Drink-driving in community sports clubs: adopting the Good Sports alcohol management program

Effects of a multi-component alcohol prevention intervention at sporting events: a quasi-experimental control group study

BACKGROUND AND AIMS

Alcohol intoxication among spectators and related problems are common at sporting events. This study estimated the impact a multi-component community-based alcohol prevention intervention, implemented at Swedish Premier Football (soccer) League matches, had on intoxication levels among spectators and refusal rates of alcohol service to, and arena entry of, obviously intoxicated spectators.

DESIGN

A quasi-experimental controlled study using a repeated cross-sectional design.

SETTING AND PARTICIPANTS

Spectators and sport arenas in Stockholm and Gothenburg, Sweden.

INTERVENTION AND COMPARATOR

The intervention was implemented in Stockholm and consisted of community mobilisation and collaboration, training of staff and improved enforcement and policy work. Gothenburg was the comparison area and received usual care.

MEASUREMENTS

Primary outcomes were spectators' mean breath alcohol concentration (BrAC), proportion of spectators with high intoxication levels, (defined as BrAC ≥0.1%), overserving at licensed premises inside arenas and refused arena entry of obviously intoxicated spectators. Baseline data were collected during 2015 and follow-up during 2016 and 2017.

FINDINGS

BrAC assessments (n = 10 188), arena entry attempts (n = 201) and alcohol purchase attempts at premises inside arenas (n = 495) were collected. There was evidence that the refusal rates of alcohol purchase at premises inside arenas improved differently between study areas and over time (adjusted odds ratio [aOR] = 0.28, 95% CI = 0.07, 1.06, P = 0.060, Bayes factor [BF] = 8.60). In both study areas, the arena entry refusal rates improved over time (aOR = 5.87, 95% CI = 1.16, 29.83, P = 0.033, BF = 17.7), but evidence that the rates improved differently between study areas and over time was equivocal (aOR = 0.57, 95% CI = 0.09, 3.56, P = 0.543, BF = 1.2). Mean BrAC levels decreased over time in both study areas (β = -0.032, 95% CI = -0.050, -0.015, P < 0.001), and differently (β = 0.104, 95% CI = 0.061, 0.146, P < 0.001), but evidence for an interaction effect was equivocal (β = -0.002, 95% CI = -0.022, 0.018, P = 0.868, BF = 1.0). Evidence was equivocal regarding whether the proportion of spectators with high intoxication levels decreased differently between study areas and over time (aOR = 1.17, 95% CI = 0.91, 1.50, P = 0.220, BF = 2.2).

CONCLUSIONS

A multi-component community-based alcohol prevention intervention at sporting events may have increased staff intervention toward obviously intoxicated spectators. It was not clear whether this translated into a reduction in intoxication, which can be explained by improvements in the comparison area.

Relationships Between Sport Participation, Problem Alcohol Use, and Violence: A Longitudinal Study of Young Adults in Australia

There is a growing body of evidence suggesting a link between sport participation and violent behavior outside of the sporting context. However, there have been few studies that have investigated the basis of this relationship. The current study examined longitudinal relationships between sport participation, problem alcohol use, and various violent behaviors, and whether sport participation moderates relationships between problem alcohol use and violence. The sample comprised 2,262 young adults (55% female, age range at Time 1 = 17-24 years) from Victoria, Australia, surveyed in 2010 and 2012. When controlling for common risk factors, substance use, and past violence, sport participation was not associated with any violent behaviors 2 years later. However, sport participation moderated the relationship between problem alcohol use and fighting, whereby problem alcohol use was associated with engaging in fights 2 years later for sport participants, but not for nonparticipants. These findings suggest that it is not sport participation per se that influences later violence but the drinking norms or culture embedded within certain sporting contexts. Prevention approaches that address the drinking culture and social approval of excessive alcohol consumption within sporting contexts may reduce the incidence of violent behavior in the community.

Interventions in sports settings to reduce risky alcohol consumption and alcohol-related harm: a systematic review

BACKGROUND

Elevated levels of risky alcohol consumption and alcohol-related harm have been reported for sportspeople and supporters compared to non-sporting populations. Limited systematic reviews have been conducted to assess the effect of interventions targeting such behaviours.

