Background
Objectives
Methods
Eligibility criteria for included studies
Interventions
Comparisons
Primary outcomes
Study design
Information sources and search strategy
Study selection/screening
Study (author/s, year) | Reason for exclusion |
---|---|
Bagnardi et al. 2011 [52] | Intervention is not in a sports setting |
Blaszczynski, 2011 [53] | No participants (commentary) |
Bormann and Stone, 2001 [54] | No comparison group |
Caetano et al. 2012 [55] | No participants (editorial) |
Casswell and Gilmore, 1989 [56] | Intervention is not in a sports setting |
Clarkson et al. 2002 [57] | No comparison group |
Donohue et al. 2013 [58] | No participants (review paper) |
Duff and Munroe, 2007 [59] | Does not report an outcome of interest |
Finch and Donaldson, 2010 [60] | No participants (framework development) |
Fromme et al. 1994 [61] | Intervention is not in a sports setting |
Gregory, 2001 [62] | Intervention is not in a sports setting |
Holder and Wagenaar, 1994 [63] | Intervention is not in a sports setting |
Kelly, 2011 [64] | Does not report an outcome of interest |
Kingsland et al. 2015 [65] | Does not report an outcome of interest |
Maclean and Bonington, 2008 [66] | No participants (commentary) |
Mann and Wickens, 2012 [67] | No participants (commentary) |
Marcello et al. 1989 [68] | Intervention is not in a sports setting |
Mentha and Waterman, 2009 [69] | No comparison group |
O’Farrell et al. 2010 [14] | No comparison group |
Pridemore et al. 2013 [70] | No comparison group |
Reboussin et al. 2012 [71] | No comparison group |
Rooney, 1984 [72] | No comparison group |
Rossow and Norstrom, 2012 [73] | Intervention is not in a sports setting |
Rowland et al. 2012a [29] | No comparison group |
Rowland et al. 2012b [31] | No comparison group |
Rowland et al. 2012c [74] | Cross-sectional study design |
Rowland et al. 2012d [30] | Cross-sectional study design |
Schewe et al. 1984 [75] | Does not report an outcome of interest |
Shakeshaft et al. 2014 [76] | Intervention is not solely in a sports setting |
Stuart et al. 2013 [77] | Intervention is not in a sports setting |
Thombs, 2002 [78] | Intervention is not in a sports setting |
Tricker, 1996 [79] | Intervention is not in a sports setting |
Trolldal et al. 2013 [80] | No comparison group |
Wagenaar et al. 2000 [81] | Community-wide intervention not specifically in a sports setting |
Warpenius et al. 2010 [82] | Community-wide intervention not specifically in a sports setting |
Watten, 1995 [83] | Intervention is not in a sports setting |
Yoruk, 2014 [84] | Intervention is not in a sports setting |
Data extraction
Study | Study design/setting | Participants | Intervention and control conditions | Outcomes of interest to the review |
---|---|---|---|---|
Carr 1992 [42] | Individually randomised trial Olympic Training Centre (OTC) in Colorado Springs, Colorado, USA. | Eight resident teams of elite athletes representing archery, gymnastics, shooting, table tennis and handball. Intervention group: 30 athletes; control group: 23 athletes Age: mean 21.3 (SD 4.1) Gender: males 59 %, females 41 % Inclusion criteria: athletes in resident training programmes at the OTC. | Intervention condition: multimodal substance abuse programme based on a cognitive-behavioural model, which included: • education component (2.5 h) • decision-making/coping skills component (3 h) • social skills/self-esteem component (2.5 h). Each component included lecture presentations, group discussions, role-play exercises, and written materials. Control condition: no intervention. Intervention offered after trial period. | All outcomes were assessed at pre-test, post-test and at the end of a 7-week follow-up period via self-completed questionnaires. • Frequency of use of alcohol in the last month • Change score for frequency of use in alcohol in the last month from pre-test to follow-up, coded as: 1 = decrease in use 2 = no change 3 = increase |
