Family-based prevention programmes for alcohol use in young people.

BACKGROUND: Alcohol use in young people is a risk factor for a range of short- and long-term harms and is a cause of concern for health services, policy-makers, youth workers, teachers, and parents. OBJECTIVES: To assess the effectiveness of universal, selective, and indicated family-based prevention programmes in preventing alcohol use or problem drinking in school-aged children (up to 18 years of age).Specifically, on these outcomes, the review aimed:• to assess the effectiveness of universal family-based prevention programmes for all children up to 18 years ('universal interventions');• to assess the effectiveness of selective family-based prevention programmes for children up to 18 years at elevated risk of alcohol use or problem drinking ('selective interventions'); and• to assess the effectiveness of indicated family-based prevention programmes for children up to 18 years who are currently consuming alcohol, or who have initiated use or regular use ('indicated interventions'). SEARCH METHODS: We identified relevant evidence from the Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library, MEDLINE (Ovid 1966 to June 2018), Embase (1988 to June 2018), Education Resource Information Center (ERIC; EBSCOhost; 1966 to June 2018), PsycINFO (Ovid 1806 to June 2018), and Google Scholar. We also searched clinical trial registers and handsearched references of topic-related systematic reviews and the included studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and cluster RCTs (C-RCTs) involving the parents of school-aged children who were part of the general population with no known risk factors (universal interventions), were at elevated risk of alcohol use or problem drinking (selective interventions), or were already consuming alcohol (indicated interventions). Psychosocial or educational interventions involving parents with or without involvement of children were compared with no intervention, or with alternate (e.g. child only) interventions, allowing experimental isolation of parent components. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We included 46 studies (39,822 participants), with 27 classified as universal, 12 as selective, and seven as indicated. We performed meta-analyses according to outcome, including studies reporting on the prevalence, frequency, or volume of alcohol use. The overall quality of evidence was low or very low, and there was high, unexplained heterogeneity.Upon comparing any family intervention to no intervention/standard care, we found no intervention effect on the prevalence (standardised mean difference (SMD) 0.00, 95% confidence interval (CI) -0.08 to 0.08; studies = 12; participants = 7490; I² = 57%; low-quality evidence) or frequency (SMD -0.31, 95% CI -0.83 to 0.21; studies = 8; participants = 1835; I² = 96%; very low-quality evidence) of alcohol use in comparison with no intervention/standard care. The effect of any parent/family interventions on alcohol consumption volume compared with no intervention/standard care was very small (SMD -0.14, 95% CI -0.27 to 0.00; studies = 5; participants = 1825; I² = 42%; low-quality evidence).When comparing parent/family and adolescent interventions versus interventions with young people alone, we found no difference in alcohol use prevalence (SMD -0.39, 95% CI -0.91 to 0.14; studies = 4; participants = 5640; I² = 99%; very low-quality evidence) or frequency (SMD -0.16, 95% CI -0.42 to 0.09; studies = 4; participants = 915; I² = 73%; very low-quality evidence). For this comparison, no trials reporting on the volume of alcohol use could be pooled in meta-analysis.In general, the results remained consistent in separate subgroup analyses of universal, selective, and indicated interventions. No adverse effects were reported. AUTHORS' CONCLUSIONS: The results of this review indicate that there are no clear benefits of family-based programmes for alcohol use among young people. Patterns differ slightly across outcomes, but overall, the variation, heterogeneity, and number of analyses performed preclude any conclusions about intervention effects. Additional independent studies are required to strengthen the evidence and clarify the marginal effects observed.

Implementing health policies in Australian junior sports clubs: an RCT.

