Have Alcohol Health Champions had a measurable impact on health and crime outcomes in Manchester?

Alcohol Health Champions in Greater Manchester seem to have had no measurable impact on health and crime outcomes, according to research published in Addiction. National Institute for Health and Care Research (NIHR) funded researchers from the Universities of Bristol, Salford and York, looked at data before and during the roll out of the Communities in Charge of Alcohol (CICA) intervention.

Alcohol Health Champions are members of the local community trained on a two-day course that incorporated the Royal Society for Public Health ‘Understanding alcohol misuse’ course, alongside training on alcohol licensing policy and how to deliver the course to others. The programme began in 2017 and was rolled out in several locations in Greater Manchester over the following years.

The Champions aimed to:

• Deliver brief alcohol advice to individuals in their communities
• Help communities influence alcohol availability and strengthen restrictions in alcohol risk environments

The research team treated the roll out of the Alcohol Health Champions from 2017-2020 as a ‘natural experiment’. Because the roll out happened at different rates in different places, comparisons could be made across locations over time, as well as with other areas where the programme was not implemented. The researchers also used different analytical techniques to measure health and crime outcomes. Combining analysis techniques means the results can be triangulated and the conclusions are more robust.

Outcomes analysed included alcohol-related hospital admissions, A&E admissions, ambulance callouts, reported crimes and anti-social behaviour incidents. Their analysis indicates that there was no consistent evidence of an effect of the CICA intervention on any of these outcomes, except for an increase in alcohol-related hospital admissions in the CICA areas. However, this increase is unlikely to be the result of the Alcohol Health Champions.

The Champions did not have any influence on licensing decisions during the period, which was one of the key aims of the programme. In reality, it was difficult for the single community voice of an Alcohol Health Champion to influence official processes.

In the paper, the research team suggest reasons why no improvement in health or crime outcomes was observed:

“Possible explanations include insufficient follow-up time, too few volunteers trained, volunteers being unwilling to get involved in licensing decisions, or that the intervention has no direct impact on the selected outcomes.”

Frank De Vocht, Professor in Epidemiology and Public Health at the NIHR Applied Research Collaboration West (ARC West) and senior author of the paper, said:

“The effect of these kind of public health interventions is generally expected to be modest at best for whole areas. That’s why we employed different comparisons and analytic methods, to make sure we could be very confident about our conclusions. However, although not measurable at population level, for individuals Alcohol Health Champions can have a big impact.”

Professor Penny Cook, University of Salford, overall principal investigator for the CICA project, said:

“We spoke to many of our Alcohol Health Champions and heard inspiring stories of their own personal development, and examples of how they had helped people in their communities. While we did show that it was possible to train volunteers for this role, and for them to have successful conversations with members of the public, we weren’t able to demonstrate that this affected the overall health and crime statistics in an area.”

This study is part of a larger evaluation of CICA, led by the University of Salford and funded by the NIHR.