Kingsland et al. 2015 [44] | Cluster randomised controlled trial Non-elite, community football clubs within the Hunter, New England and Sydney regions of New South Wales, Australia | Eighty-eight football clubs (rugby league, rugby union, soccer/association football and Australian rules football) and club members. Intervention group: 43 clubs; 700 members at pre-intervention cross section; 567 members post-intervention cross section. Control group: 45 clubs; 711 members pre-intervention cross section; 577 members post-intervention cross section. Members pre-intervention: Age: average 30 years+ Gender: intervention group 77.4 % male; control group 87 % male) Role: intervention group 60 % players, 26 % members/supporters, 14 % officials; control group 47 % players, 36 % members/supporters, 17 % officials. Inclusion criteria: Clubs: community level, non-elite football clubs who had over 40 members, sold alcohol and were not participating in an alcohol management improvement program. Members: club member who were 18+ years and spoke English | Intervention condition: 2.5 year accreditation programme which included: • Adherence to liquor licence requirement in terms of signage and alcohol service hours and areas • Staff trained in responsible service of alcohol • Water and substantial food is provided • Intoxicated people not permitted to enter, not served alcohol and not permitted to remain at the club • Alcoholic drinks are only served in standard drink measures • Club maintains a register of alcohol-related incidents • Bar servers do not consume alcohol • Non-alcoholic drinks and low-alcoholic drinks are available and are cheaper than full-strength alcoholic drinks • Club does not serve ‘shots’ or double-nips of alcohol or ready-to-drink products over 5 % alcohol/volume • Club does not conduct drinking games/promotions that encourage risky alcohol consumption • Club has some sponsorship that is not from the alcohol industry • Club has developed a written alcohol management policy and distributed it to members.
Implementation supports: based on theoretical frameworks for organisational change and consisted of: project officer support, implementation cost recovery, accreditation and associated merchandise, printed resources and newsletters, observational audits and feedback online training and letters of support from state sporting organisation. Control condition: control (and intervention) clubs were given printed resources on topics unrelated to the trial outcomes. | All outcomes were assessed at pre- and post-intervention using self-reported measures collected via telephone survey. • Risky alcohol consumption defined as ≥5 standard drinks on the one occasion • Alcohol Use Disorders Identification Test (AUDIT): ▪ Median total AUDIT score ▪ Total AUDIT score of ≥8 (indicative of hazardous consumption) ▪ Alcohol consumption subscale (score ≥6 for items 1–3) ▪ Dependency subscale (score of ≥4 for items 4–6) ▪ Alcohol-related problems subscale (score ≥1 for items 7–10). All outcome analyses adjusted for clustering and pre-intervention values. |
O’ Farrell 2010 [43] | Cluster randomised controlled trial Gaelic Athletic Association (GAA) amateur sporting clubs in the Republic of Ireland. | Forty-one hurling, Gaelic football and handball clubs within two counties in Ireland and club players. Intervention group: 12 clubs; 332 members at pre-intervention; 218 members post-intervention. Control group: 29 clubs; 628 members pre-intervention; 441 members post-intervention. Players pre-intervention: Mean age: 24 years Gender: All male Inclusion criteria: clubs: within two study counties in Ireland Players: uninjured GAA male club players aged 16 years and above. | Intervention condition: Community mobilisation approach targeting the club environment and individual player behaviour implemented over four months. Intervention included: • Alcohol education for the players (1x50mins) • Alcohol education for coaches (1x40mins) • Alcohol policy training for club managers and coaches (1 × 40 min) • Alcohol information media campaign