BACKGROUND: This pilot study aimed to test the potential effectiveness and acceptability of an intervention to support the implementation of 16 recommended policies and practices to improve the health promotion environment of junior sporting clubs. Reported child exposure to health promoting practices at clubs was also assessed. METHODS: A cluster randomised trial was conducted with eight football leagues. Fourty-one junior football clubs belonging to four leagues in the intervention group received support (e.g. physical resources, recognition and rewards, systems and prompts) to implement 16 policies and practices that targeted child exposure to alcohol, tobacco, healthy food and beverages, and participation in physical activity. Thirty-eight clubs belonging to the four control group leagues did not receive the implementation intervention. Study outcomes were assessed via telephone interviews with nominated club representatives and parents of junior players. Between group differences in the mean number of policies and practices implemented at the club level at follow-up were examined using a multiple linear regression model. RESULTS: While the intervention was found to be acceptable, there was no significant difference between the mean number of practices and policies reported to be implemented by intervention and control clubs at post-intervention (Estimate - 0.05; 95% CI -0.91, 0.80; p = 0.90). There was also no significant difference in the proportion of children reported to be exposed to: alcohol (OR 1.16; 95% CI 0.41, 3.28; p = 0.78); tobacco (OR 0.97; CI 0.45, 2.10; p = 0.94); healthy food purchases (OR 0.49; CI 0.11, 2.27; p = 0.35); healthy drink purchases (OR 1.48; CI 0.72, 3.05; p = 0.27); or participation in physical activity (OR 0.76; CI 0.14, 4.08; p = 0.74). CONCLUSIONS: Support strategies that better address barriers to the implementation of health promotion interventions in junior sports clubs are required. TRIAL REGISTRATION: Retrospectively registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12617001044314 ).

Sustaining the implementation of alcohol management practices by community sports clubs: a randomised control trial.

BACKGROUND: Risky alcohol consumption is responsible for a variety of chronic and acute harms. Individuals involved in organised sport have been identified as one population group who consume risky amounts of alcohol both at the elite and the non-elite level. 'Good Sports', an alcohol management intervention focused on the community sports setting has been successful in addressing risky alcohol use and alcohol-related harm amongst players and sports fans. Sustaining such implementation effects is a common challenge across a variety of community settings. The primary aim of this trial was to assess the effectiveness of a web-based program in sustaining the implementation of best-practice alcohol management practices by community football clubs, relative to usual program care (i.e. control clubs). METHODS: Non-elite, community football clubs in the Australian states of New South Wales and Victoria, that were participating in an alcohol management program (Good Sports) were recruited for the study. Consenting clubs were randomised into intervention (N = 92) or control (N = 96) groups. A web-based sustainability intervention was delivered to intervention clubs over three consecutive Australian winter sports seasons (April-September 2015-2017). The intervention was designed to support continued (sustained) implementation of alcohol management practices at clubs consistent with the program. Control group clubs received usual support from the national Good Sports Program. Primary outcome data was collected through observational audits of club venues and grounds. RESULTS: A total of 92 intervention clubs (574 members) and 96 control clubs (612 members) were included in the final analysis. At follow-up, sustained implementation of alcohol management practices was high in both groups and there was no significant difference between intervention or control clubs at follow-up for both the proportion of clubs implementing 10 or more practices (OR 0.53, 95%CI 0.04-7.2; p = 0.63) or for the mean number of practices being implemented (mean difference 0.10, 95%CI -0.23-0.42; p = 0.55). There were also no significant differences between groups on measures of alcohol consumption by club members. CONCLUSIONS: The findings suggest that sustained implementation of alcohol management practices was high, and similar, between clubs receiving web-based implementation support or usual program support. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12614000746639. Prospectively registered 14/7/2014.

Promotion of healthy eating in clubs with junior teams in Australia: A cross-sectional study of club representatives and parents.

