This project is to monitor changes in alcohol pricing and marketing before and after the implementation of Minimum Unit Pricing for alcohol in 2018. Our study will comprise purchase and analysis of price data from small retailer EPOS (electronic point of sale) systems, observations in stores and interviews with retailers. Our methodology builds on previous studies we have conducted for this and other funders to evaluate the implementation and impact of public health policies to regulate the retail environment.
ISM Staff: Martine Stead, Douglas Eadie, Anne Marie MacKintosh, Nathan Critchlow, Niamh Fitzgerald, Jennifer McKell, Richard Purves, Kathryn Angus
In December 2014, the ‘drink-drive limit’ was reduced in Scotland from 80mg to 50mg of alcohol in 100ml of blood. Evidence suggests this will reduce road traffic accidents (RTAs) and resultant deaths, at least initially. It could also affect overall levels of drinking and related harms, which are rising in Scotland at least in part due to increased home drinking.
The aim of the study is to explore changes in drinking perceptions, behaviours (including driving), contexts and practices, following the reduction in the drink-drive limit in Scotland, including whether, how and why initial effects were sustained (or not), and implications for overall consumption levels.
ISM will conduct group interviews with the general public and individual interviews with pub/bar owners/managers. Our findings will enable better understanding of how the change may have impacted on overall drinking levels, drinking patterns and related harms in Scotland, and will therefore inform future policies to reduce alcohol-related harm.
ISM Staff: Niamh Fitzgerald and Jennifer McKell
External: Carol Emslie, Glasgow Caledonian University and James Lewsey, University of Glasgow
EXILENS: A Mixed-method, Natural Experiment Evaluation of Public Health Engagement in Alcohol Premises Licensing and Impact on Alcohol-related Harms (2017 - 2020)
(Funded by the National Insitute for Health Research)
In Scotland and England, local councils have power over alcohol licensing – that is the system by which certain premises are allowed to sell alcohol. In recent years, professionals who work on ways to improve health across the population (‘Public Health Teams’ or ‘PHT’s) have been trying to influence this licensing system. They do this by getting involved in licensing processes and encouraging licensing authorities and licence-holders to act in ways they hope will ultimately improve the health of the local population.
The aim of the study is to find out what PHTs have been doing and whether their actions have had any impact on these alcohol-related harms.
ISM Staff: Niamh Fitzgerald, Richard Purves, Nathan Critchlow and Linda Bauld
External: Universities of Bristol, Sheffield, Edinburgh, London School of Hygiene and Tropical Medicine, Alcohol Focus Scotland and Alcohol Research UK
Obsteric Research Study - Linking Self Report and Biomarkers of Alcohol Consumption in Early Pregnancy in Glasgow to Pregnancy and Child Health Outcomes: The Obstetric Research Study - Phase 1 (2017 - 2018)
(Funded by NHS Greater Glasgow and Clyde)
This study is led by Professor David Tappin of the University of Glasgow.
Alcohol use during pregnancy is the commonest reason for significant development delay in childhood. Currently there is no way to accurately determine the prevalence of significant alcohol use in the pregnant population. This study aims to provide a baseline distribution of chronic alcohol use during pregnancy in Glasgow and Clyde, measured by elevated levels of two alcohol biomarkers.
ISM Staff: Niamh Fitzgerald and Lesley Sinclair
External: Led by David Tappin, University of Glasgow
Evidence suggests that references to alcohol occur frequently in the broadcasts of international football tournaments, such as the 2014 World Cup and the EURO 2012 Championships. This study reviewed the frequency of visual and verbal alcohol-references in EURO 2016 matches broadcast in the UK, Republic of Ireland and France. By including broadcasts from three countries the study considered whether the tighter restrictions on marketing in France, known as the Loi Evin, are successful in limiting the amount of alcohol references audiences in France are exposed to, compared to the self-regulatory approach in the UK.
ISM Staff: Richard Purves, Martine Stead and Nathan Critchlow
External: Jean Adams, University of Cambridge; Karine Gallopel-Morvan, School of Public Health, France; Patrick Kenny, Dublin Institute of Technology
Purves RI, Critchlow N, Stead M, Adams J and Brown K (2017). Alcohol marketing during the UEFA EURO 2016 football tournament: A frequency analysis. International Journal of Environmental Research and Public Health, 14(7): 704. doi:10.3390/ijerph14070704
Obesity and Alcohol Use: Is There a Role for Dually Focused Intervention in Young Adults (18-25) to Tackle Unhealthy Eating and Drinking and Effectively Reduce Future Health Inequalities (2016 - 2018)
(Funded by the Public Health Research Consortium, Department of Health)
Levels of obesity have risen steadily over the past two decades. Thirty-three percent of regular drinkers in the UK are at risk of related health and other problems.