Implementation supports: health promotion staff, presentation materials, handouts and advertising materials. Control condition: control (and intervention clubs) received an education session on sports nutrition. | All outcomes were assessed at pre- and post-intervention using self-reported measures via paper questionnaires: • Alcohol use disorder identification test (AUDIT): ▪ Mean total AUDIT score ▪ Total AUDIT score of ≥ 8 ▪ AUDIT hazardous alcohol use subscale (score ≥6 for items 1–3) ▪ AUDIT dependency subscale (score ≥4 for items 4–6) ▪ AUDIT harmful alcohol use subscale (score ≥1 for items 7–10). • Yearly alcohol consumption (litres of pure alcohol) • ≥21 standard drinks per week • Binge drinking (≥6 drinks one sitting) • Mean alcohol-related harms score (of total of 13) |
Assessment of risk of bias
Data synthesis and analysis
Assessment of study heterogeneity
Results
Results of the search
Excluded studies
Characteristics of included studies
Risk of bias in included studies
Effect of intervention
Study | Intervention effects on outcomes of interest to the review |
---|---|
Carr 1992 | Frequency of alcohol use No significant difference was reported between the groups at pre-test (X
2 = 5.94, P = 0.20), post-test (X
2 = 5.48, P = 0.24) or follow-up (X
2 = 5.96, P = 0.20). Change score Significant difference between the treatment and control group at follow-up (X
2 = 6.42, P < 0.05). In the treatment group, 3.6 % reported decreased use, 89.3 % no change and 7.1 % increased use. In the control group, 21.1 % reported decreased use, 57.9 % no change and 21.1 % increased use. |
Kingsland et al. 2015 | Risky alcohol consumption At baseline, 27 % of intervention club and 25 % of control club members reported risky alcohol consumption. Post-intervention, 19 % of intervention club members reported risky alcohol consumption compared to 24 % of control club members (OR = 0.63 95 % CI 0.40–1.00, P = 0.05). Median total AUDIT score (min, max) Pre-intervention: control 7 (0, 26), intervention 8 (0, 28); post-intervention: control 7 (0, 25), intervention 6 (0, 26) (P < 0.01). Total AUDIT score ≥8 Pre-intervention: control 46 %, intervention 54 %; post-intervention: control 45 %, intervention 38 % (OR = 0.58 (95 % CI 0.38–0.87, P < 0.01). AUDIT alcohol consumption subscale Pre-intervention: control 57 %, intervention 61 %; post-intervention: control 55 %, intervention 47 % (OR = 0.60 95 % CI 0.41–0.87 P value <0.01). AUDIT alcohol dependence subscale Pre-intervention: control 3 %, intervention 4 %; post-intervention: control 4 %, intervention 1 % (OR = 0.20 95 % CI 0.06–0.65 P value <0.01). Alcohol-related problems subscale Pre-intervention: control 48 %, intervention 56 %; post-intervention: control 45 %; intervention 41 % (OR = 0.67 95 % CI 0.43–1.03 P value 0.03). |
O’ Farrell 2010 | Mean total AUDIT score Post-intervention: control 11.0 (95 % CI 10.4–11.7); intervention 11.0 (95 % CI 10.0–11.4); P = 0.94. Total AUDIT score ≥8 Post-intervention: control 69.9 % (95 % CI 64.1–76.8), intervention: 72.2 (95 % CI 63.7–80.6); P = 0.66. AUDIT hazardous alcohol use subscale Post-intervention: control 95.1 % (95 % CI 92.6–97.6); intervention 95.0 % (95 % CI 91.5–98.6); P = 0.97. AUDIT dependency subscale Post-intervention: control 60.5 % (95 % CI 53.2–67.8), intervention 59.7 % (95 % CI 49.2–70.1); P = 0.90. Harmful alcohol use subscale Post-intervention: control 68.5 % (95 % CI 63.1–73.8), intervention 74.8 % (95 % CI 67.1–85.6); P = 0.17. Mean yearly consumption Post-intervention: control 11.6 L (95 % CI 9.2–14.2), intervention 8.8 L (95 % CI 5.6–12.1); P = 0.17. ≥21 standard drinks per week Post-intervention: control 28.5 % (95 % CI 21.4–35.7), intervention 20.1 % (95 % CI 10.6–29.5); P = 0.15. Binge drinking Post-intervention: control 43.5 % (95 % CI 35.2–51.8), intervention 49.1 % (95 % CI 37.8–60.3); P = 0.42. Mean alcohol harm score Post-intervention: control 3.0 (95 % CI 2.5–3.6), intervention 2.5 (95 % CI 1.7–3.3); P = 0.26. |