ISSUES ADDRESSED: To: (i) describe the prevalence of policies and practices promoting healthy eating implemented by sports clubs with junior teams; (ii) examine differences in such practices across geographic and operational characteristics of clubs; and (iii) describe the attitudes of club representatives and parents regarding the acceptability of sports clubs implementing policies and practices to promote healthy eating. METHODS: Cross-sectional telephone surveys of junior community football club management representatives and parents/carers of junior players were conducted in the states of New South Wales and Victoria, Australia in 2016. RESULTS: Seventy-nine of the 89 club representatives approached to participate completed the telephone survey. All clubs (100%; 95% CI 96.2-100.0) reported recommending fruit or water be provided to players after games or at half-time, 24% (95% CI 14.4-33.7) reported promoting healthy food options through prominent positioning at point of sale and only 8% (95% CI 1.6-13.6) of clubs had a written healthy eating policy. There were no significant differences between the mean number of healthy eating policies and practices implemented by club socio-economic or geographic characteristics. Club representatives and parents/carers were supportive of clubs promoting healthy eating for junior players. CONCLUSIONS: While there is strong support within sporting clubs with junior teams for policies and practices to promote healthy eating, their implementation is highly variable. SO WHAT?: A considerable opportunity remains for health promotion policy and practice improvement in clubs with junior teams, particularly regarding policies related to nutrition.

A population-based survey of knowledge of first aid for burns in New South Wales.

OBJECTIVE: To determine the current level of knowledge of first aid for a burn injury and sources of this knowledge among the general population of New South Wales. DESIGN, SETTING AND PARTICIPANTS: People aged 16 years or older were interviewed as part of the 2007 NSW Population Health Survey, a continuous telephone survey of NSW residents. MAIN OUTCOME MEASURE: Weighted proportion of the population with optimal first aid knowledge for burns. RESULTS: In total, 7320 respondents were asked questions related to burn injuries and first aid. Of the surveyed population, 82% reported that they would cool a burn with water, and 9% reported that they would cool the burn for the recommended 20 minutes. Few respondents reported that they would remove the patient's clothing and keep the injured person warm. The most common sources of first aid information were a first aid book (42%) and the internet (33%). Speaking a language other than English at home, and being over 65 years of age were associated with a lack of first aid knowledge. CONCLUSIONS: A minority of people living in NSW know the optimal time for cooling a burn injury and other appropriate first aid steps for burns. This study demonstrates a gap in the public's knowledge, especially among non-English speaking people and older people, and highlights the need for a clear, consistent first aid message.

Alcohol and fast food sponsorship in sporting clubs with junior teams participating in the 'Good Sports' program: a cross-sectional study.

OBJECTIVE: To examine: alcohol and fast food sponsorship of junior community sporting clubs; the association between sponsorship and club characteristics; and parent and club representative attitudes toward sponsorship. METHODS: A cross-sectional telephone survey of representatives from junior community football clubs across New South Wales and Victoria, Australia, and parents/carers of junior club members. Participants were from junior teams with Level 3 accreditation in the 'Good Sports' program. RESULTS: A total of 79 club representatives and 297 parents completed the survey. Half of participating clubs (49%) were sponsored by the alcohol industry and one-quarter (27%) were sponsored by the fast food industry. In multivariate analyses, the odds of alcohol sponsorship among rugby league clubs was 7.4 (95%CI: 1.8-31.0, p=<0.006) that of AFL clubs, and clubs located in regional areas were more likely than those in major cities to receive fast food industry sponsorship (OR= 9.1; 95%CI: 1.0-84.0, p=0.05). The majority (78-81%) of club representatives and parents were supportive of restrictions to prohibit certain alcohol sponsorship practices, but a minority (42%) were supportive of restrictions to prohibit certain fast food sponsorship practices. CONCLUSIONS: Large proportions of community sports clubs with junior members are sponsored by the alcohol industry and the fast food industry. There is greater acceptability for prohibiting sponsorship from the alcohol industry than the fast food industry. Implications for public health: Health promotion efforts should focus on reducing alcohol industry and fast food industry sponsorship of junior sports clubs.

Trends and future projections of child injury in New South Wales: A tool for advocacy?

