Adoption of the good sports programme

Approximately 26% of Australian adults are involved with community sport clubs. Although community sport clubs have the potential to improve health, current evidence reveals that they are settings for high rates of alcohol use and harm. The aim of this thesis was to examine the Good Sports programme by examining whether various indicators of adoption of the programme were associated with lower rates of risky alcohol consumption and drink-driving among community sports clubs members. Using a three level accreditation process, the Good Sports programme assists community sports clubs to implement alcohol-related harm reduction strategies. Once a club has implemented all relevant strategies, they are classified as a ‘stage-three’ accredited Good Sports club. In keeping with evaluation theory for large scale interventions, a series of studies (four adoption studies) were completed. All four studies found associations that aligned with the proposition that higher adoption (measured variously as time in program, or levels of club accreditation or strategy implementation) of the Good Sports programme would be associated with lower rates of risky drinking and drink-driving. Multilevel analyses were guided by model fit criteria to select an optimal selection of measures of program adoption and predictors of alcohol and driving behaviours. Study one found that stage two club members consumed 19% less alcohol than stage one club members on the main playing day (Saturday), and that more time in the programme was associated with reduced consumption. Accreditation level also predicted a 33% (95CI: 02-55) reduction in the odds of any club member being a long-term risky drinker. Using accreditation as a continuous variable study three replicated the findings of study one. Study three identified a 20% (95CI: 5-33) reduction in odds per accreditation stage in risky consumption on the playing day; a 15% (95CI: 1-26) reduction in odds, per accreditation stage for short-term risky drinking for the week prior to the survey; and a 14% (95CI: 2-25) reduction in odds, per accreditation stage, for long-term risky drinking. Study two found that higher stages of Good Sports implementation were associated with lower rates of drink-driving; however, study two (using the same sample and design as study one) found that the prevalence of drink-driving in stage one and stage two clubs was not significantly different. Nevertheless, members of stage two clubs with 10 drink-driving countermeasures formally implemented were less likely to drink-drive than individuals in clubs with zero (Level one clubs) or less than 10 countermeasures formally in place. Study four (using the same sample and design as study three) found that for each season a club was in the programme there was an 8% (95CI: 1-14) reduction in the odds of drink-driving. The findings were partly inconsistent with study two which did not find time in the programme was associated with reduced odds of drink-driving. Overall, the consistency across a range of evidence suggests that there is an association between adoption of the Good Sports programme and reduced alcohol consumption and drink-driving. The results of this thesis provide promising preliminary evidence supporting more extensive evaluation of the potential for the Good Sports programme to reduce alcohol use and long and short term harm from this drug for a significant proportion of the Australian community. A literature review, a theoretical framework, and analytical methods are also presented as independent chapters