Alcohol use peaks in early adulthood and can exacerbate weight gain. Liver disease is the third most common cause of premature death in the UK and it is increasingly seen in 15-44 year olds. A high body mass index and heavy drinking are independently associated with liver disease but, in combination, they produce a supra-additive risk of damage. Thus we need to develop interventions focused on both behaviours, especially as they can become closely inter-linked in people’s day-to-day lives.
The aim of the study was to explore the links between unhealthy eating behaviour and risky alcohol use in the social, emotional and cultural lives of young adults (aged 18-25), including perceptions of risks, benefits, costs and consequences of these behaviours in early adulthood, and to work with young adults to co-design a dually focused intervention to help reduce health risk and social inequalities due to excess weight gain and alcohol consumption.
To do this the team carried out: a systematic review, secondary quantitative data analysis of national datasets, in-depth qualitative interviews, and workshops.
ISM Staff: Martine Stead and Niamh Fitzgerald
External: Ashley Adamson (lead), Eileen Kaner, Stephanie Scott and Wendy Wrieden, Newcastle University; and, Chris Power, University College London
This project will support the Cancer Research UK Policy Research Centre for Cancer Prevention (PRCP) in the development of two new national youth surveys, one on alcohol and the other obesity. Institute for Social Marketing (ISM) staff will provide insight and training to the PRCP team in how such studies are carried out, and will also provide research support, advice, and collaboration on publications. Data from the surveys will be used to monitor patterns of youth consumption and perceptions of alcohol and obesity and the impact marketing has on these.
ISM Staff: Martine Stead, Douglas Eadie, Anne Marie MacKintosh, Jennifer McKell and Linda Bauld
The study will conduct a systematic review of self-report measures for alcohol consumption in pregnancy.
ISM Staff: Niamh Fitzgerald and Kathryn Angus
Levels of alcohol consumption amongst teenagers remain high. A key reason for this is the ineffective regulation of the industry’s marketing, with rules focusing on media and advertising content that are not working.
This pilot study had two principal objectives:
To do this, focus groups were carried out with young people, a rapid scoping review was undertaken and depth interviews were conducted with legal experts.
ISM Staff: Douglas Eadie and Richard Purves
External: Alan Tapp, University of the West of England and Gerard Hastings
This report by Niamh Fitzgerald and Colin Angus investigates the extent to which alcohol policies and programmes across the UK are based on evidence.
The divergence of alcohol policy in the four nations of the UK since devolution has allowed us to compare and contrast how evidence is used in alcohol policy and the extent to which current policies across the UK are supported by scientific evidence. In this new report, we discovered substantial differences between the 4 nations in the way that alcohol problems are framed and policies implemented. These differences appear to reflect the level of activity within each country, with alcohol framed as a minority issue affecting only a small group of dependent drinkers at the UK level, while the more active devolved administrations tend to view or portray alcohol problems as a whole population issue.
ISM Staff: Niamh Fitzgerald
External: Colin Angus, University of Sheffield
Fitzgerald N and Angus C (2015). Four Nations – How Evidence-Based are Alcohol Policies & Programmes across the UK? Alliance for Useful Evidence. Report
This study assessed the availability and usefulness of data relating to remuneration and delivery rates for alcohol brief interventions in Scotland, to facilitate a rapid review of such data, inform future remuneration systems, and further study.
ISM Staff: Niamh Fitzgerald and Lisa Scholin (left 2016)
Early diagnosis of Foetal Alcohol Syndrome [FAS], a condition resulting from heavy antenatal alcohol consumption, is difficult. This, together with difficulties detecting alcohol use during pregnancy, poses challenges for the evaluation of interventions aimed at reducing antenatal alcohol consumption. The pilot study aimed to determine if a two-stage assay system, measuring Carbohydrate-Deficient Transferrin (CDT) and Ethyl Glucuronide (EtG), could distinguish hazardous alcohol consumption from moderate or no antenatal drinking.
This assay system was then used to determine the baseline prevalence of significant alcohol consumption in the pregnant population by anonymous testing. One hundred and fifty serum samples from women living in the most deprived regions of Glasgow were assayed for the pilot. A further 8000 samples were assayed for the main study.
