Johanna Gripenberg

Effects of a Community-Based Drug Use Prevention Program Targeting Licensed Premises

This study evaluated the effects of a community-based drug use prevention program on the frequency with which doormen at licensed premises intervene in cases of obviously drug use-impaired patrons. Doormen were trained in recognizing signs of drug use impairment to be able to stop drug use–impaired patrons to enter the premises. The study included 28 trendy nightclubs in Stockholm, Sweden, that used doormen to screen patrons. Two male actors were instructed to act as if they were obviously drug use–impaired (cocaine/amphetamines) while attempting to enter nightclubs. Data were collected at pretest when 40 entry attempts were made (2003) and posttest (2004) when 48 attempts were made. At follow-up, the doormen intervened in 27% of the attempts, a significant improvement compared to the intervention rate of 7.5% at baseline. The results indicate that the intervention has had effect on doormens behavior. However, in the majority of the attempted visits, the doormen still did not intervene. Limitations of the study were the lack of a control group and problems with identifying the training status for the individual doormen. Further research is necessary to explore the effectiveness of community-based drug use prevention programs targeting licensed premises.

Alcohol prevention at sporting events: study protocol for a quasi-experimental control group study.

BackgroundAlcohol intoxication and overserving of alcohol at sporting events are of great concern, given the relationships between alcohol consumption, public disturbances, and violence. During recent years this matter has been on the agenda for Swedish policymakers, authorities and key stakeholders, with demands that actions be taken. There is promising potential for utilizing an environmental approach to alcohol prevention as a strategy to reduce the level of alcohol intoxication among spectators at sporting events. Examples of prevention strategies may be community mobilization, Responsible Beverage Service training, policy work, and improved controls and sanctions. This paper describes the design of a quasi-experimental control group study to examine the effects of a multi-component community-based alcohol intervention at matches in the Swedish Premier Football League.MethodsA baseline assessment was conducted during 2015 and at least two follow-up assessments will be conducted in 2016 and 2017. The two largest cities in Sweden are included in the study, with Stockholm as the intervention area and Gothenburg as the control area. The setting is Licensed Premises (LP) inside and outside Swedish football arenas, in addition to arena entrances. Spectators are randomly selected and invited to participate in the study by providing a breath alcohol sample as a proxy for Blood Alcohol Concentration (BAC). Actors are hired and trained by an expert panel to act out a standardized scene of severe pseudo-intoxication. Four types of cross-sectional data are generated: (i) BAC levels among ≥ 4 200 spectators, frequency of alcohol service to pseudo-intoxicated patrons attempting to purchase alcohol at LP (ii) outside the arenas (≥200 attempts) and (iii) inside the arenas (≥ 200 attempts), and (iv) frequency of security staff interventions towards pseudo-intoxicated patrons attempting to enter the arenas (≥ 200 attempts).DiscussionThere is an urgent need nationally and internationally to reduce alcohol-related problems at sporting events, and it is essential to test prevention strategies to reduce intoxication levels among spectators. This project makes an important contribution not only to the research community, but also to enabling public health officials, decision-makers, authorities, the general public, and the sports community, to implement appropriate evidence-based strategies.

Alcohol intoxication at Swedish football matches: A study using biological sampling to assess blood alcohol concentration levels among spectators

Alcohol use and alcohol-related problems, including accidents, vandalism and violence, at sporting events are of increased concern in Sweden and other countries. The relationship between alcohol use and violence has been established and can be explained by the level of intoxication. Given the occurrence of alcohol use and alcohol-related problems at sporting events, research has assessed intoxication levels measured through biological sampling among spectators. This cross-sectional study aimed to assess the level of alcohol intoxication among spectators at football matches in the Swedish Premier Football League. Spectators were randomly selected and invited to participate in the study. Alcohol intoxication was measured with a breath analyser for Blood Alcohol Concentration levels, and data on gender, age, and recent alcohol use were gathered through a face-to-face interview. Blood Alcohol Concentration samples from 4420 spectators were collected. Almost half (46.8%) had a positive Blood Alcohol Concentration level, with a mean value of 0.063%, while 8.9% had a Blood Alcohol Concentration level ≥ 0.1%, with a mean value of 0.135%. Factors that predicted a higher Blood Alcohol Concentration level included male gender (p = 0.005), lower age (p < 0.001), attending a local derby (p < 0.001), alcohol use prior to having entered the arena (p < 0.001), attending a weekend match (p < 0.001), and being a spectator at supporter sections (p < 0.001). About half of all spectators at football matches in the Swedish Premier Football League drink alcohol in conjunction with the match. Approximately one tenth have a high level of alcohol intoxication.

