Reducing alcohol-related harm in rural communities
NDARC Staff
Anthony Shakeshaft, Richard Mattick and Paul Dillon
Other Investigators
Rob Sanson-Fisher, Nathan Hawkins and Catherine D'Este (University of Newcastle), Chris Doran (Centre for Burden of Disease and Cost-Effectiveness, University of Queensland) and John Wiggers (Hunter Centre for Health Advancement).
Aims
This project aimed to develop an innovative evaluation design and series of measures to examine the impact of community-level intervention strategies on local crime rates and emergency department (ED) presentations.
Design and Method
Four towns were randomly selected in NSW, Australia. Eligible communities were identified after carefully considering a range of characteristics, such as the total population, gender distribution, socio-economic indicators and the proportion of indigenous residents. Care was taken to ensure that communities were geographically separated, in order to reduce the likelihood of possible contamination of the interventions. Of the eligible communities, four were invited to participate.
The study was evaluated using a multiple baseline design. The implementation of intervention activities was staggered across each community. Data was repeatedly collected in four communities both before and following the implementation of the intervention.
A proxy indicator of local alcohol-related harms in participating communities was assessed by examining alcohol-related presentations to emergency departments and alcohol-related incidents identified by police.
The community based intervention strategy comprised:
- GPs in the intervention communities were trained in, and provided resources for, identifying and intervening with those patients at risk of alcohol related harms
- Senior (years 10, 11 and 12) students participated in resilience education programs, aimed at giving them the skills and knowledge to resist pressures to misuse alcohol.
- Rural print media outlets published articles reporting research activities (and the underlying need for these activities) in their local communities.
Output
The community based intervention implemented in this study had little impact on local crime rates and ED presentations. Possible reasons include the intervention strategy needed to be more comprehensive, the sensitivty of the outcome measures was not sufficient or a longer follow-up period was required to observe effects.
A number of papers have been submitted for publication.
Funding
National Health and Medical Research Council