The aim was to measure the prevalence of significant alcohol consumption in the first trimester of pregnancy in the NHS Greater Glasgow and Clyde Health Board area. By measuring a baseline prevalence, interventions could be developed and assessed to reduce alcohol consumption in women of childbearing age.
ISM supported the development and set-up of sample and data collection and analysis protocols and pathways, analysed data and assisted with write up.
ISM Staff: Linda Bauld, Lesley Sinclair and Niamh Fitzgerald
External: Led by David Tappin, University of Glasgow, Helen Mactier, Roy Sherwood, Janet Brennand
Cancer Research UK funding has been secured to develop a project that will focus on analysing and monitoring the public statements of key politicians in relation alcohol policy and alcohol-related harm including cancer risk. Such monitoring is an important part of advocacy work, but there is currently no reliable or consensus-based analysis method. The UPPP project seeks to assess the feasibility and value of a bespoke ‘positional analysis’ tool for analysing and monitoring politicians’ understanding of alcohol-related cancer-risks, alcohol problems, and policy positions relating to alcohol. The project will be conducted by a team led by Dr Niamh Fitzgerald at the Institute for Social Marketing, with involvement from the Alcohol Health Alliance, University of Sheffield, University of the West of England and the University of Newcastle.
ISM Staff: Niamh Fitzgerald
Research indicates that patients who are drinking alcohol at a risky or harmful level can reduce their drinking if health professionals identify their consumption and engage them in short, structured conversations about it (brief interventions – ‘BI’s). The provision of adequate training for health professionals is considered one important factor in enabling routine delivery of BIs. In research trials, the nature of such training has varied widely.
This project will:
The outcomes of this work will inform current practice in delivering BI training, and will lay the foundation for future research exploring how training can support BI delivery and effectiveness.
ISM Staff: Niamh Fitzgerald and Kathryn Angus
In Scotland, the number of premises licensed to sell alcohol is controlled through a system of local licensing boards. Legislative changes in recent years have given such boards an objective of ‘protecting and improving public health’. Research has suggested that the controlling the number of licensed premises and therefore the availability of alcohol can reduce alcohol-related harm. This study involves qualitative interviews with individuals across Scotland working mainly in public health or in alcohol and drug partnerships who have worked on licensing issues in recent years. The study aims to identify how these individuals and their organisations have attempted to influence local licensing policies and decisions in Scotland, and in their experience, what factors are important in helping and/or hindering those efforts.
ISM Staff: Niamh Fitzgerald
Fitzgerald N (2015). Influencing the Implementation of a Public Health Objective in Scottish Alcohol Licensing: A Qualitative Interview Study – Summary Report. Stirling: University of Stirling, Institute for Social Marketing. Report
There is good evidence to suggest that a range of population-based interventions such as pricing, control of marketing, and reduction in availability of alcohol can reduce alcohol-related harm. This study will analyse published literature reviews of such interventions to determine the extent to which they report participation by women and any specific effects on women in the original studies underpinning this evidence. The results of the study will inform policy decisions as well as providing a basis for more detailed work considering how these kinds of interventions may have a differential effect by gender.
ISM Staff: Niamh Fitzgerald, Linda Bauld, Kathryn Angus and Martine Stead
The UK Centre for Tobacco and Alcohol Studies is a network of 13 universities (12 in UK, 1 in New Zealand) funded by the UK Clinical Research Collaboration, which builds on the work and success of its predecessor, the UK Centre for Tobacco Control Studies (UKCTCS).
The UKCTAS is now a leading international centre of tobacco and alcohol research and policy excellence with an extensive research programme. We have established a cohort of early career researchers, provide a teaching programme to train and engage the wider research and policy community in tobacco and alcohol research. We facilitate policy development by informing policy makers of the latest scientific research on tobacco and alcohol use, and thus contributing to the nation's public health.
The UKCTAS aims to deliver an international research and policy development portfolio, and build capacity in tobacco and alcohol research. UKCTAS work will include developing strategies for behaviour change in tobacco and alcohol use, assessing risks, identifying measures to reduce harm, monitoring the tobacco and alcohol industries, and developing effective public policies to improve public health and wellbeing.
ISM Staff: Linda Bauld and Gerard Hastings for University of Stirling
Alcohol marketing is a key focus for concern for alcohol and public health researchers because of growing evidence that it is a determinant of uptake and frequency of drinking. To date, research attention has focused on more traditional forms of marketing promotion. However, research needs to keep pace with the fast-changing, multi-platform marketing environment. Two aspects of contemporary alcohol marketing merit particular concern: packaging, and how this relates to online marketing. This research will benefit wider alcohol research and policy by exploring the way in which digital media combines with alcohol labelling and packaging to create a multi-platform marketing environment and to examine to what extent young people interact with this environment.
