Does a local Alcohol Health Champion programme have a measurable impact on health and crime outcomes? A natural experiment evaluation of Communities in Charge of Alcohol (CICA) based on triangulation of methods

IF 5.2 1区医学 Q1 PSYCHIATRY Addiction Pub Date : 2023-10-12 DOI:10.1111/add.16363

Lauren J. Scott, Mira Hidajat, Elizabeth J. Burns, Cathy Ure, Suzy C. Hargreaves, Suzanne Audrey, Margaret Coffey, Susan Hare, Noemia Siqueira, Steve Parrott, Penny A. Cook, Frank de Vocht

{"title":"Does a local Alcohol Health Champion programme have a measurable impact on health and crime outcomes? A natural experiment evaluation of Communities in Charge of Alcohol (CICA) based on triangulation of methods","authors":"Lauren J. Scott, Mira Hidajat, Elizabeth J. Burns, Cathy Ure, Suzy C. Hargreaves, Suzanne Audrey, Margaret Coffey, Susan Hare, Noemia Siqueira, Steve Parrott, Penny A. Cook, Frank de Vocht","doi":"10.1111/add.16363","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Aim</h3>\n \n <p>Drinking alcohol may cause harm to an individual's health and social relationships, while a drinking culture may harm societies as it may increase crime rates and make an area feel less safe. Local councils in Greater Manchester, UK, developed the Communities in Charge of Alcohol (CICA) intervention, in which volunteers were trained to give alcohol-related advice to the public and taught how to influence policies to restrict when, where and how alcohol is sold. As part of a larger study, the aim of the current project is to measure the impact of CICA on health and crime outcomes at the lower super output (LSOA) geographical aggregation.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Quantitative evaluation using four time series analytic methods (stepped-wedge design, and comparisons to local controls, national controls and synthetic controls) with findings triangulated across these methods. A cost–benefit analysis was carried out alongside the effectiveness analysis.</p>\n </section>\n \n <section>\n \n <h3> Setting and Participants</h3>\n \n <p>The general public in Greater Manchester, UK, between 2010 and 2020.</p>\n </section>\n \n <section>\n \n <h3> Measurements</h3>\n \n <p>The primary outcome of interest was alcohol-related hospital admissions. Secondary outcomes were accident and emergency (A&E) attendances, ambulance callouts, recorded crimes and anti-social behaviour incidents.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>Triangulation of the results did not indicate any consistent effect on area-level alcohol-related hospital admissions, A&E attendances, ambulance callouts, reported crimes or anti-social behaviour associated with the implementation of CICA. The primary stepped-wedge analysis indicated an increase in alcohol-related hospital admissions following the implementation of CICA of 13.4% (95% confidence interval −3.3%, +30.1%), which was consistent with analyses based on other methods with point estimates ranging from +3.4% to 16.4%.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>There is no evidence of a measurable impact of the Communities in Charge of Alcohol (CICA) programme on area-level health and crime outcomes in Greater Manchester, UK, within 3 years of the programme start. The increase in alcohol-related hospital admissions was likely the result of other temporal trends rather than the CICA programme. Possible explanations include insufficient follow-up time, too few volunteers trained, volunteers being unwilling to get involved in licensing decisions or that the intervention has no direct impact on the selected outcomes.</p>\n </section>\n </div>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"119 3","pages":"499-508"},"PeriodicalIF":5.2000,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.16363","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addiction","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/add.16363","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and Aim

Drinking alcohol may cause harm to an individual's health and social relationships, while a drinking culture may harm societies as it may increase crime rates and make an area feel less safe. Local councils in Greater Manchester, UK, developed the Communities in Charge of Alcohol (CICA) intervention, in which volunteers were trained to give alcohol-related advice to the public and taught how to influence policies to restrict when, where and how alcohol is sold. As part of a larger study, the aim of the current project is to measure the impact of CICA on health and crime outcomes at the lower super output (LSOA) geographical aggregation.

Design

Quantitative evaluation using four time series analytic methods (stepped-wedge design, and comparisons to local controls, national controls and synthetic controls) with findings triangulated across these methods. A cost–benefit analysis was carried out alongside the effectiveness analysis.

Setting and Participants

The general public in Greater Manchester, UK, between 2010 and 2020.

Measurements

The primary outcome of interest was alcohol-related hospital admissions. Secondary outcomes were accident and emergency (A&E) attendances, ambulance callouts, recorded crimes and anti-social behaviour incidents.

Findings

Triangulation of the results did not indicate any consistent effect on area-level alcohol-related hospital admissions, A&E attendances, ambulance callouts, reported crimes or anti-social behaviour associated with the implementation of CICA. The primary stepped-wedge analysis indicated an increase in alcohol-related hospital admissions following the implementation of CICA of 13.4% (95% confidence interval −3.3%, +30.1%), which was consistent with analyses based on other methods with point estimates ranging from +3.4% to 16.4%.

Conclusion

There is no evidence of a measurable impact of the Communities in Charge of Alcohol (CICA) programme on area-level health and crime outcomes in Greater Manchester, UK, within 3 years of the programme start. The increase in alcohol-related hospital admissions was likely the result of other temporal trends rather than the CICA programme. Possible explanations include insufficient follow-up time, too few volunteers trained, volunteers being unwilling to get involved in licensing decisions or that the intervention has no direct impact on the selected outcomes.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

当地的酒精健康冠军计划对健康和犯罪结果有可衡量的影响吗？基于三角测量方法的酒精管理社区（CICA）自然实验评估。

背景和目的：饮酒可能会损害个人的健康和社会关系，而饮酒文化可能会损害社会，因为它可能会增加犯罪率，使一个地区感到不那么安全。英国大曼彻斯特的地方议会制定了“酒精负责社区”（CICA）干预措施，对志愿者进行培训，向公众提供与酒精相关的建议，并教授如何影响限制何时、何地和如何销售酒精的政策。作为一项更大研究的一部分，当前项目的目的是在较低的超级产出（LSOA）地理聚合中衡量CICA对健康和犯罪结果的影响。设计：使用四种时间序列分析方法（阶梯式楔形设计，与地方对照、国家对照和综合对照进行比较）进行定量评估，并在这些方法中对结果进行三角测量。在进行有效性分析的同时，还进行了成本效益分析。背景和参与者：2010年至2020年间，英国大曼彻斯特的普通公众。测量：感兴趣的主要结果是与酒精相关的住院。次要结果是事故和紧急情况（A&E）就诊、救护车呼叫、记录在案的犯罪和反社会行为事件。调查结果：对结果进行三角分析并没有表明对与实施CICA相关的地区级酒精相关的入院、急诊就诊、救护车呼叫、报告的犯罪或反社会行为有任何一致的影响。初级阶梯楔形分析表明，实施CICA后，与酒精相关的住院人数增加了13.4%（95%置信区间-3.3%，+30.1%），这与基于其他方法的分析一致，点估计值在+3.4%-16.4%之间。结论：没有证据表明，在项目启动后的3年内，英国大曼彻斯特地区的酒精管理社区（CICA）项目对地区层面的健康和犯罪结果产生了可衡量的影响。与酒精相关的住院人数增加可能是其他时间趋势的结果，而不是CICA计划的结果。可能的解释包括随访时间不足、接受培训的志愿者太少、志愿者不愿意参与许可决定或干预措施对所选结果没有直接影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.