The NIHR School for Public Health Research whole school alcohol programme comprises a cluster of studies. These jointly aim to identify and evaluate approaches to reducing alcohol-related harm that are relevant in an English public health policy context. The information below focuses on the work package jointly led by SARG, Bristol University and London School of Hygiene and Tropical Medicine.
The central aim of the work package is to provide public health stakeholders within local authorities with evidence tailored to their particular context detailing the most effective and, where possible cost effective, alcohol policy interventions.
Preventing alcohol-related harm: Testing and generating evidence for local practitioners and policy makers
This project has three components which are described in turn below
Component A involves two parts:
Firstly, detailed qualitative case studies will allow us to understand the relevance of local context to the selection and implementation of Local Authority area alcohol policies, interventions and practices, to identify existing evaluations of these, and to discuss future evaluation opportunities. A grey literature search has also been undertaken to identify any local evaluations conducted.
Secondly, the mapping of alcohol interventions in local populations will allow us to understand what major policy interventions/initiatives have been used or are planned across Local Authorities. The mapping will focus on access to cheap alcohol (pricing), use of licensing to limit availability, and alcohol screening and brief intervention. Further we will be able to quantify the intensity with which different interventions have been implemented across areas and relate this to alcohol related harms (thus informing Component B of the research
Component B of the project aims to determine the feasibility of developing a new Local Authority level adaptation of an influential alcohol policy appraisal tool; the Sheffield Alcohol Policy Model (SAPM). SAPM is already used at a national level to appraise pricing policies, alcohol screening and brief intervention, and licensing restrictions on alcohol outlet opening hours and density. We aim to show how this might be adapted to allow the effect of local variation in policies on alcohol consumption and harms to be modelled.
Adaptation of SAPM for the Local Authority level requires local level data inputs, with current national-level data inputs relating to consumption, pricing, availability and harms to be substituted with local-level data. A major stream of activity for the project therefore will be in identifying or adapting data sources suitable for this purpose. The model will then be validated (for example by cross validation with Local Alcohol Profile for England data) and the Local Authority policy appraisal capacity of the new model pilot tested in selected areas.
Component C involves undertaking a number of local policy evaluations in partnership with local authority staff. The exact evaluation methods will be intervention and context specific but will aim to understand some of the context and complexity around each evaluation case study. We will work with local authority partners to consider what types of evaluation are feasible, what are the barriers to more or better evaluation in terms of skills, data and resources.
Natural experiments will also be defined using data gathered in Component B addressing variation in alcohol intervention exposure, implementation of specific interventions or combinations of interventions at a local level. Both prospective and retrospective natural experiments are envisaged and will draw on time trend data on either alcohol harms or consumption of both.
Finally, discussion documents for local authorities will be produced to provide learning regarding best practice in conducting evaluations of alcohol public health interventions. These will cover what we know about appropriate evaluative methods and what data should be collected at what time points to ensure robust estimates of effectiveness can be produced. If appropriate, recommendations may be made for consistent locally collected but nationally analysable metrics of the alcohol system.
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de Vocht F, Tilling K, Pliakas T, Angus C, Egan M, Brennan A, Campbell R, Hickman M (2017) ‘The intervention effect of local alcohol licensing policies on hospital admission and crime: a natural experiment using a novel Bayesian synthetic time-series method‘ Journal of Epidemiology and Community Health, DOI: http://dx.doi.org/10.1136/jech-2017-208931
Gavens L, Holmes J, Buykx P, de Vocht F, Egan M, Grace D, Lock K, Mooney JD, Brennan A (2017) ‘Processes of local alcohol policy-making in England: Does the theory of policy transfer provide useful insights into public health decision-making‘, Health & Place, DOI: https://doi.org/10.1016/j.healthplace.2017.05.016
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Beard E, Brown J, West R, Angus C, Brennan A, Holmes J, Kaner E, Meier P and Michie S. (2016) ‘Deconstructing the alcohol harm paradox: A population based survey of adults in England‘, PLOS One, 11 (9), e0160666. (Open Access)
de Vocht F, Brown J, Beard E, Angus C, Brennan A, Michie S, Campbell R and Hickman M. (2016) ‘Temporal patterns of alcohol consumption and attempts to reduce alcohol intake in England‘, BMC Public Health, 16 (917), pp.1-10 (Open Access)
de Vocht F, Heron J, Egan M, Mooney JD, Angus C, Brennan A, Hickman M. (2016) ‘Testing the impact of alcohol licensing policies on reported crime rates in England‘, Journal of Epidemiology and Community Health, DOI: 10.1136/jech-2016-207753. (Open Access)
Brown J, West R, Beard E, Brennan A, Drummond C, Gillespie D, Hickman M, Holmes J, Kaner E, Michie S. (2016) ‘Are recent attempts to quit smoking associated with reduced drinking in England‘, BMC Public Health, 16 (535), pp.1-7
Lewer D, Meier P, Beard E, Boniface S, Kaner E. (2016) ‘Unravelling the alcohol harm paradox: A population-based study of social gradients across very heavy drinking thresholds‘, BMC Public Health, DOI:10.1186/s12889-016-3265-9. (Open Access)
Egan M, Brennan A, Buykx P, de Vocht F, Gavens L, Grace D, Halliday E, Hickman M, Holt V, Mooney JD, Lock K (2016) ‘Local policies to tackle a national problem: Comparative qualitative case studies of an English local authority alcohol availability intervention‘, Health & Place, 41, pp.11-8
Brown J, West R, Angus C, Beard E, Brennan A, Drummond C, Hickman M, Holmes J, Kaner E and Michie S. (2016) ‘Comparison of brief interventions in primary care on smoking and excessive alcohol consumption: a population survey in England‘, British Journal of General Practice. 66(642):e1-9. (Open Access)
de Vocht, F., Campbell, R., Brennan, A., Mooney, J., Angus, C. and Hickman, M. (2015) ‘Propensity score matching for selection of local areas as controls for evaluation of effects of alcohol policies in case series and quasi case-control designs‘, Public Health, DOI: http://dx.doi.org/10.1016/j.puhe.2015.10.033. (Open Access)
de Vocht, F., Heron, J., Angus, C., Brennan, A., Mooney, A., Lock, K., Campbell, R. and Hickman, M. (2015) ‘Measurable effects of local alcohol licensing policies on population health in England‘, Journal of Epidemiology and Community Health, DOI: 10.1136/JECH-2015-206040
Beard, E., Brown, J., West, R., Acton, C., Brennan, A., Drummond, C., Hickman, M., Holmes, J., Kaner, E., Lock, K., Walmsley, M. and Michie, S. (2015) ‘Protocol for a national monthly survey of alcohol use in England with 6-month follow-up: ‘The Alcohol Toolkit Study’‘, BMC Public Health, 15 (230) doi:10.1186/s12889-015-1542-7 (Open access)