Research in this new and little understood area needs to use approaches which are reflexive and inductive, and two qualitative methods are proposed - focus groups with young people and netnography of identified social media sites and websites. A total of eight focus groups with 14-17 year-olds (n=48-64) will be used to explore young people’s knowledge, attitudes and behaviour relating to alcohol packaging and labelling. Their levels of awareness and engagement with on-line alcohol marketing through producers’ websites and social media pages, using on-product QR codes, augmented reality packaging and printed web-addresses, will also be explored. The second stage will involve the use of netnography to identify, observe and analyse on-line communications regarding alcohol products on social network pages and websites of certain alcohol brands.
ISM Staff: Richard Purves, Martine Stead and Douglas Eadie
Purves R, Stead M and Eadie D (2014) “What are you meant to do when you see it everywhere?”: Young people, alcohol packaging and digital media. London: Alcohol Research UK; December. http://alcoholresearchuk.org/downloads/finalReports/FinalReport_0120.pdf
The detection of alcohol problems is known to be enhanced by the use of appropriate screening tools, and a considerable body of research evidence now supports the use of Alcohol Brief Interventions (ABIs) in reducing health-related harm due to alcohol consumption. ABIs are time-limited interventions that focus on changing drinking behaviour, and their delivery has become a significant component of the Scottish Government Alcohol Strategy. Although studies have indicated that ABIs can be effective with adults in primary care settings, relatively little is known about their use and value when implemented in settings such as social work and the community, and with young people (under the age of 16).
This study aims to explore the feasibility and acceptability of ABIs delivered to young people and in social work settings through two phases of research; the first mapping and scoping current projects across Scotland, and the second examining delivery in a series of case study projects, and developing proposals for a potential future outcome evaluation. A mixed methods approach is being used involving interviews with project staff and stakeholders and with users of the projects; field visits and observation; and analysis of project documentation and data.
The study is a collaborative project between ISM, Nursing, Midwifery and Health, and the Faculty of Social Sciences.
ISM Staff: Martine Stead, Douglas Eadie and Jennifer McKell, ISM; Dr Tessa Parkes and Avril Nicoll, NWH; Dr Sarah Wilson and Cheryl Burgess, SASS
Stead S, Parkes T, Nicoll A, Wilson S, Burgess C, Eadie D, Fitzgerald N, McKell J, Reid G, Jepson R, McAteer J and Bauld L (2017). Delivery of alcohol brief interventions in community-based youth work settings: exploring feasibility and acceptability in a qualitative study. BMC Public Health, 17: 357. doi: 10.1186/s12889-017-4256-1
Parkes T, Stead M, Eadie D, Nicoll A, McKell J, Bauld L, Wilson S, Burgess C, Reid G, McAteer J and Jepson R (2013). Alcohol brief interventions in youth and social work settings in Scotland. Addiction Science & Clinical Practice, 8(Suppl 1): A52.
NHS Health Scotland Media release: http://www.healthscotland.com/news/news-item/250.aspx
The Alcohol Policy Interventions in Scotland and England study (APISE) is part of a multi-country collaborative project to assess the impact and effectiveness of alcohol control policies. The study design is modelled on the International Tobacco Control study. Longitudinal surveys of drinkers in participating countries together with the analysis of the policy context allows for assessment of change over time within countries and comparison between countries. Funding has been secured from the National Prevention Research Initiative (NPRI) to enable collection of baseline data in Scotland and England and a follow-up 12 months later. Three linked stages of research include an audit of alcohol control strategies in each country, exploratory research with adult drinkers and a longitudinal survey.
The baseline survey, planned for late 2012, will recruit a cohort of 2000 adult drinkers in England and 2000 in Scotland. The cohort will be followed up 12 months later. The survey will be conducted using Computer Assisted Telephone Interviews (CATI) and will collect comprehensive consumption data, using a framework that is beverage and location specific to facilitate identification of impacts of policy change. Policy related measures are measures that are closely linked to a specific policy and therefore expected to be directly affected by the introduction of a particular policy. A range of policy-related measures will be included in the study including for example affordability, which would be a key measure following the introduction of Minimum Unit Pricing (MUP). APISE will provide a comparison between Scotland and England where there is the potential for different alcohol policies to be introduced. APISE will also have an international dimension through collaboration with colleagues in New Zealand, Australia, USA, Thailand and South Korea who are planning analogous studies in their countries.
