Using the diamond dialogue to explore community ambivalence towards changing alcohol use and strengthen community action

Statement of the Problem: Alcohol related harm is considered significant in many areas in Sabah. This project aimed to provide community members with information and approaches to addressing this problem in their own area. This paper shows a unique approach to health promotion and community engagement in rural communities. Method: This project used action research methodology. A workshop for alcohol misuse was held in a rural village. At the start of the workshop four groups were formed and focus group discussions were held using the diamond dialogue technique. Responses were analysed for themes, using grounded theory methods. The position on the diamond shape was analysed by overlaying a 11 point grid, with 10 corresponding to the highest level of happiness and 0 corresponding to the lowest level of happiness. Results & Findings: The diamond dialogue was originally created as a research tool to measure the effectiveness of community level interventions on wellbeing. This tool was initially used as a way of evaluating our alcohol intervention. While being used in this way it was noted that the tool itself provided an avenue for change. It has not previously been used specifically as an intervention in itself. The respondents appeared to understand the exercise well. Five main themes were found: Family and relationships, security, health, expanding horizons, religion. Alcohol was a topic that pervaded all of these themes, with positive and negative effects. Results suggest that using the diamond dialogue created a collective motivation to change. Exploring community ambivalence towards alcohol, acceptance of both the positive and negative effects and validation of the community’s views provided a platform for engagement. This leads to “change talk” and ownership of possible solutions. Conclusion & Significance: This research suggests the diamond dialogue tool is useful both as an explorative tool and a standalone community level intervention tool. Further research is underway to further explore this conclusion and develop the tool for wider use in communities.