CICA Toolkit

Do you have a role to reduce alcohol harm at a community level?

If you are a commissioner, public health or specialist alcohol practitioner, researcher, or someone else with a role to reduce alcohol harm at a community level, this toolkit could help you to explore how to:

1. Co-design and prepare for roll-out including recruiting volunteer alcohol health champions.
2. Train and support volunteers in alcohol brief advice and/or getting involved in local alcohol licensing decisions.
3. Promote alcohol brief advice activity within a wider systems approach within the whole local alcohol treatment system.
4. Influence local alcohol licensing policy and processes including reviews of Statements of Licensing Policy (SOLPs).
5. Evaluate an alcohol health champions intervention.

To our knowledge, Communities In Charge of Alcohol (CICA) is the first alcohol-focused champion role of its kind to be investigated across multiple intervention sites. It is also the first evaluation of a health champion programme that uses methodological triangulation to strengthen inferences about effectiveness.

What did we find?

There was evidence that lay people trained as alcohol health champions (AHCs) were able to have informal conversations with people drinking alcohol at higher risk levels, demonstrating a level of skill and confidence that can sometimes be absent in health professionals. 

AHCs, their volunteer coordinators, and the public valued the role. However, significant infrastructure is needed to support an intervention such as CICA, and time is needed to develop and embed a group of volunteers.

Despite evidence from the process evaluation of the planned activity taking place at local level, we were not able to show that CICA was effective in reducing the chosen outcome measures: alcohol-related hospital admissions, ambulance call-outs, crime and anti-social behaviour. This meant we were also not able to show CICA was cost-effective. 

Possible explanations for our findings

• The number of champions trained was too small to have a sufficient number of brief advice conversations to generate any measurable effect at the area level of analysis. 
• Alcohol brief advice may not directly impact on the chosen primary health and crime outcomes at a population level, suggesting alternative study designs could be sought.
• AHCs were less willing (and had less opportunity) to get involved with alcohol licensing decisions. Since licensing policies theoretically have an impact at an area level, this would have been more likely to generate a significant area-level effect. 
• The evidence from this study is that communities continue to struggle to influence statutory alcohol licensing processes that affect alcohol availability where they live, and further consideration of how to enable increased community engagement is necessary.

We hope you find this toolkit useful including the Resource Library and free downloads. If you have any questions or would like any further information please do not hesitate to Contact us.