A feasibility study of a licensed premise intervention to reduce alcohol misuse and violent injury

A feasibility study of a licensed premise intervention to reduce alcohol misuse and violent injury

Introduction

The health and economic costs of alcohol misuse in the UK are estimated to be between 2% and 5% of UK gross domestic product and reflect sexual health outcomes, injury, stroke and cancer as well as lost productivity and absenteeism in the workplace. Evidence suggests that interventions targeted at licensed premises which address known risk factors (e.g. serving alcohol to intoxicated customers, irresponsible alcohol promotions, deficits in server training) can be effective in reducing the health costs associated with alcohol misuse.

Aims of Project

This project builds on the applicants previous research by assessing the feasibility of a premises-level intervention designed to reduce alcohol misuse, and outcomes of misuse including disorder and violent injury. It is necessarily a feasibility study since available evidence suffers from poorly defined outcome measures which are too diverse to be generalisable and inappropriate methodology. For example, randomised controlled trials (RCT) have been rarely been used.

The interventions will be based on identification of premises risk factors. Experts in auditing the licensed trade and researchers will work with licensees to address shortcomings. The key intervention component involves feedback: experimental premises will receive feedback and be subject to action plans whereas control premises will not. Although the means of identifying shortcomings in premises management has been used across England and Wales and interventions which raise standards appear to have reduced disorder according to various police and health indicators (usually injury measures) this process has not been evaluated using a randomised controlled trial.

This feasibility study will pilot the intervention using a RCT design to provide effect sizes. This study will pilot a breathalyser survey to measure the prevalence of alcohol intoxication in drinkers and will utilise police and accident and emergency data to measure the incidence and prevalence of violence and alcohol problems. A process evaluation will involve interviewing staff within the licensed trade both in intervention premises and senior staff in large licensed premise chains to determine barriers, fidelity of the intervention, acceptability and sustainability. Premises level interventions which reduce misuse are strategically relevant to a range of partnership activities, policy initiatives and funding streams across health and criminal justice. However, Primary Care Trusts and other agencies are required to develop plans which are evidence based. The proposed feasibility study begins to address the deficit in evidence for such interventions to inform a future definitive trial.

Funder

Medical Research Council. A feasibility study of a licensed premise intervention to reduce alcohol misuse and violent injury. (Moore S PI, with 3 co-applicants)