PDF(Pubmed)
Abstract：
BACKGROUND: Harms associated with the use of alcohol and other drugs (AOD) in licensed entertainment settings (LES) and outdoor music festivals (OMF) are ongoing public health and criminal justice concerns. This systematic review provides a comprehensive, synthesized report on the evidence base of interventions that impact harm in these settings, and how they affect health, behavioral, and criminal justice outcomes.
METHODS: Nine databases were searched for experimental and observational studies published between 2010 and 2021. Studies were included if they were peer-reviewed, published in English, described interventions which could impact AOD-related harms in LES or OMF (and were delivered in these environments), and reported on health, criminal justice and/or behavioral outcomes. Methodological quality was assessed using the Effective Public Health Practice Project\'s Quality Assessment Tool for Quantitative Studies and the Critical Appraisal Skills Program for qualitative studies. A narrative synthesis was conducted to synthesize outcomes across studies. The review protocol was registered in PROSPERO (CRD42020140004).
RESULTS: Of the 48,303 studies screened, 100 met the inclusion criteria. 86 focused solely on reducing alcohol-related harm, 7 on reducing illicit drug-related harm, and 7 on both. Most (n = 88) focused on LES and evaluated changes in laws and regulations (n = 28) and/or multicomponent interventions/policies (n = 41). Multicomponent interventions showed the best results for both health (62% positive) and criminal justice (84% positive) outcomes, with 71% of studies being rated as strong quality. There was also good evidence to support the careful application of trading hour restrictions and limited but promising evidence to support medical services and drug checking.
CONCLUSIONS: The breadth, quality and volume of evidence regarding what works in reducing AOD-related harm in recreational settings have increased in the past decade, particularly regarding LES. Findings support onsite medical services (reducing ambulance transfer rates), multicomponent interventions targeting alcohol accessibility and availability (reducing assaults), and drug checking services, but suggest other interventions such as drug detection dogs may exacerbate harm. Further, higher quality research is required to address identified gaps in the evidence base, particularly on optimal interventions within OMF, around illicit drugs more broadly and in the Global South.
METHODS: Nine databases were searched for experimental and observational studies published between 2010 and 2021. Studies were included if they were peer-reviewed, published in English, described interventions which could impact AOD-related harms in LES or OMF (and were delivered in these environments), and reported on health, criminal justice and/or behavioral outcomes. Methodological quality was assessed using the Effective Public Health Practice Project\'s Quality Assessment Tool for Quantitative Studies and the Critical Appraisal Skills Program for qualitative studies. A narrative synthesis was conducted to synthesize outcomes across studies. The review protocol was registered in PROSPERO (CRD42020140004).
RESULTS: Of the 48,303 studies screened, 100 met the inclusion criteria. 86 focused solely on reducing alcohol-related harm, 7 on reducing illicit drug-related harm, and 7 on both. Most (n = 88) focused on LES and evaluated changes in laws and regulations (n = 28) and/or multicomponent interventions/policies (n = 41). Multicomponent interventions showed the best results for both health (62% positive) and criminal justice (84% positive) outcomes, with 71% of studies being rated as strong quality. There was also good evidence to support the careful application of trading hour restrictions and limited but promising evidence to support medical services and drug checking.
CONCLUSIONS: The breadth, quality and volume of evidence regarding what works in reducing AOD-related harm in recreational settings have increased in the past decade, particularly regarding LES. Findings support onsite medical services (reducing ambulance transfer rates), multicomponent interventions targeting alcohol accessibility and availability (reducing assaults), and drug checking services, but suggest other interventions such as drug detection dogs may exacerbate harm. Further, higher quality research is required to address identified gaps in the evidence base, particularly on optimal interventions within OMF, around illicit drugs more broadly and in the Global South.
摘要：
背景：在许可娱乐环境（LES）和户外音乐节（OMF）中使用酒精和其他药物（AOD）的危害是持续存在的公共卫生和刑事司法问题。这个系统的审查提供了一个全面的，关于在这些环境中影响危害的干预措施的证据基础的综合报告，以及它们如何影响健康，行为，和刑事司法结果。
方法：搜索了9个数据库，寻找2010年至2021年发表的实验和观察性研究。如果是同行评审的研究，以英文出版,描述了可能影响LES或OMF中AOD相关危害的干预措施（并在这些环境中交付），并报告健康状况，刑事司法和/或行为结果。使用有效公共卫生实践项目的定量研究质量评估工具和定性研究关键评估技能计划评估方法质量。进行了叙述性综合，以综合研究的结果。审查方案在PROSPERO(CRD42020140004)中注册。
结果：在筛选的48,303项研究中，100人符合纳入标准。86只专注于减少与酒精有关的伤害，7关于减少与非法药物有关的伤害，7在这两个大多数（n=88）专注于LES，并评估了法律法规（n=28）和/或多组分干预/政策（n=41）的变化。多组分干预措施对健康（62％积极）和刑事司法（84％积极）结果均表现出最佳效果。71%的研究被评为高质量。也有充分的证据支持谨慎应用交易时间限制，并有有限但有希望的证据支持医疗服务和药物检查。
结论：广度，在过去十年中，关于在娱乐环境中减少AOD相关伤害的证据的质量和数量有所增加，尤其是LES。调查结果支持现场医疗服务(降低救护车转运率)，针对酒精可及性和可用性的多组分干预措施(减少攻击)，和毒品检查服务，但建议其他干预措施，如药物检测狗可能会加剧伤害。Further,需要更高质量的研究来解决证据基础中发现的差距，特别是在OMF内部的最佳干预措施上，更广泛地和全球南方的非法药物。
方法：搜索了9个数据库，寻找2010年至2021年发表的实验和观察性研究。如果是同行评审的研究，以英文出版,描述了可能影响LES或OMF中AOD相关危害的干预措施（并在这些环境中交付），并报告健康状况，刑事司法和/或行为结果。使用有效公共卫生实践项目的定量研究质量评估工具和定性研究关键评估技能计划评估方法质量。进行了叙述性综合，以综合研究的结果。审查方案在PROSPERO(CRD42020140004)中注册。
结果：在筛选的48,303项研究中，100人符合纳入标准。86只专注于减少与酒精有关的伤害，7关于减少与非法药物有关的伤害，7在这两个大多数（n=88）专注于LES，并评估了法律法规（n=28）和/或多组分干预/政策（n=41）的变化。多组分干预措施对健康（62％积极）和刑事司法（84％积极）结果均表现出最佳效果。71%的研究被评为高质量。也有充分的证据支持谨慎应用交易时间限制，并有有限但有希望的证据支持医疗服务和药物检查。
结论：广度，在过去十年中，关于在娱乐环境中减少AOD相关伤害的证据的质量和数量有所增加，尤其是LES。调查结果支持现场医疗服务(降低救护车转运率)，针对酒精可及性和可用性的多组分干预措施(减少攻击)，和毒品检查服务，但建议其他干预措施，如药物检测狗可能会加剧伤害。Further,需要更高质量的研究来解决证据基础中发现的差距，特别是在OMF内部的最佳干预措施上，更广泛地和全球南方的非法药物。
