communities [52] | |||
Opportunity cost harms | Commissioners may miss opportunities to invest in alternative public health interventions [53] | Missed opportunities to identify “at-risk” populations [54] due to stereotyping those ‘in need’ as only the most severe drinking patterns [55] | None identified |