AIMS: To describe the trend of unintentional hospitalised injury in children aged 0-14 years in New South Wales (NSW), Australia during 1993-1994 to 2004-2005 and to estimate future projections of common child injury hospitalisations from 2006 to 2021. METHODS: NSW hospitalisation data were used to describe injury trends of children aged 14 years or less who were residents of NSW (1993-1994 to 2004-2005). Projected injury-related hospitalisations of children for 2006-2021 were estimated assuming that the current observed rate of change in childhood injury hospitalisation rates continued to 2021. RESULTS: During 1993-1994 to 2004-2005, there were 238 093 injury-related hospitalisations of children aged 14 years or less in NSW. Assuming the rate of change in injury hospitalisation observed between 1993-1994 and 2004-2005 continued into the future, the all hospitalised injury incidence rate for children aged 14 years or less is projected to decrease by 1.0% each year to 2021. Injury mechanisms such as burns and scalds, swimming pool non-fatal drowning and poisoning are all projected to decrease in the future, although not for all age groups. Falls (excluding those from playground equipment) and falls from playground equipment hospitalisations (excluding children less than 1 year) are projected to increase. CONCLUSION: Although the incidence of hospitalisation for some common child-related injury mechanisms is projected to decrease over the coming years, others are projected to increase. It is possible that advocacy efforts might benefit from using projected injury trends. Co-ordinated cross-government action is needed to successfully implement child injury prevention strategies, particularly in the playground environment.

Soft landings: encouraging compliance with safety standards in Local Government Authority playgrounds.

ISSUES ADDRESSED: Consistent with health promotion principles of good practice, addressing playground injury necessitates the creation of a supportive environment for the enhancement of wellbeing and the prevention of injuries. This study aims to survey local governments to: determine compliance with playground safety standards; establish frequency of playground inspections and maintenance; and identify motivators and barriers to compliance with safety standards. METHODS: A survey of key informants for playground safety in all 152 local government councils in New South Wales (NSW) was undertaken. RESULTS: Of 152 local councils in NSW (43 metropolitan and 109 non-metropolitan), 71.7% (n=109) completed the survey, 12.5% (n=19) refused to participate and no response was received by 15.8% (n=24). Self-reported compliance with key aspects of the standard was generally high. However, only 55% of councils complied with surface impact attenuation <200 gmax and <1,000 HIC. Further, only 14.7% of councils reported impact testing the playground surface during inspections. The main motivators to compliance included: reducing risk of litigation or liability; enhancing community and child safety, and minimising the risk of injury. The main barriers included a lack of: time; personnel, and a lack of adequate and appropriate funding. CONCLUSIONS: Local Government Authorities have a duty of care to ensure the safety of playgrounds in their jurisdiction. They require time, personnel and adequate and appropriate funding in order to achieve this aim.

Student survey trends in reported alcohol use and influencing factors in Australia.

INTRODUCTION AND AIMS: There is a need to explain reported trends of reduced alcohol and drug (substance) use in school-aged children in Australia. This study used student survey data collected in the states of Victoria, Western Australia and Queensland to examine trends in substance use and associated influencing factors. DESIGN AND METHODS: Youth self-reports were examined from 11 cross-sectional surveys completed by 41 328 adolescents (average age 13.5 years, 52.5% female) across 109 Australian communities between 1999 and 2015. Multi-level modelling was used to identify trends in adolescent reports of lifetime alcohol, tobacco and cannabis use, adjusted for age, gender, social disadvantage and minority status. Trends in influencing factors were also examined that included: individual attitudes, and family, school and community environments. Multivariate analyses estimated the main contributors to alcohol use trends. RESULTS: Alcohol, tobacco and cannabis use all fell significantly from 1999 to 2015. Higher levels of use were observed in Victoria compared to Western Australia or Queensland. Multivariate analyses identified reductions in favourable parent attitudes and lower availability of substances as direct contributors to reducing alcohol use trends. Indicators of school and family adjustment did not show similar trend reductions. DISCUSSION AND CONCLUSIONS: Reductions in adolescent alcohol, tobacco and cannabis use from 1999 to 2015 were associated with similar reductions in parent favourable attitudes and availability of substances. It is plausible that a reduced tendency for parents and other adults to supply adolescent alcohol are implicated in the reductions in adolescent alcohol use observed across Australia.

