HOW DO ADULTS IN NORTH GLASGOW RELATE WITH ALCOHOL A QUALITATIVE STUDYWITH ALCOHOL – A QUALITATIVE STUDY

PRESENTER SUPERVISORSOKON, MARIAN EMMANUEL Mr William Spence

Dr Deborah Shiptonp

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BACKGROUNDBACKGROUNDAlcohol - Scotland’s economy, escalating evidence of alcohol misuse (Room et al., 2005, Beeston et al., 2011)In Scotland - alcohol related mortality: 12/100,000 (1982) - 28/100,000 populationIn Scotland alcohol related mortality: 12/100,000 (1982) 28/100,000 population (2003); 2003 and 2012; 36% fall (Beeston et al., 2013; Scottish Government, 2013). Alcohol related acute hospital discharge - 800/100,000 population (2007/2008); 691/100 000 population (2011/12) (Beeston et al 2013)691/100,000 population (2011/12) (Beeston et al., 2013). Though there are recent decline in the above statistics, alcohol related mortality in Scotland is double that of England and Wales (combined) (Beeston et al., 2013);

Men: 28/100,000 compared to 16/100,000 population (2011) Women:14/100,000 compared to 8/100,000 population (2011)

Huge cost of alcohol misuse to Scotland : £1.13 billion in 2002/2003; £3.6 billion inHuge cost of alcohol misuse to Scotland : £1.13 billion in 2002/2003; £3.6 billion in 2007 (Bromley et al., 2008; The Scottish Government, 2010).

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Ai d Obj tiAim and Objectives

Aim: To understand how communities relate with alcohol as well as explore people’s views on what actions are necessary to reduce alcohol harms and to also identify the barriers that may pose challenge to effective action on alcohol misuse.

Objectives:To explore the views of the people who live in North Glasgow on the beliefs and culture relating to alcohol consumption in their communitiesculture relating to alcohol consumption in their communities.To identify the factors that impact on alcohol consumption and the barriers that may pose challenge to effective action on alcohol misuse in the people who live in North GlGlasgow.

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Alcohol related mortality in Glasgow and Scotlandy g

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North Glasgow (GCPH, 2008)g

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Alcohol related mortality in North East and North West Glasgowy g

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PARTICIPANTSThe members of the communities in North Glasgow: Councillors and other members of the general

public

Ad lt ( d 18 d b )Adults (aged 18 and above)

Alcohol drinkers and non drinkers

l f i h i b k dPeople from various ethnic backgrounds

Location SIMD 1 (Most deprived) – SIMD 5 (Least deprived)

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METHODOLOGYMETHODOLOGYPilot study: seven participants

Identify methodological weaknesses/improve the researcher ‘s skills (Kvale, 2008).Purposive sampling (30) : four focus groups (n=13) and individual interviews (n=17) Location - North Glasgow; North Maryhill, Possilpark, Springburn, Partick, Hillhead Qualitative methodology (Ritchie and Lewis 2003)Qualitative methodology (Ritchie and Lewis, 2003). The theoretical framework - interpretivist point of view (Ulin et al, 2004).Primary data collection method - Focus group discussions and individual interviews

The focus groups- data on subjective understandings of different and collective views and generated due to the interaction of the participants (Liamputtong, 2011). Interviews employed semi-structured interviews (Gill et al 2008)Interviews employed semi structured interviews (Gill et al, 2008).

Analysis: by CADQAS - Nvivo (Bryman, 2012) and 12 themes / subthemes emerged. Member checking - 17 participantsEthical Approval - UoG College of MVLS 4th of April 2014.

Issues around informed consent, confidentiality, anonymity, risks & voluntary participation were addressed (MRC, 2012)

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Demographic InformationDemographic InformationParticipants

ages from 18 to 60 years d 18 f l / 12 lgender : 18 females / 12 males

categories of people - students, health workers, Glasgow city councillors, members of religious bodies, university teachers and unemployed people Drinking status - 21 alcohol drinkers and 9 non-drinkersEthnicity - 7 white Scottish, 1 black British, 8 black African and 14 from other white backgrounds

Residential location of the participants cut across all the SIMD quintiles:

SIMD 1 2 3 4 5. Quintile

n 10 3 4 3 7

three not categorized into any SIMD quintile. 9

RESULTSRESULTSThe beliefs and perceptions on alcohol misuse and its related harms

It has been reported that alcohol misuse has a huge negative impact on people’s health, healthcare and social services and the economy (Scottish Government, 2013).health, healthcare and social services and the economy (Scottish Government, 2013). This was reflected in the views of the participants in this research. For example;

(IG4 F): “ I can hear a lot of noise and things at night late at night especially at(IG4, F): “…I can hear a lot of noise and things at night, late at night, especially at weekends [...] with people being drunk emm…usually at the weekends [...] noise, emm…bottles being smashed on the street…..lots of aggression and some violence….”.

