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 timeseries 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, United Kingdom, 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 call-outs, reported crimes, or anti-social behaviour associated with the implementation of CICA. The primary stepped-wedge analysis indicated an increase in alcohol-related hospital 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 +3.4%-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 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.
Design: Quantitative evaluation using four timeseries 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, United Kingdom, 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 call-outs, reported crimes, or anti-social behaviour associated with the implementation of CICA. The primary stepped-wedge analysis indicated an increase in alcohol-related hospital 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 +3.4%-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 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.
| Original language | English |
|---|---|
| Article number | ADD-23-0130.R1 |
| Journal | Addiction |
| Early online date | 12 Oct 2023 |
| DOIs | |
| Publication status | E-pub ahead of print - 12 Oct 2023 |
Bibliographical note
Funding Information:This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research Programme (Award ID: 15/129/03) and supported by the NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust. The views expressed in this article are those of the authors and do not necessarily represent those of the NHS, the NIHR or the Department of Health and Social Care. Funding information
Publisher Copyright:
© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