Whole-of-community interventions to reduce population-level harms arising from alcohol and other drug use: a systematic review and meta-analysis.

BACKGROUND AND AIMS: Whole-of-community interventions aim to reduce alcohol and other drug (AOD) use and harms by mobilizing community leaders, organizations and policy-makers to respond effectively to AOD use. The aim of this review is to estimate the effectiveness of whole-of-community interventions in reducing population-level harms arising from AOD use. DESIGN: A systematic review of electronic databases CENTRAL, Embase, Medline, Medline in Process and PsycINFO was conducted from database inception to August 2017. Eligible trials had a parallel comparison group, implemented interventions in two or more community settings, and reported data on AOD use or harms. SETTING: Intervention settings included schools, sporting clubs, police and law enforcement agencies, community centres, local media and retail premises. PARTICIPANTS: Twenty-four trials from 63 publications were included (n = 249 125 participants). MEASUREMENTS: Outcomes from AOD consumption (quantity and frequency), AOD-related crime and AOD-related accidents, injuries and hospital admissions. Data were pooled using random-effects inverse variance meta-analysis in Review Manager version 5.3. FINDINGS: Risk of bias was mostly high, due to lack of random allocation, selective reporting and significant attrition. Meta-analyses indicated significant reductions in risky drinking [Alcohol Use Disorders Identification Scale (AUDIT) > 8; three trials (7 data points), relative risk (RR) = 0.78, 95% confidence interval (CI) = 0.62-0.99)], but found no impact on past-month alcohol use (five trials, RR = 0.95, 95% CI = 0.89-1.02), binge drinking (five trials, RR = 0.97, 95% CI = 0.89-1.06) or 12-month marijuana use (two trials, RR = 0.98, 95% CI = 0.86-1.11). Narrative synthesis indicated some reductions in AOD-related assault rates and arrests, but were equivocal for quantity of alcohol consumed, 12-month illicit drug use, assault or abuse, motor vehicle accidents and hospital admissions. CONCLUSIONS: Interventions to reduce alcohol and other drug use and harms applied to whole communities have resulted so far in small reductions in risky alcohol consumption, but have had little impact upon past month alcohol use, binge drinking or 12-month marijuana use and the studies have been subject to high risk of bias.

Randomised controlled trial of a web-based programme in sustaining best practice alcohol management practices at community sports clubs: a study protocol.

INTRODUCTION: Community-based interventions have been found to effectively increase the implementation of alcohol management practices and reduce excessive alcohol use and alcohol-related harm at sports clubs. However, once implementation support ceases there may be a reduction in such intervention effects. Thus, ongoing contribution to improving the health of the community is diminished; sustaining practice implementation is a key determinant to address this. One possible solution to the strategic and logistical challenges of sustainability involves the use of the web. The primary aim of this study is to assess the effectiveness of a web-based programme in sustaining the implementation of alcohol management practices by community football clubs. The secondary aim is to assess the effectiveness of the programme in preventing excessive alcohol consumption and alcohol-related harm among members of community football clubs. METHODS AND ANALYSIS: The study will employ a repeat randomised controlled trial design and be conducted in regional and metropolitan areas within two states of Australia. Community level football clubs who are currently accredited with an existing alcohol management programme ('Good Sports') and implementing at least 10 of the 13 core alcohol management practices (eg, not serving alcohol to <18-year-olds) required by the programme will be recruited and randomised to either a web-based sustainability programme or a 'minimal contact' programme. The primary outcome measures are the proportion of football clubs implementing ≥10 of the 13 required alcohol management practices and the mean number of those practices being implemented at 3-year follow-up. Secondary outcomes include: the proportion of club members who report risky drinking at their club, the Alcohol Use Disorder Identification Test (AUDIT) score and mean AUDIT score of club members. Outcome data will be collected via observation at the club during a 1-day visit to a home game, conducted by trained research assistants at baseline and follow-up. ETHICS AND DISSEMINATION: The study was approved by The University of Newcastle Human Research Ethics Committee (reference: H-2013-0429). Study findings will be disseminated widely through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER: ACTRN12614000746639; Pre-results.

