Alcohol Use in a Tribal Rural Population of India: Prevalence, Social Determinants, and Impact of a Community-Based Health System-Integrated Intervention

Background: Alcohol consumption is an overlooked public health concern in tribal populations of India. Culturally and systemically rooted factors contribute to neglect in engagement and treatment, even with prohibition policies in place. Therefore, this study analyzed the prevalence and sociodemographic factors associated with alcohol consumption in a tribal rural district of India and evaluated the effects of a health system-integrated, community-based intervention on knowledge, attitudes, and practices (KAP) concerning abstinence.Method: A total of ۲۶۹ community members and ۸۱ healthcare workers participated in this quasi-experimental study. The KAP survey and Alcohol Use Disorders Identification Test (AUDIT) were used, and sociodemographic details were noted. Tailored to local cultural settings, a ۳-month community mobilization and provider training intervention was carried out. Statistical analyses, including logistic regression, Cox regression, and structural equation modeling, were performed.Findings: The prevalence of alcohol use was ۱۱۱ (۴۱.۳%). The significant predictors were identified as male sex, education level, and family history (adjusted odds ratios = ۲.۷۳, ۱.۹۶, and ۲.۸۳, respectively). Following the intervention, community participant KAP scores (۴.۶۰ to ۸.۵۳, P < ۰.۰۰۱) and healthcare worker KAP scores (۱۵.۰ to ۲۲.۳, P < ۰.۰۰۱) improved significantly. Of the ۱۱۱ alcohol users, ۸۱(۷۳%) started treatment. Abstinence rates were ۶۳(۷۷.۸%) at ۱ month and ۳۹ (۴۸.۱%) at ۳ months. Those aged over ۴۰ years who had low income and those with unstable employment faced the highest relapse risk.Conclusion: Using community-specific approaches within broad systemic frameworks improves intervention outcomes for alcohol use among tribal populations. To maintain long-term effectiveness, concurrent support from socioeconomic systems is essential.

کلیدواژه ها:

Alcohol Dependence ، Community-based participatory research ، Health knowledge ، attitudes ، Practice