Early results from a school alcohol harm minimization study: the School Health and Alcohol Harm Reduction Project.

AIMS: The School Health and Alcohol Harm Reduction Project aims to reduce alcohol-related harm by enhancing students' abilities to identify and deal with high-risk drinking situations particularly likely to be encountered by young people. DESIGN: The SHAHRP study has adopted a quasi-experimental research design, incorporating intervention and control groups and measuring change over a 3-year period. SETTING: The study is set in metropolitan, government secondary schools (13-17-year-olds) in Perth, Western Australia. The 14 schools involved in the SHAHRP study represent approximately 23% of government secondary schools in the Perth metropolitan area. PARTICIPANTS: The sample was selected using cluster sampling, with stratification by socio-economic area, and involves over 2300 intervention and control students from junior secondary schools. Seventy-three per cent (73.7%) of students completed surveys at both baseline and first follow-up. INTERVENTION: The intervention incorporated evidence-based approaches to enhance potential for behaviour change in the target population. The intervention is a curriculum-based programmeme with an explicit harm minimization goal and will be conducted in two phases over a 2-year period. MEASURES AND FINDINGS: The early results of the study demonstrate initial knowledge and attitude change, predicted by the students' involvement in the intervention. A surprising impact of the first phase of SHAHRP was the significant difference in alcohol consumption and harms between control and intervention groups, with the SHAHRP group demonstrating a significantly lower increase in alcohol consumption than the control group. Students who were supervised drinkers at baseline and who received the SHAHRP intervention were overwhelmingly represented in the change results. CONCLUSIONS: Results from phase one of the SHAHRP study suggest that classroom-based alcohol education programmemes can reduce harm, particularly in students who are supervised drinkers prior to the intervention.

What harms do young Australians experience in alcohol-use situations?

OBJECTIVE: An insight into the alcohol-related experiences of young students in Perth, Western Australia, with particular emphasis to alcohol-related harm. METHOD: The sample of 2,329 students (female: n = 1,089, male: n = 1,240) is a school-based group selected using cluster sampling, with stratification by socio-economic area and represents 11 to 12 year olds' experiences with alcohol and alcohol-related harm. The SHAHRP survey instrument was developed and pre-tested to measure students' knowledge, attitudes, patterns and context of use, harms associated with the students' own alcohol consumption and harms associated with other people's use of alcohol and incorporates the students' perceptions of alcohol-related harm. RESULTS: Nearly two-thirds of all young people consumed alcohol under adult supervision; nearly 40% of all young males and 34% of all young females drink alcohol in unsupervised situations; and a fifth of young males consumed alcohol alone. Young males start drinking younger and consumed alcohol more regularly than young females, and consumed more alcohol per occasion. In the past 12 months, young males experienced more than five and young females more than three alcohol-related harms associated with their own alcohol consumption. They experienced a similar number of harms associated with other people's use of alcohol. Unsupervised drinkers were nearly seven times more likely to experience alcohol-related harm than supervised drinkers and nearly 13 times more likely to experience alcohol-related harm than non-drinkers. CONCLUSION AND IMPLICATIONS: The results can help inform the development of alcohol education programs for young people.

Encouraging schools to promote health: impact of the Western Australian School Health Project (1992-1995).

The Western Australian School Health (WASH) Project, a school health promotion intervention operating over a four-year period (1992-1995), provided a comprehensive, year-long intervention to help successive groups of schools develop health promotion programs. The WASH Project worked with self-selected school communities and used community development strategies to support participating schools in identifying and responding to health concerns relevant to their students. This paper reports the school impact results of the WASH Project. School impact data involved 24 variables categorized into two areas: school organizational factors supportive of health promotion, and school health promotion factors. Two methods of analysis were used: logistic regression indicating the direction of change, and linear regression indicating the magnitude of change. Results demonstrated that schools successfully made organizational changes, such as the allocation of additional time, personnel, and monetary resources, to support health promotion.

Consumption of different alcoholic beverages as predictors of local rates of night-time assault and acute alcohol-related morbidity.

OBJECTIVE: To determine whether population levels of consumption of some alcoholic beverages are more closely associated with levels of harm than others, particularly if consumption of cask wine is more strongly related to rates of acute alcohol problems than consumption of bottled wine as a consequence of the extremely low rates of federal tax levied on the former. METHOD: A database of alcohol consumption and related problems was established for 130 areas of Western Australia. Demographic and economic data for these areas were included from the 1991 census. Empirically derived assumptions regarding the mean wholesale price of cask and bottled wine were utilised. Regression analyses examined the extent to which the consumption of different alcoholic beverages predicted levels of major varieties of harm. RESULTS: Only cask wine and high-strength beer consumption were significantly associated with rates of night-time assault; consumption of all beverage varieties except bottled wine was significantly associated with rates of acute alcohol-related morbidity. Further analyses, which included controls for an effect of total alcohol consumption, confirmed the pronounced contributions of cask wine and high-strength beer to rates of night assaults and acute alcohol-related morbidity. The proportion of all alcohol consumed as low-alcohol beer was significantly negatively associated with these harms. CONCLUSIONS: The beverages most associated with rates of night-time assaults and acute alcohol-related morbidity are those with the lowest federal taxation per standard drink, i.e. cask not bottled wine and regular-strength not low-alcohol beer.

Alcohol consumption and injury in Western Australia: a spatial correlation analysis using geographic information systems.

Geographic information systems technology was used to describe, in geographical terms, the nature and strength of the relationship in Western Australia between alcohol consumption and the rates of related injury: night-time assaults (10 p.m. to 6 a.m.); minor night-time road crashes (10 p.m. to 6 a.m.), weighted by traffic density; and hospital E-code (external-cause) morbidity, weighted by alcohol aetiologic fractions. The data were aggregated by five conventional state regions: northern, central, western, southern and Perth metropolitan. There was a general association, of equal significance for males and females, between estimated per capita alcohol consumption and the selected rates of injury in the five regions. However, the nature and strength of association between alcohol consumption and individual injury measures varied. Night-time assaults and hospital E-code morbidity were strongly, associated with consumption. Minor night-time crashes had only a weak association. The variation in the relationship between alcohol consumption and injury suggests that prevention strategies need to take into account the particular drinking patterns and associated harm that occur in different regions of the state, and to develop a range of targeted responses. High rates of consumption and injury in most country areas support the need for greater regional prevention efforts.

Alcohol consumption and harm in two Western Australian regional centres.

The application of national or state alcohol harm-prevention programs at a regional level can be inappropriate. The involvement of local communities is critical if harm-prevention responses are to be sensitive to local needs. Unfortunately, individuals and agencies usually have little idea of the impact of alcohol at the local level. Alcohol consumption and harm data have been gathered for Geraldton and Bunbury, two regional centres of comparable size in Western Australia. The indices of harm presented include the nature and cost of hospital morbidity attributable to alcohol, and drink-driving charges. In Geraldton, the impact of alcohol tends to be acute and affects young adults, particularly young males. In Bunbury, the consequences of alcohol use tend to be more chronic in nature and affect older adults. These findings have been used to inform local harm-prevention responses, but more than that, this study is a practical example of how available data can be aggregated at a community level to illustrate local alcohol use and harm. This method can be replicated in any community that wants to understand better the effects of alcohol in its own local context.