The study is being led by researchers at the University of Stirling and is being conducted in collaboration with the University of Sheffield, The Open University and the University of Wollongong.
ISM Staff: Gerard Hastings, Anne Marie MacKintosh and Douglas Eadie
Li J, Lovatt M, Eadie D, Dobbie F, Meier P, Holmes J, Hastings G and MacKintosh AM (2017) Public attitudes towards alcohol control policies in Scotland and England: Results from a mixed-methods study. Social Science and Medicine, 177: 177-189. http://dx.doi.org/10.1016/j.socscimed.2017.01.037
Research to Develop and Apply a Methodology for Retrospective Adjustment of Alcohol Consumption Trend Data (2012-2013)
(Commissioned by the Department of Health, through the Public Health Research Consortium)
Changes over the past couple of decades in glass size and alcohol strength, particularly the trends towards larger measures and higher alcohol content, have made it difficult to obtain a clear picture of alcohol consumption over time, as the underlying assumptions and understanding regarding a standard drink or serving have not been consistent. In order for alcohol policy to be based on accurate consumption data, there is a need to develop and apply a robust methodology for retrospective adjustment of official trend data on alcohol consumption, to take account of changes in glass size and shape and alcohol strength over time. This scoping and feasibility study was commissioned by the Department of Health through the Public Health Research Consortium. Its objectives were to:
The mapping element of the study was conducted by ISM, while the formulae development was conducted by the National Centre for Social Research (NatCen). The mapping element sought to identify and map key changes in glass size, shape and drink strength (percentage of alcohol by volume) since 1990. Two methods were used, desk-based research involving searches of academic and trade periodicals and commercial market research sources, and interviews with key stakeholders. Overall, the findings indicate that the average strength of beer and wine has increased over the period, such that previous survey data on reported consumption of 'standard drinks' have under-estimated the actual amount of alcohol consumed by a considerable degree. Findings from the mapping informed the formula development strand of the work, which proposes conversion factors to make survey data from different years more comparable.
ISM Staff: Martine Stead, Kathryn Angus and Laura Macdonald
Stead M, Angus K, Macdonald L and Bauld L (2014). Looking into the glass: Glassware as an alcohol marketing tool, and the implications for policy. Alcohol and Alcoholism, online 9th January. doi:10.1093/alcalc/agt178.
Stead M, Bauld L, Angus K, Macdonald L, Munafò M, Attwood A, Ataya A, Fuller E, Pickering K (2013). Scoping and Feasibility Study to Develop and Apply a Methodology for Retrospective Adjustment of Alcohol Consumption Data. Final Report. London: Public Health Research Consortium; October.
ALICE RAP aims to study and analyse the development and place of well-acknowledged and new addictions as a major societal trend in Europe in relation to governance and public policies and responses. The study involves 67 research institutions from 25 European countries covering the humanities, social sciences and biological and medical sciences. Its scientific objectives are:
ISM is contributing specifically to Objectives 1 and 4.
ISM Staff: Martine Stead, Kathryn Angus, Richard Purves, Gerard Hastings, Anne Marie MacKintosh and Crawford Moodie
Stead M, Dobbie F, Angus K, Purves RI, Reith G and Macdonald L (2016). The online bingo boom in the UK: A qualitative examination of its appeal. PLoS ONE, 11(5): e0154763. doi:10.1371/journal.pone.0154763
McLeod J, Gell L, Holmes J, Allamani A, Bjerge B, Bühringer G, Forberger S, Frank V, Lingford-Hughes A, Meier P, Neumann M, Room R, Baumberg B, Eiroa-Orosa FJ, Lees R, Meerkerk G-J, Schmidt L, Stead M, van de Mheen D, and Weirs R (2016). Determinants of risky substance use and risky gambling. Chapter 3 in: Gell L, Bühringer G, McLeod J, Forberger S, Holmes J, Lingford-Hughes A and Meier PS (eds), What Determines Harm from Addictive Substances and Behaviours? Oxford: Oxford University Press, pp35-76. ISBN: 9780198746683. doi:10.1093/acprof:oso/9780198746683.003.0003
