An exploratory randomised controlled trial of a premises-level intervention to reduce alcohol-related harm including violence in the United Kingdom

BMC Public Health

Laurence Moore²  Jonathan Shepherd³  Ellie Byrne²  Iain Brennan¹  Susan N Moore²  Simon Murphy²  Simon C Moore³ 

[1]Department of Social Sciences, University of Hull, Cottingham Rd., Hull, HU6 7RX, UK

[2]Cardiff Institute for Society and Health, Cardiff School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff CF10 3BD, UK

[3]Violence & Society Research Group, School of Dentistry, Cardiff University, Cardiff CF14 4XY, UK

关键词: Intervention;    Exploratory trial;    Licensed premises;    Alcohol;    Violence;   

Others  :  1163563
DOI  :  10.1186/1471-2458-12-412

 received in 2011-09-09, accepted in 2012-05-16,  发布年份 2012

【 摘 要 】

Background

To assess the feasibility of a randomised controlled trial of a licensed premises intervention to reduce severe intoxication and disorder; to establish effect sizes and identify appropriate approaches to the development and maintenance of a rigorous research design and intervention implementation.

Methods

An exploratory two-armed parallel randomised controlled trial with a nested process evaluation. An audit of risk factors and a tailored action plan for high risk premises, with three month follow up audit and feedback. Thirty-two premises that had experienced at least one assault in the year prior to the intervention were recruited, match paired and randomly allocated to control or intervention group. Police violence data and data from a street survey of study premises’ customers, including measures of breath alcohol concentration and surveyor rated customer intoxication, were used to assess effect sizes for a future definitive trial. A nested process evaluation explored implementation barriers and the fidelity of the intervention with key stakeholders and senior staff in intervention premises using semi-structured interviews.

Results

The process evaluation indicated implementation barriers and low fidelity, with a reluctance to implement the intervention and to submit to a formal risk audit. Power calculations suggest the intervention effect on violence and subjective intoxication would be raised to significance with a study size of 517 premises.

Conclusions

It is methodologically feasible to conduct randomised controlled trials where licensed premises are the unit of allocation. However, lack of enthusiasm in senior premises staff indicates the need for intervention enforcement, rather than voluntary agreements, and on-going strategies to promote sustainability.