(FG3, 1, M): “[…] they are admitted in the hospitals which also could lead to increase budget for the NHS […] so looking….considering the NHS perspective, I think g [ ] g g p p ,alcohol also serve as a burden to NHS….”.

(IC5, M): “…there are issues to do with the effect upon the individual emm […] the(IC5, M): …there are issues to do with the effect upon the individual emm […] the physical health in relation to personal safety, the harm they can do to themselves, while in the influence emm excessive alcohol […] the effect it has upon their immediate relationships and family…”.

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RESULTSRESULTSParticipants believed that people in their community were not aware of the safe levels of drinking or cannot practically translate the recommended drinking levels to the quantity of alcohol they drink. For example;quantity of alcohol they drink. For example;

(IC4, F): “I think people delude themselves […] I thought I knew about alcohol but actually I don’t think I did emm you know I went home and I talked to my familyactually, I don’t think I did emm…you know I went home and I talked to my family and said….you know, see this amount…that’s your whole week amount you’ve just had right there…you know and emm…they were surprised, I think people don’t…”.

(IG8, M): “…not usually unless they are given a sort of external frame of reference […] that is when they usually start questioning themselves, as in maybe this isn’t the only way to drink but until that point happens, a lot of people might not even consider y y p pp , p p gthinking about alcohol consumption as a variable thing…”.

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RESULTSRESULTSThe participants believed that the drinking culture in their communities revolved around the use of alcohol majorly as a social stimulant or lubricant. These views are in line with previous studies (Pavis et al, 1997) and indicate that this culture isin line with previous studies (Pavis et al, 1997) and indicate that this culture is embedded in people’s daily lives. For example;

(IG8 M) “ ll it’ t f lik t d i i t l i t ti(IG8, M): “…well, it’s sort of like emm….an expected presence in societal interaction, you know […] you are expected to sort of drink as a basis of your social foundation…”.

(IC5, M): “…births, marriages, deaths and so on…and that sort of ritual points in life […] people get together and they expect that there would be alcohol…”.

(IG2, M): “…it’s about, it’s pressure to drink because everyone is drinking, pressure to celebrate life events and to commiserate with alcohol and I think that people, as a culture in Scotland [ ] I mean its its (stutters) inherent in Scottish culture”culture in Scotland […] I mean its…its…(stutters)….inherent in Scottish culture .

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RESULTSRESULTSReduction of alcohol misuse and harms and its barriers

Participants’ views on how to reduce alcohol misuse and harms included: reducing alcohol availability increasing alcohol price/minimum unit pricing communityalcohol availability, increasing alcohol price/minimum unit pricing, community development programmes, awareness creation, restricting media promotion of alcohol use and restricting internet sales of alcohol. For example;

(FG2, 2, F): “…I think a major problem is those giant bottles emm […] when you see somebody getting really drunk and you see them with a bottle of that just in their hand and that’s what they have been drinking [ ] minimum pricing things likehand and that’s what they have been drinking […] minimum pricing…things like that, I think that would really get people to think twice about buying it….”.

(IG2 M) “ d l t i i f th l b I id it’ t(IG2, M): “we need a lot more provision for youth clubs, emm… as I said, it’s not only young people that have such problem but if we start with the young people, and we socialise young people, to realise that alcohol was not the centre of their lives emm…, ,

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RESULTSParticipants picked up on a number of barriers which could impact on any alcohol strategy and they were; culture, media and alcohol marketing, the power of alcohol industries and retailers as well as internet sales of alcohol. For example;

(FG2, 2, F): “…Scotland has a very old culture, you know….it’s been kind of building up for thousands of years in a way and I think it’s…you know people use to drink beer instead of water […] but you can’t really change a culture that has been building up for so many years…”.

(IC1, F): “….one big issue is marketing […] create a scene in a film, often drinks are used emm…to act the character, to make it more interesting [...]”.

(IC4, F): “…the alcohol industry, the license industry….seems to always win the argument which y y y gis I find that incredible, emm…we let them get away with, we didn’t let tobacco industry get away with it…the way the law is set at the moment….there is a presumption…an assumption that we would grant a license application unless there is a really…really good reason not to […]”

(IC3, F): “…is concerning for me because the controls...there’s minimal controls in […] what age the person is […] if you’re buying it online, it’s very difficult to monitor, to implement controls”

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CCONCLUSION AND RECOMMENDATION

Most of the findings of this research were consistent with those in other studies but the following where highlighted in this research; .