Effectiveness and implementation of a community-based prevention programme targeting anabolic androgenic steroid use in gyms: study protocol of a quasi-experimental control group study

BackgroundDuring the past decades, concerns about increased anabolic androgenic steroid (AAS) use among recreational sportspeople have been raised, yet there is a paucity of AAS prevention efforts targeting this group. Accordingly, doping prevention efforts aimed at gyms have been recommended. The overall objective of the present project is to examine a prevention programme named 100% Pure Hard Training (100% PHT), which targets AAS use among recreational sportspeople training in gyms. Specifically, the project aims to: 1) assess the prevalence of AAS, and its associations with alcohol, illicit drugs, and nutritional supplements use; 2) examine whether 100% PHT can decrease AAS use in gyms, and 3) provide insights into which factors facilitate and/or impede implementation of the programme.Methods/designThe intervention group consists of 27 gyms, and 27 gyms serve as controls. Intervention gyms take part in 100% PHT, a community-based programme involving several components: (a) training of key stakeholders (i.e., gym staff, gym owners, local police, and municipal prevention coordinators) regarding AAS use; (b) developing an action plan for AAS prevention for each gym; (c) certification of gyms that follow 100% PHT; (d) cooperative relationship between stakeholders; (e) annual follow-up of gyms. The project consists of two studies: Study A will examine the prevalence of AAS use and the effectiveness of 100% PHT (aims 1 and 2), and data for Study A will be collected using questionnaires distributed to gym attendees at two assessment points: baseline (pre-intervention) and follow-up (post-intervention). Study B will evaluate the implementation of 100% PHT (aim 3), and semi-structured interviews with participating stakeholders will be carried out post-intervention.DiscussionKnowledge gained from the present project can be used to develop community-based doping prevention efforts aimed at recreational sportspeople training in gyms. Furthermore, it can provide insights into which factors are important for successful implementation of AAS prevention programmes that target gyms. Results are also expected to yield information on the prevalence of AAS use as well as associations between the use of AAS and other licit and illicit substances, including nutritional supplements, among recreational sportspeople.Trial registrationThe study was registered retrospectively at isrctn.com (Identifier: ISRCTN11655041; Registration date: 3 November 2016;).

Public opinion on alcohol consumption and intoxication at Swedish professional football events

BackgroundAlcohol-related problems at professional sporting events are of increasing concern and alarming reports are often reported in international media. Although alcohol consumption increases the risk for interpersonal violence, it is viewed as a focal element of large football events. Sweden has a long tradition of high public support for strict alcohol-control policies. However, little is known about public opinions on alcohol intoxication and the support for interventions to decrease intoxication at football events. The current study explored the public opinion towards alcohol use, intoxication and alcohol policies at professional football matches in Sweden.MethodsA cross-sectional design was utilized and a random general population sample of 3503 adult Swedish residents was asked to participate in a web survey during 2016 (response rate 68%).ResultsIn total, 26% of the respondents supported alcohol sales at football events. Over 90% reported that obviously intoxicated spectators should be denied entrance or evicted from arenas. The support for regulations limiting alcohol availability varied with background factors such as gender, alcohol use and frequency of football event attendance.ConclusionsThere is a strong public consensus for strategies and policies to reduce alcohol sales and intoxication levels at football matches. This public support has implications for our preventive efforts and will facilitate the implementation of strategies and policy changes.