Gell L, McLeod J, Holmes J, Allamani A, Baumberg B, Bjerge B, Bühringer G, Eiroa-Orosa J, Forberger S, Frank V, Lingford-Hughes A, Meerkerk G-J, Meier P, Neumann M, Room R, Schmidt L, Stead M, van de Mheen D, Weirs R, and Withington P (2016). Determinants of harmful substance use and gambling. Chapter 4 in: Gell L, Bühringer G, McLeod J, Forberger S, Holmes J, Lingford-Hughes A and Meier PS (eds), What Determines Harm from Addictive Substances and Behaviours? Oxford: Oxford University Press. ISBN: 9780198746683. doi:10.1093/acprof:oso/9780198746683.003.0004
McLeod J, Gell L, Holmes J, Allamani A, Baumberg B, Bjerge B, Bühringer G, Eiroa-Orosa FJ, Forberger S, Frank V, Lingford-Hughes A, Meerkerk GJ, Meier P, Neumann M, Room R, Schmidt L, Stead M, van de Mheen D, Wiers R and Withington P (2016). Determinants of transitions from harmful to low-risk substance use and gambling. Chapter 5 in: Gell L, Bühringer G, McLeod J, Forberger S, Holmes J, Lingford-Hughes A and Meier PS (eds), What Determines Harm from Addictive Substances and Behaviours? Oxford: Oxford University Press. ISBN: 9780198746683. doi:10.1093/acprof:oso/9780198746683.003.0005
Gell L, Bühringer G, Room R, Allamani A, Eiroa-Orosa FJ, Forberger S, Holmes J, Lingford-Hughes A, McLeod J, Meier PS and Stead M (2016). Discussion and Integration of Key Findings. Chapter 6 in: Gell L, Bühringer G, McLeod J, Forberger S, Holmes J, Lingford-Hughes A and Meier PS (eds), What Determines Harm from Addictive Substances and Behaviours? Oxford: Oxford University Press. ISBN: 9780198746683. doi:10.1093/acprof:oso/9780198746683.003.0006
Alcohol and Public Health Strategy (2011-2013)
(Funded by Cancer Research UK, British Liver Trust, UKCTCS, Alcohol Focus Scotland, Nottingham University Hospital, Balance North East, Our Life, Alcohol Research UK and Breakthrough Breast Cancer)
This project involved the development of an alcohol and public health strategy independent from government and the alcohol industry. It was developed by a steering group of experts drawn from a range of sectors, chaired by Sir Ian Gilmore of the Alcohol Health Alliance, and supported by researchers from ISM and other Universities. The strategy was informed by reviews of relevant literature and a public opinion element.
The report 'Health First: An evidence-based alcohol strategy for the UK', was published on 1st March 2013, and sets out key recommendations, and the evidence to underpin them, to reduce the harm from alcohol in the UK. The report was endorsed by more than 70 organisations from across the UK.
ISM Staff: Gerard Hastings, Linda Bauld, Martine Stead, Anne Marie MacKintosh and Richard Purves
An Evaluation to Assess the Implementation of NHS Delivered Alcohol Brief Interventions in Primary Care: Case Study Analysis (2010-2011)
(Funded by NHS Health Scotland and carried out in collaboration with Nursing and Midwifery, University of Stirling, and the School of Business, University of Dundee)
Alcohol Brief Interventions (ABIs) are short evidence-based, structured conversations that focus on changing drinking behaviour. In support of the SIGN Guideline 74 that ABIs should be delivered to harmful and hazardous drinkers in Primary Care settings, A&E Departments and Antenatal Care settings, the Scottish Government established a new health improvement target for NHS health boards (H4: HEAT target - Health Improvement, Efficiency, Access and Treatment) to deliver 149,449 ABIs between April 2008 and March 2011 in these settings.
Commissioned by NHS Health Scotland, this project evaluated the implementation of ABIs in all three priority settings with a specific emphasis on primary care. Focusing on how screening and ABIs have been implemented, practitioners (n=35) and patients (n=25) were interviewed across eight practices and three health boards, representing a mixture of urban and rural, high and low socio-economic areas and high and low ABI recording rates. These data were supplemented by additional interviews with key informants in each case health board (n=21). Considering processes at both the individual and organisational level, and the level of overall adoption and reach, the findings will support improved delivery of ABIs when embedded into the mainstream delivery of the NHS.
Abstract and Report available from the Health Scotland website.
ISM Staff: Douglas Eadie, Susan MacAskill, Stuart Bryce (left 2011) and Oona Brooks (left 2010)
Parkes T, Eadie D, Petrie D et al (2011). An evaluation to assess the implementation of NHS delivered alcohol brief interventions: Study summary. Drugs and Alcohol Findings. Posted 10th Dec 2012.
