Alcohol Misuse: Electronic Longitudinal Alcohol Study in Communities (ELAStiC)
Lead Research Organisation:
CARDIFF UNIVERSITY
Department Name: Dentistry
Abstract
There exists a unique opportunity to exploit existing UK data to better understand alcohol misuse across the life course. The overall goals of this project are to 1) incorporate data into the UK Secure eResearch Platform (UKSeRP) and develop facilities to enable research access, 2) undertake hypothesis driven research using this platform to provide critical insights into alcohol use, it's effects and pathways into harm, 3) exploit the current research group's expertise to capitalise on the most recent developments in analytical methodology, and 4) make explicit the policy relevance of the work and exploit opportunities to interface with possible intervention development. This project therefore aims to leverage the value of a broad set of longitudinal studies and data linkage facilities to construct an analytical platform within UKSeRP that facilitates the investigation of harmful alcohol use across the life course. The proposal is balanced, it combines a broad skillset, with considerable expertise with the available data together with techniques in the analysis of such data.
The data itself covers youngsters, those in mid- and later-life. These data are then linked to routine administrative data including those from schools (e.g. educational attainment), the NHS (health), the police (anti-social behaviour) and other sources including births and deaths. These then allow us to understand how alcohol affects general health, health service use, mental health, educational attainment and criminality. The nature of these data also allow us to understand how alcohol use affects cognitive decline in later life, and emotional and cognitive development in young people.
There has already been considerable activity generating opportunities to use longitudinal data for research, although only limited work has looked at alcohol specifically. We are therefore able to exploit these on-going investments and collaborate with the UK Dementia Platform, Centre for the Improvement of Population Health through e-Records Research (CIPHER) at Swansea University (funded by a consortium led by the Medical Research Council) which will provide technical and financial support for data linkage. In addition, the project will explicitly examine the policy and impact relevance of outputs, use outputs to investigate opportunities to develop novel interventions with, for example, the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (funded by the Economic and Social Research Council, amongst others). These collaborations bring together a unique set of skills that are required for such work as well as technical support.
Fundamental to the project is the opportunity to bring together a diverse skillset. Investigators come from a broad range of backgrounds and have varying skills in relation to the analysis and interpretation of longitudinal data. This provides opportunities for work in specific areas to inform the project as a whole. Although the project is based on specific research hypotheses, these feed into work packages that use the project team's skills as a whole to develop relevant outputs. This added value is realised through organising resources to maximise collaborative working and therefore go beyond the fundamental questions asked of the data.
The data itself covers youngsters, those in mid- and later-life. These data are then linked to routine administrative data including those from schools (e.g. educational attainment), the NHS (health), the police (anti-social behaviour) and other sources including births and deaths. These then allow us to understand how alcohol affects general health, health service use, mental health, educational attainment and criminality. The nature of these data also allow us to understand how alcohol use affects cognitive decline in later life, and emotional and cognitive development in young people.
There has already been considerable activity generating opportunities to use longitudinal data for research, although only limited work has looked at alcohol specifically. We are therefore able to exploit these on-going investments and collaborate with the UK Dementia Platform, Centre for the Improvement of Population Health through e-Records Research (CIPHER) at Swansea University (funded by a consortium led by the Medical Research Council) which will provide technical and financial support for data linkage. In addition, the project will explicitly examine the policy and impact relevance of outputs, use outputs to investigate opportunities to develop novel interventions with, for example, the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (funded by the Economic and Social Research Council, amongst others). These collaborations bring together a unique set of skills that are required for such work as well as technical support.
Fundamental to the project is the opportunity to bring together a diverse skillset. Investigators come from a broad range of backgrounds and have varying skills in relation to the analysis and interpretation of longitudinal data. This provides opportunities for work in specific areas to inform the project as a whole. Although the project is based on specific research hypotheses, these feed into work packages that use the project team's skills as a whole to develop relevant outputs. This added value is realised through organising resources to maximise collaborative working and therefore go beyond the fundamental questions asked of the data.