Cluster randomised controlled trial of a multicomponent intervention to support the implementation of policies and practices that promote healthier environments at junior sports clubs: study protocol.

INTRODUCTION: A large proportion of children and adolescents participate in organised sport, making community sports clubs a promising setting to support healthy behaviours. To date, however, there have been few interventions conducted in junior sports clubs that have targeted health-promoting practices. The primary aim of this pilot study is to assess the potential effectiveness of an intervention to implement health-promoting policies and practices in junior sporting clubs targeting alcohol and tobacco practices, healthy food and beverage availability, and physical activity via participation in sport. A secondary outcome is to assess the impact of such strategies on child exposure to alcohol and tobacco use at the club, purchasing behaviours by/for children at the club canteen and child sports participation opportunities. METHODS AND ANALYSIS: The study will employ a cluster randomised controlled trial design and be conducted in metropolitan and regional areas of two Australian states. Randomisation will occur at the level of the football league. Community football clubs with over 40 junior players (players under 18 years) within each league will be eligible to participate. The intervention will be developed based on frameworks that consider the social, cultural and environmental factors that influence health behaviours. Intervention clubs will be supported to implement 16 practices targeting alcohol management, tobacco use, nutrition practices, new player recruitment activity, equal participation for players and the development of policies to support these practices. Trained research staff will collect outcome data via telephone interviews at baseline and follow-up. Interviews will be conducted with both club representatives and parents of junior players. ETHICS AND DISSEMINATION: The study has been approved by the University of Newcastle Human Research Ethics Committee (H-2013-0429). The results of the study will be disseminated via peer-reviewed publications and presentations at conferences. TRIAL REGISTRATION NUMBER: ACTRN12617001044314; Pre-results.

Alcohol management practices in community sporting clubs: Validation of an online self-report tool.

INTRODUCTION AND AIMS: Those involved in organised sport have a high risk of excessive alcohol consumption and alcohol-related harm, the implementation of alcohol management practices have been proven to reduce these risks. Measuring alcohol management practice implementation by sporting clubs is impeded by a lack of valid tools. The aim of this study was to determine the validity of online self-report of alcohol-management practices by community football clubs via comparison with observational methods. DESIGN AND METHODS: A cross-sectional study was undertaken with a sample of community football clubs within Australia. The implementation of 12 alcohol management practices was collected via: (i) an online survey; and (ii) observational audit at a clubs home ground. The prevalence of implementation of alcohol management practices for both data collection methods was calculated as was percent agreement and Kappa/Prevalence Adjusted and Bias Adjusted Kappa (PABAK) statistics. RESULTS: Data were collected from 58 football clubs. For both assessment methods, implementation prevalence was greater than 80% for 6 of the 12 alcohol management practices. A total of 75% (n = 9) of practices had at least 70% agreement between the online and observation methods of assessment. Kappa/PABAK scores ranged from -0.08 (poor agreement) to 0.97 (almost perfect agreement). DISCUSSION AND CONCLUSION: The online survey provided valid measure of assessing some but not all alcohol management practices in community sporting clubs. The validity of the measure may be improved by enhancements to the manner in which the self-report data are collected.

Falls from playground equipment: will the new Australian playground safety standard make a difference and how will we tell?

