Abstract
The North Coast Operation Drinksafe was based on the premise that elements from brief intervention programmes in primary healthcare settings could be applied to the general population in more naturalistic environments such as hotels and clubs. These settings were selected because they are associated with alcohol-related problems such as drink-driving offences, road accidents, violence and street crime (Ireland & Thommeny, 1993; Stockwell, Lang & Rydon, 1993; Wood et al., 1995).
To identify and intervene opportunistically with people in naturalistic environments such as bars and taverns. The program utilized the Alcohol Use Disorders Identification Test (AUDIT) and a blood alcohol concentration (BAC) reading to provide a personalized risk assessment to patrons. The aim was to investigate the impact of a brief intervention strategy on drinking behaviour and, more specifically, to determine which types of drinkers benefited in terms of reductions in AUDIT scores, consumption and binge drinking.
The programme utilized brief intervention strategies to provide an assessment, as well as information, advice or referral to drinkers about their alcohol consumption.
The median AUDIT score was 11.0, with 53% scoring in the hazardous range and 25% in the harmful range. For binge drinking, almost two-thirds (62%) of males drank six or more drinks once a week or more compared to 29% of females. Median BAC was 0.03 mg/100 ml with 11% of males above 0.10. Regression analysis revealed that significant predictors of alcohol-related injury were being aged less than 30 years, forgetting the previous night, having had another person express concern about your drinking, and binge drinking weekly or more.
The program had high acceptance among licensees and their patrons. Patrons who are ready to change their at-risk drinking behaviour may benefit from this type of minimal intervention when presented in an interesting way in their drinking environments.
Intervention details
Patrons of bars and taverns
A project team consisting of a uniformed Police Officer and a Health Educator set up an information stand in bars and taverns. Patrons completed a specially designed 20-item questionnaire that included the 10-item AUDIT and then underwent BAC testing on a Drager Alcotest 7110 breath analysis instrument. Individuals were then provided with a personalized risk assessment based on their AUDIT score and BAC reading by the Police Officer and Health Educator. Information was available in the form of a specially designed leaflet explaining 'what your score means?', as well as alcohol leaflets, pamphlets, self-help books, easy tips for cutting down and other materials. Referral to alcohol and other drug services was provided to people who had alcohol problems.
Two major reviews (Bien et al., 1993; Effective Health Care Team, 1993) concluded that brief interventions in clinical settings were effective in reducing risky alcohol consumption. A large-scale WHO multi-centre trial found that one in five persons exposed to a brief intervention respond favourably (Babor et al., 1994; WHO Brief Intervention Study Group, 1996).
Evaluation details
5412 patrons participated in the intervention of which a sample of 2302 (70%) was randomly selected for a 12-month follow-up. After a brief introduction, each respondent was reminded that they had taken part in the initial survey and had agreed to be followed up. They were provided with definitions of standard drinks. They were then asked the same 10 AUDIT questions they had answered at baseline plus some additional questions regarding changes they may have made to their drinking behaviour since or because of their involvement in Operation Drinksafe.
The follow-up sample consisted of 1211 or 53% of the survey sample of 2302. At baseline, 74% of respondents returned AUDIT scores which indicated that they were drinking at hazardous or harmful levels, and males were more likely to be in this range than females (80% compared to 57%). All analysis groups, except for those participants who had low-risk AUDIT scores at baseline, returned decreases in their mean AUDIT score from pre to post and these decreases were all significant. The mean change represented a 15% reduction from the baseline values and the greatest reduction was for those who initially had 'harmful' scores. Changes in reported weekly consumption show a similar trend in that most groups reduced their intake and again most decreases were significant (harmful drinkers again reduced most). Frequency of binge drinking among the whole cohort decreased by a significant 19% (12 binges per person per year). Again, the greatest absolute reduction was among harmful drinkers).
Van Beurden, E., Reilly, D. Dight, R., Mitchell, E. & Beard, J. (2000). Alcohol brief intervention in bars and taverns: a 12-month follow-up study of Operation Drinksafe in Australia. Health Promotion International, 15(4), 293-302.
An abstract for this journal article can be found in the HNT literature section here.
Reilly, D., Van Beurden, E., Dight, R., Mitchell, E., Scott, C. & Beard, J. (1998). Alcohol education in licensed premises using brief intervention strategies. Addiction, 93, 385-398.