Trial registration

UKCRN 7090; ISRCTN: 80875696

【 授权许可】

   
2012 Moore et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Calling Time: The Nation’s Drinking as a Major Health Issue. London: Academy of Medical Sciences; 2004.
• [2]Gilmore I: Alcohol - Can the NHS Afford It? A report of a Working Party of the Royal College of Physicians. London: Royal College of Physicians; 2001.
• [3]The Impact of Alcohol on the NHS. St Ives, Cambs: Institute of Alcohol Studies; 2007.
• [4]Holmila M: Community Prevention of Alcohol Problems. London: Macmillan; 1997.
• [5]Homel R, Clark J: The prediction and prevention of violence in pubs and clubs. Crime Prev Stud 1994, 3:1-46.
• [6]Treno AJ, Lee JP: Approaching alcohol problems through local environmental interventions. Alcohol Health Res World 2002, 26:35-40.
• [7]Green J, Plant MA: Bad bars: a review of risk factors. J Substance Use 2007, 12:157-189.
• [8]Giesbrecht N, Pederson A: Focusing on the drinking environment or the high-risk drinker in prevention projects: limitations and opportunities. In Community Prevention Trials for Alcohol Problems: Methodological Issues. Edited by Holder HD, Howard JM. Westport, CT: Praeger; 1992:97-112.
• [9]Milvihill C, Taylor L, Waller S, Naidoo B, Thom B: Prevention and Reduction of Alcohol Misuse: Evidence Briefing. London: Health Development Agency; 2005.
• [10]Calafat A, Juan M: Health and safety problems in recreational nightlife in the island of Mallorca. Int J Drug Pol 2004, 15:157-162.
• [11]Moore SC, Perham NR, Shepherd J, Cusens B: The prevalence of alcohol intoxication in the night-time economy. Alcohol Alcohol 2007, 42:629-634.
• [12]Perham NR, Moore SC, Shepherd JP, Cusens B: Identifying drunkenness in the night time economy. Addiction 2007, 102:377-380.
• [13]Johnsson KO, Berglund M: Education of key personnel in student pubs leads to a decrease in alcohol consumption among the patrons: a randomized controlled trial. Addiction 2003, 98:627-633.
• [14]Burns L, Coumarelos C: Policing pubs: evaluation of a licensing enforcement strategy. Sydney: New South Wales Bureau of Crime Statistics and Research; 1993.
• [15]Felson M, Berends R, Richardson B, Veno A: Reducing pub-hopping and related crime. Crime Prev Stud 1997, 7:115-132.
• [16]Hawkins N, Sanson-Fisher R, Shakeshaft A, Webb G: Differences in licensee, police and public opinions regarding interventions to reduce alcohol-related harm associated with licensed premises. Aust N Z J Publ Health 2009, 33:160-166.
• [17]National Standards, Local Action: Health and Social Care Standards and Planning Framework 2005/06-2007/08. London: Department of Health; 2004.
• [18]Moore SC, Brennan IR, Murphy S, Byrne E, Moore SN, Shepherd JP, Moore L: Study protocol. The reduction of intoxication and disorder in premises licensed to serve alcohol: an exploratory randomised controlled trial. BMC Publ Health 2010., 10
• [19]Moore SC, Shepherd J: Observational and methodological issues in a multi-agency community-based intervention to reduce excessive drinking. Drugs Educ Prev Pol 2009, 15:26-37.
• [20]Moore SC, Brennan IR, Murphy S: Measuring and predicting premises-level harm in the night time economy. Alcohol Alcohol 2011, 46:357-363.
• [21]Developing and Evaluating Complex Interventions: New Guidance. London: Medical Research Council; 2008.
• [22]Brennan IR, Moore SC, Byrne E, Murphy S: Interventions for disorder and severe intoxication in and around licensed premises, 1989–2009. Addiction 2011, 106:706-713.
• [23]Graham K, Homel R: Raising the Bar: Aggression in and Around Bars, Pubs and Clubs. Cullompton: Willan Publishing; 2008.
• [24]Moore SC: Red alert. Jane’s Pol Rev 2006, 114:22-23.
• [25]Newton A, Hirschfield A, Armitage A, Rogerson M, Monchuk L, Wilcox A: Evaluation of Licensing Act: Measuring Crime and Disorder in and around Licensed Premises, Research Study SRG/05/007 Final Report. Huddersfield: Applied Criminology Centre, University of Huddersfield; 2008.
• [26]Graham K, Osgood WD, Zibrowski E, Purcell J, Gliksman L, Leonard K, Pernanen K, Saltz RF, Toomey TL: The effect of the Safer Bars programme on physical aggression in bars: results of a randomized controlled trial. Drug Alcohol Rev 2004, 23:31-41.
• [27]Toomey TL, Wagenaar AC, Gehan JP, Wilian G, Murray DM, Perry CL: Project ARM: alcohol risk management to prevent sales to underage and intoxicated patrons. Health Educ Behav 2001, 28:186-199.
• [28]Cohen LE, Felson M: Social change and crime rate trends: a routine activity approach. Am Sociol Rev 1979, 44:588-608.
• [29]Skogan WG: Disorder and Decline: Crime and the Spiral of Decay in American Neighbourhoods. New York: Free Press; 1990.
• [30]Wilson JQ, Kelling GL: Broken windows. Atl Mon 1982, 29-38.
• [31]Keizer K, Lindenberg S, Steg L: The spreading of disorder. Science 2008, 322:1681-1685.
• [32]Campbell CA, Hahn RA, Elder R, Brewer R, Chattopadhay S, Fielding J, Naimi TS, Toomey TL, Lawrence B, Cook Middleton J: The effectiveness of limiting alcohol outlet density as a means of reducing excessive alcohol consumption and alcohol-related harms. Am J Prev Med 2009, 37:556-571.
• [33]Livingston M: Alcohol outlet density and assault: a spatial analysis. Addiction 2008, 103:619-628.
• [34]Moore SC, Flajšlik M, Rosin P, Marshall D: A particle model of crowd behavior: exploring the relationship between alcohol, crowd dynamics and violence. Aggression Viol Behav 2008, 13:413-422.
• [35]Eck JE: Police problems: the complexity of problem theory, research and evaluation. Crime Prevent Stud 2003, 15:79-113.
• [36]Quigley B, Leonard K, Collins R: Characteristics of violent bars and bar patrons. J Stud Alcohol 2003, 64:765-772.