ISSUE ADDRESSED: This study describes the trend in incidence of hospitalised falls from playground equipment of children aged 14 years or less in New South Wales (NSW) and considers the potential effectiveness of playground safety standards in reducing the impact of playground-related injuries. METHOD: Hospitalisations of children aged 14 years or less following a fall from playground equipment were identified from the NSW hospitalisation data for the financial years 1992/93 to 2003/04 and described. RESULTS: During 1992/93 to 2003/04 there were 16,828 hospitalisations of children aged 0-14 years as a result of a fall from playground equipment, at a rate of 106.6 per 100,000 children. The incidence of hospitalisation increased from 83.3 to 130.3 per 100,000 children between 1992/93 to 2003/04. Males aged 5-9 years had the highest rate of hospitalisation at 198.4 per 100,000 children. Injury type varied by age group, but injuries to the elbow and forearm were common for all age groups. The rate of upper limb fractures that resulted in hospitalisation increased, while the rate of serious head injuries decreased. CONCLUSIONS: While severe head injuries have declined between 1992/93 to 2003/04, the increasing trend of upper limb fractures is of concern. Many factors need to be taken into account to assess the effectiveness of playground safety standards. The collection of exposure data is also crucial to be able to calculate the true risk associated with childhood falls from playground equipment.

The Feasibility and Acceptability of a Web-Based Alcohol Management Intervention in Community Sports Clubs: A Cross-Sectional Study.

BACKGROUND: The implementation of comprehensive alcohol management strategies can reduce excessive alcohol use and reduce the risk of alcohol-related harm at sporting venues. Supporting sports venues to implement alcohol management strategies via the Web may represent an effective and efficient means of reducing harm caused by alcohol in this setting. However, the feasibility and acceptability of such an approach is unknown. OBJECTIVE: This study aimed to identify (1) the current access to and use of the Web and electronic devices by sports clubs; (2) the perceived usefulness, ease of use, and intention to use a Web-based program to support implementation of alcohol management policies in sports clubs; (3) the factors associated with intention to use such a Web-based support program; and (4) the specific features of such a program that sports clubs would find useful. METHODS: A cross-sectional survey was conducted with club administrators of community football clubs in the state of New South Wales, Australia. Perceived usefulness, ease of use and intention to use a hypothetical Web-based alcohol management support program was assessed using the validated Technology Acceptance Model (TAM) instrument. Associations between intention to use a Web-based program and club characteristics as well as perceived ease of use and usefulness was tested using Fisher's exact test and represented using relative risk (RR) for high intention to use the program. RESULTS: Of the 73 football clubs that were approached to participate in the study, 63 consented to participate and 46 were eligible and completed the survey. All participants reported having access to the Web and 98% reported current use of electronic devices (eg, computers, iPads/tablets, smartphones, laptops, televisions, and smartboards). Mean scores (out of a possible 7) for the TAM constructs were high for intention to use (mean 6.25, SD 0.87), perceived ease of use (mean 6.00, SD 0.99), and perceived usefulness (mean 6.17, SD 0.85). Intention to use the Web-based alcohol management program was significantly associated with perceived ease of use (P=.02, RR 1.4, CI 1.0-2.9), perceived usefulness (P=.03, RR 1.5, CI 1.0-6.8) and club size (P=.02, RR 0.8, CI 0.5-0.9). The most useful features of such a program included the perceived ability to complete program requirements within users' own time, complete program accreditation assessment and monitoring online, develop tailored action plans, and receive email reminders and prompts to complete action. CONCLUSIONS: A Web-based alcohol management approach to support sports clubs in the implementation of recommended alcohol management policies appears both feasible and acceptable. Future research should aim to determine if such intended use leads to actual use and club implementation of alcohol management policies.

Drunk, drowsy, doped: skiers' and snowboarders' injury risk perceptions regarding alcohol, fatigue and recreational drug use.

