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Item Alcohol e-Help: study protocol for a web-based self-help program to reduce alcohol use in adults with drinking patterns considered harmful, hazardous or suggestive of dependence in middle-income countries(Addiction, 2018) Michael P. Schaub; Marcela Tiburcio; Nora Martinez; Atul Ambekar; Yatan Pal Singh Balhara; Andreas Wenger; Andre Luiz Monezi Andrade; Dzianis Padruchny; Sergey Osipchik; Elise Gehring; Vladimir PoznyakBackground and aimsGiven the scarcity of alcohol prevention and alcohol use disorder treatments in many low and middle-income countries, the World Health Organization launched an e-health portal on alcohol and health that includes a Web-based self-help program. This paper presents the protocol for a multicentre randomized controlled trial (RCT) to test the efficacy of the internet-based self-help intervention to reduce alcohol use. DesignTwo-arm randomized controlled trial (RCT) with follow-up 6 months after randomization. SettingCommunity samples in middle-income countries. ParticipantsPeople aged 18+, with Alcohol Use Disorders Identification Test (AUDIT) scores of 8+ indicating hazardous alcohol consumption. Intervention and comparatorOffer of an internet-based self-help intervention, Alcohol e-Health', compared with a waiting list' control group. The intervention, adapted from a previous program with evidence of effectiveness in a high-income country, consists of modules to reduce or entirely stop drinking. MeasurementsThe primary outcome measure is change in the Alcohol Use Disorders Identification Test (AUDIT) score assessed at 6-month follow-up. Secondary outcomes include self-reported the numbers of standard drinks and alcohol-free days in a typical week during the past 6 months, and cessation of harmful or hazardous drinking (AUDIT < 8). AnalysisData analysis will be by intention-to-treat, using analysis of covariance to test if program participants will experience a greater reduction in their AUDIT score than controls at follow-up. Secondary outcomes will be analysed by (generalized) linear mixed models. Complier average causal effect and baseline observations carried forward will be used in sensitivity analyses. CommentsIf the Alcohol e-Health program is found to be effective, the potential public health impact of its expansion into countries with underdeveloped alcohol prevention and alcohol use disorder treatment systems world-wide is considerable.Item Air pollution governance in China and India: Comparison and implications(Environ. Sci. Policy, 2023) Pu Wang; Dachuan Liu; Arideep Mukherjee; Madhoolika Agrawal; Huawei Zhang; Evgenios Agathokleous; Xue Qiao; Xiaobin Xu; Yan Chen; Tong Wu; Mengye ZhuSevere air pollution in China and India threatens the health of over one-third of the global population. When it comes to air pollution governance, the two countries have vastly different approaches. China's approach features centralized target-setting and implementation, with policies enforced primarily through top-down administrative lines. While India's approach reflects the division of power among central and state governments and relies substantially on legislative and judiciary systems for accountability. We conduct a detailed review of the trends and sources of six air pollutants in China and India, and make a structured comparison of China and India's air pollution policy frameworks. An extensive literature review is conducted to evaluate the effectiveness of policies in each country. The studies show that China's policy efforts have achieved significant improvements in air quality, while India's policies have been largely ineffective. Nevertheless, both approaches have the potential to lead to effective air pollution governance, if a country can build strong political will and clearly defined accountability systems. We further identify key lessons learned from the two countries for air pollution poli-cymaking in developing countries, including taking good advantage of post-crisis policy window, and targeting low-hanging fruits to make incremental improvements in a cost-effective way.Item Adolescent health in the Sustainable Development Goal era: are we aligned for multisectoral action?(BMJ Glob. Health, 2021) Asha George; Tanya Jacobs; Rajani Ved; Troy Jacobs; Kumanan Rasanathan; Shehla Abbas ZaidiAdolescents are an increasing proportion of low and middle-income country populations. Their coming of age is foundational for health behaviour, as well as social and productive citizenship. We mapped intervention areas for adolescent sexual and reproductive health, including HIV, mental health and violence prevention to sectors responsible for them using a framework that highlights settings, roles and alignment. Out of 11 intervention areas, health is the lead actor for one, and a possible lead actor for two other interventions depending on the implementation context. All other interventions take place outside of the health sector, with the health sector playing a range of bilateral, trilateral supporting roles or in several cases a minimal role. Alignment across the sectors varies from indivisible, enabling or reinforcing to the other extreme of constraining and counterproductive. Governance approaches are critical for brokering these varied relationships and interactions in multisectoral action for adolescent health, to understand the context of such change and to spark, sustain and steer it.