• [37]Clarke RV: Situational Crime Prevention: Successful Case Studies. New York: Harrow and Heston; 1997.
• [38]Graham K, Bernards S, Osgood DW, Wells S: Bad nights or bad bars? Multi-level analysis of environmental predictors of aggression in late-night large-capacity bars and clubs. Addiction 2006, 101:1569-1580.
• [39]Single E, Pomeroy H: Drinking and setting: a season for all things. In Alcohol and Pleasure. Edited by Peele S, Grant M. Philadelphia: Taylor and Francis; 1999.
• [40]Homel R, Tomsen S, Thommeny JL: Public drinking and violence: not just an alcohol problem. J Drug Issues 1992, 22:679-697.
• [41]Bach PJ, Schafer JM: Tempo of country music and the rate of drinking in bars. J Stud Alcohol 1979, 40:1058-1059.
• [42]Graham K: Determinants of heavy drinking and drinking problems: the contribution of the bar environment. In Public Drinking and Public Policy. Edited by Single E, Storm T. Toronto: Addiction Research Foundation; 1985:71-84.
• [43]Anderson CA: Temperature and aggression: effects on quarterly and yearly city rates of violent and nonviolent crime. J Pers Soc Psychol 1987, 52:1161-1173.
• [44]Baron RA, Bell PA: Aggression and heat: mediating effects of prior provocation and exposure to an aggressive model. J Pers Soc Psychol 1975, 31:825-832.
• [45]Griffit W, Veitch R: Hot and crowded: influences of population density and temperature on interpersonal behavior. J Pers Soc Psychol 1971, 17:92-99.
• [46]Homel R, Carvolth R, Hauritz M, McIlwain G, Teague R: Making licensed venues safer for patrons: what environmental factors should be the focus of interventions? Drug Alcohol Rev 2004, 23:19-29.
• [47]Ker K, Chinnock P: The effectiveness of interventions in the alcohol server setting for preventing injuries. Cochrane Database Syst. Rev 2008, 3:CD005244.
• [48]Homel R, Hauritz M, Wortley R, McIlwain G, Carvolth R: Preventing alcohol–related crime through community action: the Surfers Paradise Safety Action Project. Crime Prevent Stud 1997, 7:35-90.
• [49]Stockwell T, Lang E, Rydon P: High risk drinking settings: the association of serving and promotional practices with harmful drinking. Addiction 1993, 88:1519-1526.
• [50]McMurran M: Alcohol and aggressive cognition. In Aggressive Offenders’ Cognition: Theory, Research and Practice. Edited by Gannon TA, Ward T, Beech AR, Fisher D. London: John Wiley; 2007. [Hollin CR, McMurran M (Series Editor): Forensic Clinical Psychology]
• [51]Hayes RJ, Moulton LH: Cluster Randomised Trials. London: CRC Press; 2009.
• [52]Guidance Issued Under Section 182 of the Licensing Act 2003. London: Department for Culture Media and Sport; 2007.
• [53]Moore SC, Perham NR, Shepherd J: A Multi-Agency Community Based Intervention to Reduce Excessive Drinking in Cardiff City Centre. Cardiff: Cardiff University; 2006.
• [54]Becker GS, Murphy KM: A theory of rational addiction. J Polit Econ 1988, 96:675-700.
• [55]Hodgson R, Alwyn T, John B, Thom B, Smith A: The Fast Alcohol Screening Test. Alcohol Alcohol 2002, 37:61-66.
• [56]Moore SC, Cusens B: Delay discounting predicts increase in blood alcohol level in social drinkers. Psychiatr Res 2010, 179:324-327.
• [57]Copas J, Marshall P: The offender group reconviction scale: a statistical reconviction score for use by probation officers. Appl Stat 1998, 47:159-171.
• [58]Foreman-Peck J, Moore SC: Gratuitous violence and the rational offender model. Int Rev Law Econ 2010, 30:160-172.
• [59]Aldridge J, Charles V: Researching the intoxicated: informed consent implication for alcohol and drug research. Drug Alcohol Depend 2008, 93:191-196.
• [60]Andersen PK, Gill RD: Cox’s regression model for counting processes: a large sample study. Ann Stat 1982, 10:1100-1120.
• [61]Aalen OO, Borgan O, Gjessing HK: Survival and Event History Analysis: A Process Point of View. New York: Springer; 2008.
• [62]Cook RJ, Lawless JF: The Statistical Analysis of Recurrent Events. New York: Springer; 2007.
• [63]Rabe-Hesketh S, Skrondal A: Multilevel and Longitudinal Modeling Using Stata. College Station, Texas: Stata Press; 2008.
• [64]Steckler A, Linnan L: Process Evaluation for Public Health Interventions and Research. San Francisco, CA: Jossey-Bass; 2004.
• [65]Foster JH, Herring R, Waller S, Thom B: The Licensing Act 2003: a step in the right direction? J Substance Use 2009, 14:113-123.
• [66]Feiveson AH: Power by simulation. Stata J 2002, 2:107-124.
• [67]Goodsite B, Klear L, Rosenberg H: The impact of behavioral signs of intoxication on bartender service. Drug Educ Prev Pol J 2008, 15:545-551.
• [68]Dubourg R, Hamed J, Thorns J: The Economic and Social Costs of Crime Against Individuals and Households 2003/04. Home Office Report 30/05. London: Home Office; 2005.
• [69]Castro FG, Barrera M Jr, Martinez CR Jr: The cultural adaptation of prevention interventions: resolving tensions between fidelity and fit. Prev Sci 2004, 5:41-45.
• [70]Holliday J, Audrey S, Moore L, Parry-Langdon N, Campbell R: High fidelity? How should we consider variations in the delivery of school-based health promotion interventions? Health Educ J 2009, 68:44-62.
• [71]Byng R, Norman I, Redfern S, Jones R: Exposing the key functions of a complex intervention for shared care in mental health: case study of a process evaluation. BMC Health Serv. Res 2008., 8
• [72]Hawe P, Shiell A, Riley T: Complex interventions: how “out of control” can a randomised controlled trial be? Br Med J 2004, 328:1561-1563.
• [73]Marteau T, Ogilvie D, Roland M, Suhrcke M: Judging nudging: can nudging improve population health? Br Med J 2011, 342:263-265.