The objective was to investigate perceptions of snowfield resort visitors about injury risk regarding alcohol, fatigue and recreational drug use. Visitors to a resort village in a large Australian snowfield region completed a brief survey about fatigue, alcohol and recreational drug use and injury risk perception. Participants stated their ability to ski or snowboard and drive safely following a lack of sleep, alcohol and recreational drug use. Intoxicated snowfield resort visitors were compared with non-intoxicated visitors. Safety beliefs across snow sport and transport were compared. Participants reported that they generally slept less than usual and 30% reported both drinking alcohol and using drugs more than usual while visiting the snowfields. Participants perceived driving as a greater injury risk than skiing/snowboarding (p < 0.001). Fatigue was perceived as a relatively weak injury risk factor, particularly whilst skiing and snowboarding. Awareness needs to be raised among snowfield resort visitors about the contribution of alcohol, fatigue and recreational drug use to snow sport and transport-related injury risk.

The epidemiology of competition and training-based surf sport-related injury in Australia, 2003-2011.

OBJECTIVES: To describe the epidemiology of competition and training-based surf sport-related injury in Australia in the years 2003-2011. DESIGN: A retrospective epidemiological review. METHODS: Information on surf sport-related injuries was obtained from Surf Life Saving Australia's SurfGuard Incident Reporting Database during 1 January 2003 to 20 August 2011. RESULTS: There were 2645 surf sport-related competition or training-related incidents. Males and females experienced similar proportions of injury by activity type, with older individuals experiencing a higher proportion of injuries during training than younger individuals. Minor first aid was required for 54.5% of the competition and 43.7% of the training-related incidents, with major first aid required in just over 10% of both incident types. Overall, inflatable rescue boats, beach flags, and surf boats were the most common activities performed at the time of the incident, with returning to shore and negotiating the break the most common possible contributing factors to surf boat incidents. Bruises/contusions, strains, inflammation/swelling, and sprains were the most common types of injuries that occurred during both competition and training. RICE--Rest-Ice-Compression-Elevation--was the most common form of initial treatment for the injury during both competition and training. CONCLUSIONS: Participation in surf sports is not without risk of injury. Information from this study will inform injury prevention efforts for surf sport and act as a guide for future research in this area, and towards improved injury surveillance for surf sport-related injuries.

The impact of recent changes in smoke alarm legislation on residential fire injuries and smoke alarm ownership in New South Wales, Australia.

In 2006, New South Wales (NSW) state legislation changed from requiring smoke alarms in new houses only to all houses. We evaluated the impact of this legislative change on residential fire injury and smoke alarm ownership characteristics. Residential fire injuries for 2002 to 2010 were identified from hospitalization data for all hospitals in NSW. Data relating to smoke alarm ownership and demographic factors were obtained from the NSW Population Health Survey. Negative binomial regression analysis was used to analyze trends over time. Prior to the introduction of universal legislation, hospitalization rates were increasing slightly; however, following the introduction of legislation, hospitalization rates decreased by an estimated 36.2% (95% confidence interval [CI], 16.7-55.8) annually. Smoke alarm ownership increased from 73.3% (95% CI, 72.5-74.2) prelegislation to 93.6% (95% CI, 93.1-94.2) 18 months postlegislation. Thirty percent of households reported testing their alarms regularly. Speaking a language other than English (relative risks [RRs], 1.82; 95% CI, 1.44-2.99), allowing smoking in the home (RR, 1.73; 95% CI, 1.31-2.27), and being part of the most disadvantaged socioeconomic group (RR, 1.47; 95% CI, 1.14-1.91) remain major risk factors for nonownership. Broadening the scope of state legislation has had a positive impact on residential fire-related hospitalizations and smoke alarm ownership. However, it is of concern that the legislation has been the least effective in increasing smoke alarm ownership among non-English-speaking households, in households where smoking is allowed, in low socioeconomic households, and that a high proportion of householders do not test their smoke alarms regularly. Targeted campaigns are needed to reach these high-risk groups and to ensure that smoke alarms are functional.