In analysing the internal marketing documents from both alcoholic beverage producers and their advertising agencies for the Health Select Committee (see below), it was apparent that there has been a rapid growth in the use of new media (ie. digital forms of communication such as the internet, mobile devices, electronic games, blogs and podcasting) to market alcohol in recent years, yet this is an area which presents particular challenges to the current system of self-regulation. This report examines the use of new media to market leading alcohol brands in the UK using a case study approach.
ISM Staff: Oona Brooks (left 2010)
Report: Brooks O (2010). “Routes to Magic” - The Alcoholic Beverage Industry’s Use of New Media in Alcohol Marketing. Stirling: Institute for Social Marketing.
Health Select Committee Alcohol Document Analysis (2009)
(Commissioned by the Health Select Committee and the Alcohol Education and Research Council (AERC))
As part of its 2009 investigation into the conduct of the UK alcohol industry, the House of Commons Health Select Committee obtained access to internal marketing documents from both producers and their advertising agencies. These documents were then analysed by the Institute for Social Marketing.
These revealed major shortcomings in the current self-regulatory codes covering alcohol advertising. Specifically, the codes do not, as they are supposed to, protect young people from alcohol advertising; prevent the promotion of drunkenness and excess; or the linking of alcohol with social and sexual success. Nor do they even attempt to address sponsorship, and the documents show this is being systematically used to undermine rules prohibiting the linking of alcohol with youth culture and sporting prowess. Finally, the codes are extremely weak in their treatment of new media which are rapidly becoming the biggest channel for alcohol promotion. The result is a regulatory system that is impossible to police and vulnerable to exploitation.
ISM Staff: Gerard Hastings, Oona Brooks (left 2010), Kathryn Angus, Martine Stead, Thomas Anker (left) and Tom Farrell (Open University)
Report: Hastings G (2010). Memorandum by Professor Gerard Hastings - "They'll drink bucket loads of the stuff". An analysis of internal alcohol industry documents. Available here
Hastings G, Brooks O, Stead M, Angus K, Anker T and Farrell T (2010). Failure of self-regulation of UK alcohol advertising (Alcohol advertising: The last chance saloon). British Medical Journal, 340: 184-186. Online
Alcohol problems are a major and growing public health problem in Scotland with the relationship between alcohol and crime, in particular, violent crime, increasingly being recognised. This study was part of a wider Scottish Government funded alcohol research programme in criminal justice settings which also includes a pilot of the delivery of alcohol brief interventions and a scoping study of alcohol interventions in community justice settings. It was anticipated that the study findings would inform broader health service development such as the integration of prison health care into the NHS and the update of core alcohol treatment and support services. These developments were set within a policy and practice context which acknowledges alcohol problems in the population and increasingly so the alcohol problem in offenders, along with the importance of applying a person-centred, recovery orientated approach underpinned by the NHS commitment to quality of services.
The aim of this study was to undertake a needs assessment of alcohol problems experienced by prisoners and provide recommendations for service improvement including a model of care. Key elements included:
The study involved both quantitative and qualitative information being gathered through primary data collection and document retrieval and analysis.
The final report was launched at the Alcohol & Offenders Event, Edinburgh, 8th February 2011. Tessa Parkes presentation from this event can be found here. Conference presentations and paper submissions are ongoing.
ISM Staff: Susan MacAskill, Douglas Eadie and Oona Brooks (left 2010)
Collaborators: Tessa Parkes (lead), Ruth Jepson, Iain Atherton, Lawrence Doi and Stephen McGhee, Nursing, Midwifery and Health, University of Stirling
A Review of the Evidence for Effective Alcohol Education for the UK (2009-2010)
(Commissioned by the Alcohol Education and Research Council (AERC))
The Alcohol and Education Research Council, on behalf of Drinkaware, commissioned ISM to conduct a review of reviews of the international evidence base, with special reference to its applicability and relevance to the UK. ISM was asked to recommend and develop proposals for next steps to strengthen the research agenda and evidence base. ISM developed the design and research objectives for a systematic review of most promising approaches for alcohol education-based interventions, and a longitudinal study of a community and/or family + school-based intervention.
AERC Second Stage: A Systematic Investigation of Critical Elements for Optimum Effectiveness of Promising Approaches and Delivery Methods in School and Family Linked Alcohol Education
Building on the findings of the first stage scooping study, this project systematically reviewed the evidence base on interventions intended to reduce or prevent alcohol misuse amongst young people. The review identified and interrogated the evidence base over a ten year period. Thematic analysis, case study and process and impact evidence collation methods were used. Internal and external elements of intervention programmes most frequently associated with positive behavioural outcomes were reported and strategic implications for future development were identified.
