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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Study protocol

Communities in charge of alcohol (CICA): a protocol for a stepped-wedge randomised control trial of an alcohol health champions programme

Authors: Penny A. Cook, Suzy C. Hargreaves, Elizabeth J. Burns, Frank de Vocht, Steve Parrott, Margaret Coffey, Suzanne Audrey, Cathy Ure, Paul Duffy, David Ottiwell, Kiran Kenth, Susan Hare, Kate Ardern

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

Communities In Charge of Alcohol (CICA) takes an Asset Based Community Development (ABCD) approach to reducing alcohol harm. Through a cascade training model, supported by a designated local co-ordinator, local volunteers are trained to become accredited ‘Alcohol Health Champions’ to provide brief opportunistic advice at an individual level and mobilise action on alcohol availability at a community level. The CICA programme is the first time that a devolved UK region has attempted to coordinate an approach to building health champion capacity, presenting an opportunity to investigate its implementation and impact at scale. This paper describes the protocol for a stepped wedge randomised controlled trial of an Alcohol Health Champions programme in Greater Manchester which aims to strengthen the evidence base of ABCD approaches for health improvement and reducing alcohol-related harm.

Methods

A natural experiment that will examine the effect of CICA on area level alcohol-related hospital admissions, Accident and Emergency attendances, ambulance call outs, street-level crime and anti-social behaviour data. Using a stepped wedged randomised design (whereby the intervention is rolled out sequentially in a randomly assigned order), potential changes in health and criminal justice primary outcomes are analysed using mixed-effects log-rate models, differences-in-differences models and Bayesian structured time series models. An economic evaluation identifies the set-up and running costs of CICA using HM Treasury approved standardised methods and resolves cost-consequences by sector. A process evaluation explores the context, implementation and response to the intervention. Qualitative analyses utilise the Framework method to identify underlying themes.

Discussion

We will investigate: whether training lay people to offer brief advice and take action on licensing decisions has an impact on alcohol-related harm in local areas; the cost-consequences for health and criminal justice sectors, and; mechanisms that influence intervention outcomes. As well as providing evidence for the effectiveness of this intervention to reduce the harm from alcohol, this evaluation will contribute to broader understanding of asset based approaches to improve public health.

Trial registration

ISRCTN 81942890, date of registration 12/09/2017.
Footnotes
1
Lower super output area (LSOA) is a unit of measurement generated for small area statistics; they are consistent in size of population, reflect the characteristics of census data where possible and are stable boundaries https://​www.​ons.​gov.​uk/​methodology/​geography/​ukgeographies/​censusgeography#output-area-oa, accessed November 2017. http://​www.​datadictionary.​nhs.​uk/​data_​dictionary/​nhs_​business_​definitions/​l/​lower_​layer_​super_​output_​area_​de.​asp?​shownav=​1, accessed November 2017.
 
2
Crime data relates to those events where a crime (in law) has occurred, and where this is included within the Home Office Counting Rules for Recorded Crime (i.e. a ‘notifiable’ crime as defined within the National Crime Recording Standard), Home Office (2017) Counting Rules for Recorded Crime, https://www.gov.uk/government/publications/counting-rules-for-recorded-crime, accessed January 2018.
 
3
Anti-social behaviour data relates to those events reported to the police where a crime has not occurred, but where the police receive a call for service and the recorded incident is classified by the call handler as involving anti-social behaviour, in accordance with national guidance, Home Office (2011) National Standard for Incident Recording (NSIR), https://www.gov.uk/government/publications/the-national-standard-for-incident-recording-nsir-counting-rules, accessed January 2018
 
4
The narrow indicator of alcohol-related hospital admissions measures the number of individuals admitted to hospital due to a primary diagnosis with an alcohol-attributable code or any secondary diagnosis with an external alcohol-attributable code, Public Health England (2015) Local Alcohol Profiles for England user guide 2015, http://​webarchive.​nationalarchives​.​gov.​uk/​20171107173500/​http://​www.​lape.​org.​uk/​downloads/​LAPE%20​User%20​Guide_​Final.​pdf, accessed December 2017
 
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Metadata
Title
Communities in charge of alcohol (CICA): a protocol for a stepped-wedge randomised control trial of an alcohol health champions programme
Authors
Penny A. Cook
Suzy C. Hargreaves
Elizabeth J. Burns
Frank de Vocht
Steve Parrott
Margaret Coffey
Suzanne Audrey
Cathy Ure
Paul Duffy
David Ottiwell
Kiran Kenth
Susan Hare
Kate Ardern
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5410-0

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