Communities In Charge of Alcohol (CICA) takes an Asset Based Community Development approach to reducing alcohol harm. Through a cascade training model, supported by a designated local co-ordinator, local volunteers are trained to become accredited ‘Alcohol Health Champions’ to provide brief opportunistic advice at an individual level and mobilise action on alcohol availability at a community level. The CICA programme is the first time that a devolved UK region has attempted to coordinate an approach to building health champion capacity, presenting an opportunity to investigate its implementation and impact at scale.
CICA aims to target alcohol harm at two levels: by influencing individuals (through brief interventions) and communities (through reducing the availability of alcohol). Led by the team at Salford, the project is a partnership between the University of Salford, University of Bristol, the University of York and Greater Manchester Health and Social Care Partnership, the Royal Society for Public Health – and all ten Greater Manchester Local Authorities.
Three stages of evaluation are being undertaken:
A process evaluation to understand the context and factors that enable or hinder the intervention and obtain process measures
An outcome evaluation that compares CICA areas with matched comparison areas in terms of hospital admissions, A&E attendances, ambulance call outs and levels of crime
An economic evaluation to find out whether the CICA programme is worth investing in
In the first year, 123 alcohol health champions were trained and over 1100 brief conversations with family, friends, colleagues and community members held. AHCs have reported having impact on others through signposting to other services, improving knowledge of others. Many AHCs report increased social value gained from being an AHC and many have acquired new jobs or moved back into training or education as a result of increased confidence and a sense of making a difference in their communities.
“A pioneering programme led by community volunteers who are trained to help family, friends and colleagues to rethink their drinking habits, with a view to reducing excessive drinking across the Greater Manchester region” Professor Kate Ardern, Director of Public Health, Wigan Council and GM Lead DPH for Drugs and Alcohol Harm Reduction
“Tackling alcohol harm in the UK needs law-makers, healthcare professionals and our communities to work together to create lasting healthy habits and improve our relationship with alcohol. We welcome this initiative which will empower communities to influence licensing decisions and the availability of alcohol in their area which should help to create a healthier, safer environment for all. It is vital that these community champions are working closely with existing hospital and community alcohol teams so that patients in need can access the most appropriate services and are receiving consistent advice” Professor Sir Ian Gilmore, Chair of the Alcohol Harm Alliance UK,
“I’ve had a lived experience of substance issues myself, and I’ve been known for that in my community that so now when they come into the library and they see me doing my role as an alcohol champion it makes them so much more aware of, if Lee can turn his life around and be doing something positive, then why can’t all the community join in and do the same thing”? Lee Hall, Alcohol Health Champion, Manchester
If shown to be successful CICA will be rolled out in GM, while national decision makers will be briefed on opportunities for UK roll-out. Interest in CICA has been shown both internationally and nationally, including by the All Party Parliamentary Group on Alcohol Harm.
Funder: National Institute for Health Research (NIHR) Public Health Programme
Team: Professor Penny Cook, Liz Burns, Dr Margaret Coffey, Dr Cathy Ure, Suzy Hargreaves and collaborators from the University of Bristol, University of York and the Royal Society for Public Health