ISM Staff: Georgina Cairns, Martine Stead, Kathryn Angus, Richard Purves, Jennifer McKell and Stuart Bryce (left 2011)
Cairns G, Purves R, Bryce S, McKell J, Gordon R and Angus K (2011). Investigating the Effectiveness of Education in Relation to Alcohol: A Systematic Investigation of Critical Elements for Optimum Effectiveness of Promising Approaches and Delivery Methods in School and Family Linked Alcohol Education. Stirling: Institute for Social Marketing. Report online
Reducing the Damaging Effects of Alcohol: A Technical Assistance Project for the European Alcohol and Health Forum (2009-2012)
(Commissioned by the European Commission (DG SANCO))
In many cultures, alcohol is used to facilitate social interactions and is seen to have many other benefits. However, alcohol consumption is also associated with a broad range of health and social problems with risky drinking patterns becoming progressively more embedded in European cultures. In many member states of the EU such as France , Italy and Spain although alcohol consumption is falling there is increasing evidence of binge drinking and associated harms. In some states such as the UK overall consumption has risen by up to 20% in the last 20 years alongside a change in drinking patterns. In Sweden and the UK, drinking at the weekends in binge sessions has become the dominant alcohol consumption trend. These patterns are becoming more common in Spain whereas previously drinking was traditionally spread out over the week and involved smaller quantities per drinking episode.
Combating the damaging effects of alcohol is a public health priority in many of the Member States and at EU level. Notwithstanding the considerable health consequences of excessive alcohol consumption, there are a number of other associated harms including; lost productivity, violence, hooliganism, crime, family problems, social exclusion, problems at work and drink-driving. A review of the total tangible cost of alcohol to EU society conducted in 2003 estimated this to be €125bn (€79bn-€220bn), which is equivalent to 1.3% GDP. The intangible costs caused by indirect criminal, social and health harms caused by alcohol were estimated to be €270bn in the same review, although other reviews s produced estimates between €150bn and €760bn.
Therefore policy initiatives are required to reduce the damaging effect of alcohol in each of these areas. With its Communication of 24 October 2006 (COM (2006) 625 final), the Commission adopted a European Union strategy to help the Member States reduce the damaging effects of alcohol. Consequently, there is a need to better understand, report and evaluate the impact of policy and strategy designed to minimising the harm associated with alcohol.
ISM provides research-led technical assistance to The European Alcohol and Health Forum. The Forum is a multi-stakeholder collaboration convened and managed by the European Union Directorate-General for Health and Consumer Affairs (DG SANCO). The Forum meets regularly to review evidence for the causes and effects of alcohol misuses and to explore opportunities, policy, activities and their effectiveness in reducing alcohol-related social and health harms.
ISM provides scientific reports and briefings on various topics. During the first 18 months of this four-year project, this has included mapping reports on European social marketing interventions to reduce alcohol-related harms, European alcohol prevention and reduction interventions for young people and European self-regulation of alcohol marketing; a review of the European evidence base for effective alcohol education interventions; building a database of good practice for youth-targeted projects to reduce alcohol misuse.
ISM Staff: Georgina Cairns, Kathryn Angus, Ross Gordon (now based at the University of Wollongong), Laura Macdonald, Douglas Eadie and Richard Purves
Learning About Alcohol: Influences of the Family Context (2008-2010)
(Commissioned by the Joseph Rowntree Foundation)
Understanding how drinking habits are learned is central to developing effective means of shifting problematic drinking patterns and cultures. Family settings are increasingly recognised as important initial reference points of individuals' socialisation and exposure to alcohol. Consequently, there is a need to examine the way alcohol is handled in a range of ‘normal' family settings and how this influences children. This study, which is funded by the Joseph Rowntree Foundation, aims to identify influences on how young children aged 7-12 years learn about alcohol and to examine differences by socio-economic status, age, family structure, geographical locality and parental drinking behaviour. The study employs qualitative modes of enquiry, combining two primary data collection methods: focus groups with children and parents to explore of social interaction within the family and beyond, norms and values re. drinking, and response to policy and practice interventions; and family case studies using in-depth interviews with children, parents and significant others to analyse influences within the family network and home context.
Report and summary available from Joseph Rowntree Foundation website
ISM Staff: Douglas Eadie, Susan MacAskill and Oona Brooks (left 2010)