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. 2022 Sep;30(5):e2737-e2749.
doi: 10.1111/hsc.13717. Epub 2022 Jan 17.

A mixed methods analysis evaluating an alcohol health champion community intervention: How do newly trained champions perceive and understand their training and role?

Suzy C Hargreaves  1 , Cathy Ure  1 , Elizabeth J Burns  1 , Margaret Coffey  1 , Suzanne Audrey  2 , Kate Ardern  3 , Penny A Cook  1
Affiliations

A mixed methods analysis evaluating an alcohol health champion community intervention: How do newly trained champions perceive and understand their training and role?

Suzy C Hargreaves et al. Health Soc Care Community. 2022 Sep.

Abstract

Globally, alcohol harm is recognised as one of the greatest population risks and reducing alcohol harm is a key priority for the UK Government. The Communities in Charge of Alcohol (CICA) programme took an asset-based approach in training community members across nine areas to become alcohol health champions (AHCs); trained in how to have informal conversations about alcohol and get involved with alcohol licensing. This paper reports on the experiences of AHCs taking part in the training through the analysis of: questionnaires completed pre- and post-training (n = 93) and semi-structured interviews with a purposive sample of five AHCs who had started their role. Questionnaires explored: characteristics of AHCs, perceived importance of community action around alcohol and health, and confidence in undertaking their role. Following training AHCs felt more confident to talk about alcohol harms, give brief advice and get involved in licensing decisions. Interviews explored: AHCs' experiences of the training, barriers and facilitators to the adoption of their role, and how they made sense of their role. Four overarching themes were identified through thematic analysis taking a framework approach: (a) perceptions of AHC training; (b) applying knowledge and skills in the AHC role; (c) barriers and facilitators to undertaking the AHC role; and (d) sustaining the AHC role. Findings highlight the challenges in establishing AHC roles can be overcome by combining the motivation of volunteers with environmental assets in a community setting: the most important personal asset being the confidence to have conversations with people about a sensitive topic, such as alcohol.

Keywords: alcohol; brief intervention; community; licensing; public health.

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Conflict of interest statement

In this early phase of the intervention AHCs had not experienced many barriers in offering brief advice, although they were aware of potential barriers. One example was in setting up a drop‐in service, which was felt to ‘restrict people’ who were concerned they might be seen attending a particular location, such as a specific café, that they would not normally attend. There were also concerns that members of the wider community might be ‘a bit aggressive’ towards AHCs, although these were hypothetical concerns at this stage of their role.

Negotiating licensing processes was viewed as a potential barrier, ‘full of bureaucracies’. However, when faced with this, Peter felt that it was ‘easier to go in’ to the licensed premises to discuss issues directly than go through the paperwork of putting in an official representation (commenting/complaining in writing to the licensing authority), thus working around the barrier showing a positive example of AHC action. Peter applied his new knowledge of alcohol licensing legislation (Licensing Act 2003) to talk to an initially defensive manager of a pub (public house; licensed to sell/supply alcohol ‘on the premises’), who felt that issues of litter, empty glasses and noise around his premises were ‘not a licensing issue’. To maintain a positive relationship with the local community, Peter reminded the manager of his responsibility to the neighbourhood and this had the positive outcome of reducing some of the anti‐social behaviour around the premises:

Clear the glasses, tell them if they want a drink go inside but don’t have them sitting out at two and three in the morning chatting away because you’re making money…He said yeah but when I shut the door they’re outside they can do what they want. Well then you need to know, if they’re your clients at the pub, that there’s kids across the road that need sleeping…That’s how it went…’cos he was being all defensive like, it’s outside the pub, it’s not a licensing thing…and we’re neighbours. (Peter, Area 6)

An example of a more definite barrier was identified by Amy, who had a potential conflict of interest regarding taking licensing action due to working part time in a pub. Amy felt ambivalent about raising concerns about a pub setting:

Yeah, I’m not a complainer really. That’s just me…I probably wouldn’t do it for a pub, but I might do it for a shop. ‘Cos I think pubs have to earn a living and I don’t know. I think if you’re going into a pub, you know you want a drink. If you’re going into a shop, I don’t know… (Amy, Area 8)

Perhaps more pervading was a socio‐cultural barrier to making complaints within a community: ‘We don't grass each other up’ (Peter, Area 6).

KA is a trustee of the RSPH. SA is a member of the NIHR public health research board. All other authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Thematic map: early perceptions and experiences of AHC role
See this image and copyright information in PMC

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