The views and perceptions of people who live in the communities in North Glasgow around alcoholThe perceived culture around alcohol consumption in the communities in North GlasgowThe barriers to effective reduction of alcohol misuse and harms in the communities inThe barriers to effective reduction of alcohol misuse and harms in the communities in North Glasgow

However, to develop effective alcohol strategies in the communities in North Glasgow, th i h ld b l k d tthese views should be looked at.

RECOMMENDATIONMore representative sample/evaluation of the barriers

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SSTRENGTHS AND LIMITATIONS

StrengthsMember checking; to ensure accuracy and validity of the data (Creswell and Miller, 2000). A semi-structured schedule; to obtain extract in-depth meaning from their responses.; p g pPilot study; to identify and correct the weakness and limitations of the research design.

Li it tiLimitationsSome participants lived in these communities for a short period of timeDuration of some interviews were quite shortSmall sample size due to short duration for the project

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BEESTON, C., REID, G., ROBINSON, M., CRAIG, N., MCCARTNEY, G., GRAHAM, L. & GRANT, I.

GLASGOW CENTRE FOR POPULATION HEALTH (GCPH). (2014). Briefing Paper Findings

RITCHIE, J. & LEWIS, J. (2003). Qualitative research practice: A guide for social science students

(2013). Monitoring and Evaluating Scotland’s Alcohol Strategy: Third Annual Report. Edinburgh: NHS Health Scotland.

BEESTON C ROBINSON M CRAIG N &

( ) ( ) f g p gSeries 42: Alcohol-related harm in Glasgow: Appendix 2. [Online] Available from: http://www.gcph.co.uk/assets/0000/4260/Appendix_2.pdf. [Accessed: 05th June 2014].

p g fand researchers. London: Sage.

ROOM, R., BABOR, T. & REHM, J. (2005). Alcohol and public health. The lancet, 365, 519-530.

BEESTON, C., ROBINSON, M., CRAIG, N. & GRAHAM, L. (2011). Monitoring and Evaluating Scotland’s Alcohol Strategy. Setting the Scene: Theory of change and baseline picture. Edinburgh: NHS Health Scotland.

GLASGOW CENTRE FOR POPULATION HEALTH (GCPH). (2008). A Community Health and Wellbeing Profile for North Glasgow. [Online] Available from: http://www.gcph.co.uk/assets/0000/0625/NorthGlasg

SCOTTISH GOVERNMENT. (2010). The Societal Cost of Alcohol Misuse in Scotland for 2007. Available from: http://www.scotland.gov.uk/Resource/Doc/297819/0092744 pdf [Accessed: 19th June 2014]

BROMLEY, C., CORBETT, J., ERENS, B. & MOODY, A. (2008). Scottish Health Survey 2003: Revised Alcohol Consumption Estimates. Edinburgh: The Scottish Government.

p g p gow.pdf . [Accessed: 28th October 2014].

KVALE, S. (2008). Doing interviews. London: Sage.

92744.pdf. [Accessed: 19th June 2014].

SCOTTISH GOVERNMENT. (2013). Scottish Health Survey 2012: Volume 1 Main Report. [Online] Available from:

BRYMAN, A. (2012). Social research methods. 4th Ed. New York: Oxford university press.

CRESWELL, J. W. & MILLER, D. L. (2000).

LIAMPUTTONG, P. (2011). Focus Group Methodology: Principle and Practice. Los Angeles: SAGE.

MEDICAL RESEARCH COUNCIL (MRC). (2012).

http://www.scotland.gov.uk/Publications/2013/09/3684/7. [Accessed: 5th May 2014].

ULIN, P. R., ROBINSON, E. T. & TOLLEY, E. E. (2004). Qualitative methods in public health: a field ( )

Determining validity in qualitative inquiry. Theory into Practice, 39, 124-130.

GILL, P., STEWART, K., TREASURE, E. & CHADWICK B (2008) Methods of data collection

( ) ( )MRC ethics series: Good research practice: Principles and Guidelines. [Online] Available from: http://www.mrc.ac.uk/documents/pdf/good-research-practice-principles-and-guidelines/. [Accessed: 13th May 2014].

( ) Q p fguide for applied research. [Online] Hoboken: John Wiley & Sons. Available from: http://books.google.co.uk/books?id=PLz_UNIDveYC&printsec. [Accessed: 16th May 2014].

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CHADWICK, B. (2008). Methods of data collection in qualitative research: interviews and focus groups. British dental journal, 204, 291-295. PAVIS, S., CUNNINGHAM-BURLEY, S. &

AMOS, A. (1997). Alcohol consumption and young people: exploring meaning and social context. Health Education Research, 12, 311-322.

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