The thesis draws on historical and social policy perspectives to examine the factors influencing development and change in alcohol treatment policy between 1950 and 1990. The study uses data from primary and secondary documentation and from taped interviews. Three themes are highlighted as particularly relevant to an examination of policy trends. The first of these is the emergence and evolution of a `policy community'. Spearheaded by psychiatrists in the 1960s, the `policy community' broadened to include other professional groups and the voluntary sector by the 1990s. The second theme concerns the role of research in influencing the nature and direction of treatment policy. The study indicates increasing use of research as the rationale for policy and illustrates the move towards a `contractor' relationship between research workers and policy makers. The final theme deals with the influence on policy of ideological frames and changing conceptualisations of the alcohol problem. Two major shifts were important for treatment, the re-discovery of the disease concept of alcoholism in the 1950s and the emergence of a new public health model of alcohol problems in the 1970s. Within these broad themes, the study includes an examination of tensions - between different professional perspectives, between government departments with differing responsibilities, between different ideologies - and of moves to secure consensus in the formulation and implementation of treatment policy. The final chapter addresses shifts in thinking from the re-emergence of a `disease' model of alcoholism in the 1950s, to a `consumptionist' (population-based) model in the 1970s, towards a `harm reduction' approach to alcohol problems management in the 1990s. The thesis concludes that over the past forty years competing paradigms of the alcohol problem have emerged and gained policy salience within particular historical-social contexts in the search for policy consensus to manage the problematic aspects of alcohol consumption.

The purpose of this study was to explore specific activities school psychologists performed related to both testing and placing within a medical model and prevention within a public health model. Spurred by landmark legal mandates, school districts are moving toward preventative practice within a framework consistent with tenets of a public health model or Response to Intervention (RtI) framework. These activities are counter to traditional test-and-place activities performed by school psychologists associated with a medical model of service delivery. School psychologists assigned to 41 elementary schools in the northwest corner of Oregon completed a survey that included activities associated with testing-and-placing students typified by a medical model and those activities akin to a public health model. All schools participating in this study implemented Positive Behavioral Interventions and Supports (PBIS). PBIS is a widely implemented evidence-based practice in education that emphasizes prevention, and is a reflection of RtI or the public health model. Although PBIS was a common denominator across all schools, there were differences in overall implementation effectiveness as measured by the School-wide Evaluation Tool (SET). This study investigated the degree to which activities performed by school psychologists impacted PBIS implementation in their buildings. School psychologists estimated the frequency devoted to these activities. Frequency served as a proxy for priority and also defined the service models that guided their practices. In addition to this descriptive statistical analysis, inferential statistics were used to measure the correlation between the School Psychologist Survey, the SET-General Index scores, and the SET-Behavior Expectations Index scores. A multiple-regression analysis was also conducted to determine which variable (i.e., SET-General Index or SET-Behavior Expectations Index) was the best predictor of outcome data from the School Psychologist Survey. These data were also entered into scatterplots to provide interpretations of meaningful statistical significance for an in-depth analysis of the School Psychologist Survey, SET-General Index, and SET-Behavior Index scores. This study is important because it potentially provides school psychologists with specific preventative activities they can perform within a public health model of service delivery to make contributions for improving the overall school environment for students.

Violence is considered a public health problem in the United States, yet little is known about the benefit of using a combined epidemiology and criminology (EpiCrim) approach to focus on urban youth gun violence. The purpose of this general qualitative study was to determine in what ways Akers and Lanier's EpiCrim approach in tandem with Benet's polarities of democracy approach is explanatory of gun homicides by youth in U.S. urban areas and if the Youth Risk Behavior Surveillance System adequately addresses gun abatement measures. Data were collected through semi structured interviews of 16 criminal justice practitioners and medical professionals with experience relative to juvenile justice policies pertaining to gun violence. Interview data were inductively coded, then subjected to a thematic analysis procedure. The findings indicate that EpiCrim provides a platform to focus research efforts on complex issues that are drivers for behavioral risk factors associated with youth gun violence in urban areas. Participants perceive a necessity for legislative revisions supporting gun violence research and the reduction of privacy issues that pose barriers to EpiCrim research. EpiCrim research can provide data that help identify the root cause of youth gun violence in urban areas, and the Youth Risk Behavior Surveillance System does not fully address gun abatement measures. The positive social change implications stemming from this study include recommendations to local, state, and federal legislatures to explore legislative action to incorporate EpiCrim strategies as a method to reduce gun violence among youth in urban communities.