Environmental and capacity requirements are critical for implementing and sustaining a drug prevention program: a multiple case study of “Clubs against drugs”

Background“Clubs against drugs” (CAD) is a comprehensive program with a systems approach to prevention with the intention of preventing drug use in nightclub environment. In 2001 CAD was developed and implemented in Stockholm and was disseminated to 20 other municipalities in Sweden up until 2010. This study investigates the factors related to the implementation and compares Stockholm to the rest of the municipalities.MethodsA sequential exploratory method was used which consisted of three steps including a questionnaire and two rounds of interviews. Questionnaires included all communities and the interviews included twelve respondents from three example municipalities in the first phase and four respondents from Stockholm in the second phase. The interviews were analyzed using content analysis.ResultsIn Stockholm the program was described as having been implemented and sustained over time. The implementation in the example municipalities was perceived as difficult with many obstacles and achieving sustainability was also described as difficult. Two of three municipalities were not active at the time of this study, illustrating that the program only lasted a few years. Factors identified as being related to implementation outcomes were need assessments, participation, support, collaboration and local enthusiasts.ConclusionsThe capacity to implement and sustain CAD differed substantially between Stockholm and the other municipalities. If the prerequisites and capacity are not sufficient the implementation is not likely to be successful, even when the activities are promoted on a national level like CAD. The needs of the interventions and the capacity to implement the program should be examined before adopting the program. This was not done, probably because the drive to spread the activity was not sufficiently questioned.

Alcohol and drug use among staff at licensed premises in Norway

Aims: There is increased concern about the use of alcohol and illicit drugs in nightlife settings. Most studies of substance use in nightlife settings are from the patrons’ perspective, which leaves an understudied population – the nightclub staff. The aim of this paper is to study self-reported alcohol and substance use among staff at licensed premises in Norway: types of illicit drugs used, attitudes towards drugs, and observed drug use among patrons. Methods: A survey was conducted at server-training courses in 20 different cities in Norway during 2015. The survey included: demographics, respondents’ own alcohol and drug experience, attitudes towards drug use, and observed drug use among patrons at licensed premises. Results: Data were collected from 912 staff working at licensed premises. A majority reported alcohol use in the past year, and 61% reported alcohol use two or more times a month. Overall, 45% of the respondents reported ever-used of illicit drugs. The four most commonly used drugs among staff were cannabis, cocaine, ecstasy/MDMA, and amphetamine. The majority of respondents supported Norway’s strict drug laws, and 63% reported observing drug-intoxicated patrons at licensed premises during the past six months. Conclusions: The proportion of frequent drinkers and heavy episodic drinking among staff at licensed premises was high, and the prevalence of illicit drug use was much higher compared with the general population. Thus, staff at licensed premises can be considered a risk-group for alcohol and illicit drug use and therefore represent an important target population in club drug-prevention programmes.

Alcohol policies and attitudes toward alcohol prevention at Swedish student unions

Aims: High alcohol consumption among young adults is of great concern. About half of all young adults in Sweden are university students, and high alcohol consumption is common in this group. This makes student unions a potential arena for alcohol prevention. Little is known about attitudes toward alcohol prevention and to what extent Swedish student unions have written alcohol policies. The aim of the present study was to investigate whether student union representatives consider alcohol to be a problem, their attitudes toward alcohol prevention, the presence of written alcohol policies at student unions, and factors possibly associated with the existence of such policies. Methods: During November 2014, student union representatives (n = 95) were invited to participate in a web-based questionnaire; data were obtained from 78 unions. Results: The majority (93%) reported positive attitudes toward alcohol prevention, and many also recognised that alcohol consumption could be a problem (47%). Furthermore, 81% reported having an alcohol policy at their student union. Unions that frequently arranged pubs were more likely to have a policy (OR = 1.9). Conclusions: Many participants recognised that alcohol consumption could be a problem and reported positive attitudes toward alcohol prevention in the student union setting. This, together with the fact that the majority of student unions had written alcohol policies, suggests that the student union setting is a promising arena for alcohol prevention.