METHODS

A review was undertaken to determine if interventions implemented in sports settings decreased alcohol consumption and related harms. Studies were included that implemented interventions within sports settings; measured alcohol consumption or alcohol-related injury or violence and were either randomised controlled trials, staggered enrollment trials, stepped-wedged trials, quasi-randomised trials, quasi-experimental trials or natural experiments. Studies without a parallel comparison group were excluded. Studies from both published and grey literature were included. Two authors independently screened potential studies against the eligibility criteria, and two authors independently extracted data from included studies and assessed risk of bias. The results of included studies were synthesised narratively.

RESULTS

The title and abstract of 6382 papers and the full text of 45 of these papers were screened for eligibility. Three studies met the inclusion criteria for the review. One of the included studies was a randomised controlled trial (RCT) of a cognitive-behavioural intervention with athletes within an Olympic training facility in the USA. The study reported a significant change in alcohol use between pre-test and follow-up between intervention and control groups. The other two studies were RCTs in community sports clubs in Ireland and Australia. The Australian study found a significant intervention effect for both risky alcohol consumption at sports clubs and overall risk of alcohol-related harm. The Irish study found no significant intervention effect.

CONCLUSIONS

A limited number of studies have been conducted to assess the effect of interventions implemented in sports settings on alcohol consumption and related harms. While two of the three studies found significant intervention effects, it is difficult to determine the extent to which such effects are generalisable. Further controlled trials are required in this setting.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42014001739.

The impact of a hypothetical designated driver program on intended alcohol-related behavior: an RCT

This study was aimed to assess, using vignettes, the impact of a hypothetical 'designated driver' (DD) initiative on level of intended alcohol consumption. A secondary aim was to assess whether using any form of transport where someone else drove was associated with level of intended consumption. A total of 390 individual sports club members from 72 clubs in New South Wales, Australia, completed a telephone survey. Individuals were randomized into one of two groups: one receiving a hypothetical vignette where the sports club members drank in a setting that provided a DD program; and the other receiving a vignette where the setting in which sports club members drank did not have a DD program. Individuals in both groups were asked to estimate the amount of alcohol they would be likely to consume and the time over which they would consume alcohol, and to indicate the likely means of traveling home afterwards. No difference in the amount of alcohol intended to be consumed between those in the DD and the non-DD group was identified. However, secondary analysis identified that, after controlling for group allocation, greater alcohol consumption was reported by individuals who used transport that relied on someone else to drive them home. DD programs implemented in community sports clubs may not affect intended alcohol consumption by club members. However, using someone else to drive home was associated with greater alcohol consumption. To mitigate against this risk, licensed premises that implement safe transport strategies should consider the use of additional strategies to moderate alcohol consumption that may be inadvertently encouraged.

TRIAL REGISTRATION

(Australian Clinical Trials Registry) ACTRN12611000831987.

Alcohol consumption and sport: a cross-sectional study of alcohol management practices associated with at-risk alcohol consumption at community football clubs

BACKGROUND

Excessive alcohol consumption is responsible for considerable harm from chronic disease and injury. Within most developed countries, members of sporting clubs participate in at-risk alcohol consumption at levels above that of communities generally. There has been limited research investigating the predictors of at-risk alcohol consumption in sporting settings, particularly at the non-elite level. The purpose of this study was to examine the association between the alcohol management practices and characteristics of community football clubs and at-risk alcohol consumption by club members.

METHODS

A cross sectional survey of community football club management representatives and members was conducted. Logistic regression analysis (adjusting for clustering by club) was used to determine the association between the alcohol management practices (including alcohol management policy, alcohol-related sponsorship, availability of low- and non-alcoholic drinks, and alcohol-related promotions, awards and prizes) and characteristics (football code, size and location) of sporting clubs and at-risk alcohol consumption by club members.

RESULTS

Members of clubs that served alcohol to intoxicated people [OR: 2.23 (95% CI: 1.26-3.93)], conducted 'happy hour' promotions [OR: 2.84 (95% CI: 1.84-4.38)] or provided alcohol-only awards and prizes [OR: 1.80 (95% CI: 1.16-2.80)] were at significantly greater odds of consuming alcohol at risky levels than members of clubs that did not have such alcohol management practices. At-risk alcohol consumption was also more likely among members of clubs with less than 150 players compared with larger clubs [OR:1.45 (95% CI: 1.02-2.05)] and amongst members of particular football codes.

CONCLUSIONS

The findings of this study suggest a need and opportunity for the implementation of alcohol harm reduction strategies targeting specific alcohol management practices at community football clubs.