Iain Brennan

Effectiveness of anonymised information sharing and use in health service, police, and local government partnership for preventing violence related injury: experimental study and time series analysis

Objective To evaluate the effectiveness of anonymised information sharing to prevent injury related to violence. Design Experimental study and time series analysis of a prototype community partnership between the health service, police, and local government partners designed to prevent violence. Setting Cardiff, Wales, and 14 comparison cities designated “most similar” by the Home Office in England and Wales. Intervention After a 33 month development period, anonymised data relevant to violence prevention (precise violence location, time, days, and weapons) from patients attending emergency departments in Cardiff and reporting injury from violence were shared over 51 months with police and local authority partners and used to target resources for violence prevention. Main outcome measures Health service records of hospital admissions related to violence and police records of woundings and less serious assaults in Cardiff and other cities after adjustment for potential confounders. Results Information sharing and use were associated with a substantial and significant reduction in hospital admissions related to violence. In the intervention city (Cardiff) rates fell from seven to five a month per 100 000 population compared with an increase from five to eight in comparison cities (adjusted incidence rate ratio 0.58, 95% confidence interval 0.49 to 0.69). Average rate of woundings recorded by the police changed from 54 to 82 a month per 100 000 population in Cardiff compared with an increase from 54 to 114 in comparison cities (adjusted incidence rate ratio 0.68, 0.61 to 0.75). There was a significant increase in less serious assaults recorded by the police, from 15 to 20 a month per 100 000 population in Cardiff compared with a decrease from 42 to 33 in comparison cities (adjusted incidence rate ratio 1.38, 1.13 to 1.70). Conclusion An information sharing partnership between health services, police, and local government in Cardiff, Wales, altered policing and other strategies to prevent violence based on information collected from patients treated in emergency departments after injury sustained in violence. This intervention led to a significant reduction in violent injury and was associated with an increase in police recording of minor assaults in Cardiff compared with similar cities in England and Wales where this intervention was not implemented.

Interventions for disorder and severe intoxication in and around licensed premises, 1989-2009.

AIMS To systematically review rigorous evaluation studies into the effectiveness of interventions in and around licensed premises that aimed to reduce severe intoxication and disorder. METHODS A systematic search was conducted. Papers that rigorously evaluated interventions based in and around licensed premises to reduce disorder or intoxication were included. RESULTS Fifteen studies were identified, three randomized controlled trials and 12 non-randomized quasi-experimental evaluations. Outcome measures were intoxication (n = 6), disorder (n = 6) and intoxication and disorder (n = 3). Interventions included responsible beverage service training (n = 5), server violence prevention training (n = 1), enhanced enforcement of licensing regulations (n = 1), multi-level interventions (n = 5), licensee accords (n = 2) and a risk-focused consultation (n = 1). Intervention effects varied, even across studies using similar interventions. CONCLUSIONS Server training courses that are designed to reduce disorder have some potential, although there is a lack of evidence to support their use to reduce intoxication and the evidence base is weak.

Risk Factors for Violent Victimisation and Injury from Six Years of the British Crime Survey

Identifying factors that increase the likelihood of victimisation and injury reveals the considerable variability across groups and between incidents. It also allows the efficient allocation of prevention resources to protect those at greatest risk of harm. In this study, three statistical models were developed to identify risk factors for violent victimisation, violent injury and assault-related treatment at an Emergency Department (ED). The cross-sectional sample included all respondents in successive sweeps of the British Crime Survey between 2002/03 and 2007/08 (n = 261,238). Based on logistic regression, risk factors for violent victimisation included male gender, younger age, being divorced or separated, lower household income, living in an urban area and frequency of visiting a licensed premises. Among victims of violence, sustaining an injury was associated with weapon use and degree of alcohol intoxication. Among those injured in violence, weapon use, alcohol intoxication and being black increased risk of treatment at an ED. While sociodemographic factors can be used to predict incidence of victimisation, offence-specific factors offer greater predictive validity in predicting harm outcomes.

An economic evaluation of anonymised information sharing in a partnership between health services, police and local government for preventing violence-related injury

Objective To assess the costs and benefits of a partnership between health services, police and local government shown to reduce violence-related injury. Methods Benefit-cost analysis. Results Anonymised information sharing and use led to a reduction in wounding recorded by the police that reduced the economic and social costs of violence by £6.9 million in 2007 compared with the costs the intervention city, Cardiff UK, would have experienced in the absence of the programme. This includes a gross cost reduction of £1.25 million to the health service and £1.62 million to the criminal justice system in 2007. By contrast, the costs associated with the programme were modest: setup costs of software modifications and prevention strategies were £107 769, while the annual operating costs of the system were estimated as £210 433 (2003 UK pound). The cumulative social benefit-cost ratio of the programme from 2003 to 2007 was £82 in benefits for each pound spent on the programme, including a benefit-cost ratio of 14.80 for the health service and 19.1 for the criminal justice system. Each of these benefit-cost ratios is above 1 across a wide range of sensitivity analyses. Conclusions An effective information-sharing partnership between health services, police and local government in Cardiff, UK, led to substantial cost savings for the health service and the criminal justice system compared with 14 other cities in England and Wales designated as similar by the UK government where this intervention was not implemented.

