Reducing risky drinking and alcohol-related harm in the sports setting

Research Doctorate - Doctor of Philosophy (PhD)Background: Players and spectators of sport report consuming alcohol at levels that place them at increased risk of alcohol-related harm compared to the overall adult population. Sports clubs represent a promising setting for the implementation of interventions to reduce such consumption and harm. Aims: This thesis aimed: 1. To identify the characteristics and practices of community football clubs that are associated with risky alcohol consumption (Chapter 2). ; 2. To assess attitudes of football club management regarding alcohol use at sports clubs and alcohol harm reduction strategies (Chapter 3). ; 3. To develop (Chapter 4) and evaluate the effectiveness of interventions to: a) improve the implementation of alcohol management practices at community sports clubs (Chapter 5) ; b) reduce risky alcohol consumption and alcohol-related harm among community sports club members (players, spectators and officials) (Chapter 6). ; 4. To systematically review and synthesise current evidence of the effectiveness of interventions to reduce risky drinking and alcohol-related harm in sports settings generally (Chapters 7 and Chapter 8). ; 5. To provide recommendations for future research and practice regarding interventions to reduce risky alcohol consumption and alcohol-related harm in the sports setting (Chapter 9). Methods: Aims 1 to 3 have been addressed through a series of studies undertaken within community football clubs and club members in urban and rural areas of New South Wales, Australia. These studies involved: a cross-sectional survey of 1428 football club members from 88 football clubs (Aim 1); a cross-sectional survey of 101 community football club management representatives (Aim 2); a randomised controlled trial of 87 football clubs (Aim 3a); and, a cluster randomised controlled trial of members of community football clubs (N=1411 at pre-intervention; N=1143 post-intervention)(Aim 3b). Aim 4 was addressed through a systematic review of published and grey literature. Key findings: Members of clubs that served alcohol to intoxicated people (OR: 2.23, 95%CI: 1.26-3.93; p=0.0074) conducted ‘happy hour’ promotions (OR: 2.84, 95%CI: 1.84-4.38; p<0.0001) or provided alcohol-only awards and prizes (OR: 1.80, 95%CI: 1.16-2.80; p=0.0084) were at significantly greater odds of consuming alcohol at risky levels than members of clubs that did not undertake such practices (Chapter 2). ; Over half of sports club representatives believed that players often consume too much alcohol (55%), 95-99% agreed that it is important that clubs ensure alcohol is served responsibly and that doing so is a responsibility of the club, and 75% believed that their club could benefit from assistance to encourage responsible alcohol consumption (Chapter 3). ; Following an organisational change intervention, 88% of community sports clubs in the intervention group reported implementing ‘13 or more’ of 16 responsible alcohol management practices, compared with 65% of control group clubs (OR: 3.7, 95%CI: 1.1-13.2; p=0.04) (Chapter 5). ; Following an alcohol management intervention, members of community sports clubs from the intervention group reported significantly lower proportions of: risky alcohol consumption at the club (Intervention: 19%; Control: 24%; OR: 0.63, 95%CI 0.40-1.00; p=0.05); risk of alcohol-related harm (Intervention: 38%; Control: 45%; OR: 0.58, 95%CI 0.38-0.87; p<0.01); alcohol consumption risk (Intervention: 47%; Control: 55%; OR: 0.60, 95%CI 0.41-0.87; p<0.01) and possible alcohol dependence (Intervention: 1%; Control: 4%; OR: 0.20, 95% CI 0.06-0.65; p