Predicting and Measuring Premises-Level Harm in the Night-Time Economy

AIMS To assess associations between measures of premises-level alcohol-related harm and risk factors for harm. METHODS Thirty-two licensed premises with a history of on-premises violent assault were recruited. An environmental survey of the drinking context of each premises was undertaken. Levels of patron intoxication were assessed using a breathalyser and a visual assessment of customers at each premises. Premise-level violence was identified via routine police and hospital emergency department data. Analyses examined associations between hospital and police data, surveyor and objective ratings of intoxication and the relationship between intoxication, drinking context and violence at the premises level. RESULTS Hospital and police data were associated. Aggregate levels of surveyor-rated intoxication were associated with aggregate alcometer breath alcohol levels. Analyses further suggest that premises with the highest levels of violence also had customers whose entry-exit change in intoxication was greatest, were open for longer hours, had alcohol promotions and had visible security staff present. CONCLUSIONS Police and hospital data can be used to identify violent premises and to assess outcomes from premises-level interventions to reduce violence. Relatively low-cost observational survey methods can be used to identify high-risk premises, and can be used as outcomes for premises-level interventions. Features of premises that promote intoxication are associated with violence, suggesting that targeting resources at risky premises will likely address two public health concerns: excessive intoxication and assault-related injury.

Aggression and attitudes to time and risk in weapon-using violent offenders

The use of weapons in violence increases both the severity of harm to victims and the severity of legal consequences for offenders, but little is known of the characteristics of violent offenders who choose to use weapons. Levels of anger, attitude to risk, time discounting, and antisocial history among a sample of weapon-using violent offenders (n=15) were compared to violent offenders who had not used a weapon (n=10) and nonviolent offenders (n=15). Results showed that weapon-using violent offenders displayed greater trait aggression and were more risk seeking than other offender types. In addition, weapon-using violent offenders were first convicted at an earlier age and truanted from school more frequently compared to other offender types. The results indicate that weapon users are more aggressive and more risk taking, but no more present focused than other violent and nonviolent offenders. Further research into the cognitive and social factors that influence weapon use is required if this dangerous behavior is to be reduced.

An exploratory randomised controlled trial of a premises-level intervention to reduce alcohol related harm including violence in the United Kingdom

BackgroundTo assess the feasibility of a randomised controlled trial of a licensed premises intervention to reduce severe intoxication and disorder; to establish effect sizes and identify appropriate approaches to the development and maintenance of a rigorous research design and intervention implementation.MethodsAn exploratory two-armed parallel randomised controlled trial with a nested process evaluation. An audit of risk factors and a tailored action plan for high risk premises, with three month follow up audit and feedback. Thirty-two premises that had experienced at least one assault in the year prior to the intervention were recruited, match paired and randomly allocated to control or intervention group. Police violence data and data from a street survey of study premises’ customers, including measures of breath alcohol concentration and surveyor rated customer intoxication, were used to assess effect sizes for a future definitive trial. A nested process evaluation explored implementation barriers and the fidelity of the intervention with key stakeholders and senior staff in intervention premises using semi-structured interviews.ResultsThe process evaluation indicated implementation barriers and low fidelity, with a reluctance to implement the intervention and to submit to a formal risk audit. Power calculations suggest the intervention effect on violence and subjective intoxication would be raised to significance with a study size of 517 premises.ConclusionsIt is methodologically feasible to conduct randomised controlled trials where licensed premises are the unit of allocation. However, lack of enthusiasm in senior premises staff indicates the need for intervention enforcement, rather than voluntary agreements, and on-going strategies to promote sustainability.Trial registrationUKCRN 7090; ISRCTN: 80875696

Tackling knife violence

Every emergency department should contribute to local crime reduction partnerships

Early diversion and empowerment policing : evaluating an adult female offender triage project

ABSTRACT This paper provides an evaluation of a police pilot early-diversion scheme for adult females who were arrested for low-severity offences using a natural experiment design. The intervention is novel in that it diverts arrestees to a women’s centre for assistance to address their criminogenic needs rather than process them through the criminal justice system. The intervention is timely and attractive given its rehabilitative features and its potential for reducing demand on the criminal justice system through community resolution. The study found a promising effect of the intervention on rates of rearrest and daily risk of rearrest over a 12-month follow-up period, but a higher frequency of rearrest among those of the intervention group who were rearrested. The findings are discussed in relation to the political context, theoretical background and police performance and the gendered dynamics of offending.

Value similarity: the key to building public trust in charitable organisations

© Policy Press 2016. This article explores the relationship between value similarity and public trust in charitable organisations. Through a focus group interview and an empirical study based on a sample in the United Kingdom, findings show that value similarity between the public and charitable organisations is an important driver of trust in charities even when individuals lack in-depth knowledge of them. It is also an elemental domain of public trust in charities and makes the greatest contribution to explaining this concept. It is concluded that value similarity is the key to understanding and establishing public trust, which is essential for prosperity of the voluntary sector.