Planned Impact
Academics nationally and internationally will benefit through documenting and making available the enhanced data created as a part of this project (see Data Management Plan). Peer reviewed journal articles will contribute to numerous fields including epidemiology, alcohol, psychology, health and sociology. Moreover, while a data driven study, this project does overlap with key theoretical constructs associated with behaviour (e.g. disinhibition), the socio-ecology of alcohol misuse and mechanistic approaches including brain function and damage.
Research outputs are varied and are likely to be of interest to, not only academics but also, given the nature of some of the work (e.g. the effect of mother's alcohol consumption on their child's development) the public as well. Indeed, research surrounding health generally and alcohol in particular regularly feature in national and international media. Through disseminating our findings in partnership with media outlets we will be able to enrich the public's own knowledge of the harms that alcohol might elicit.
We aim to contribute towards evidence based policy-making and influence public debate and legislation at a local, regional, national and international level. End users include national and local policy makers and statutory authorities including social services, education and the police. Nationally there is interest in which policy mechanisms could curb the growing costs of alcohol-related harm. There are numerous way our work impacts at this level, probably of greatest significance is the work streams on well-being, alcohol price and availability. Also, at a local level, Local Authorities are now required to clearly state how they are working towards ensuring their residents health and well-being. For example, planning departments will be interested in the effects of alcohol availability; education services will be interest in the effects of alcohol on children's development. Internationally, we will engage with organisations including the World Health Organisation.
There are likely significant opportunities with the third sector. We have engaged with Alcohol Concern and Newlink to facilitate opportunities to work across policy makers and the third sector to realise outputs in a manner that can inform the development and implementation of interventions to challenge alcohol misuse and related harms.
The project further has a strong emphasis on advancing early career researchers. Daniel Farewell is a MRC fellow, and postdoctoral researchers will be employed on the project and a training budget requested in order to consolidate and extend their skill base. We therefore aim to contribute to the knowledge economy through delivering highly skilled researchers in an area of considerable interest (the use of "big data" and alcohol-related harm).
Research outputs are varied and are likely to be of interest to, not only academics but also, given the nature of some of the work (e.g. the effect of mother's alcohol consumption on their child's development) the public as well. Indeed, research surrounding health generally and alcohol in particular regularly feature in national and international media. Through disseminating our findings in partnership with media outlets we will be able to enrich the public's own knowledge of the harms that alcohol might elicit.
We aim to contribute towards evidence based policy-making and influence public debate and legislation at a local, regional, national and international level. End users include national and local policy makers and statutory authorities including social services, education and the police. Nationally there is interest in which policy mechanisms could curb the growing costs of alcohol-related harm. There are numerous way our work impacts at this level, probably of greatest significance is the work streams on well-being, alcohol price and availability. Also, at a local level, Local Authorities are now required to clearly state how they are working towards ensuring their residents health and well-being. For example, planning departments will be interested in the effects of alcohol availability; education services will be interest in the effects of alcohol on children's development. Internationally, we will engage with organisations including the World Health Organisation.
There are likely significant opportunities with the third sector. We have engaged with Alcohol Concern and Newlink to facilitate opportunities to work across policy makers and the third sector to realise outputs in a manner that can inform the development and implementation of interventions to challenge alcohol misuse and related harms.
The project further has a strong emphasis on advancing early career researchers. Daniel Farewell is a MRC fellow, and postdoctoral researchers will be employed on the project and a training budget requested in order to consolidate and extend their skill base. We therefore aim to contribute to the knowledge economy through delivering highly skilled researchers in an area of considerable interest (the use of "big data" and alcohol-related harm).
Publications
Aresi G
(2015)
'That right level of intoxication': A Grounded Theory study on young adults' drinking in nightlife settings
in Journal of Youth Studies
Hallingberg BE
(2016)
Characteristics associated with risk taking behaviours predict young people's participation in organised activities.
in Journal of adolescence
Aresi G
(2016)
Drinking, Drug Use, and Related Consequences Among University Students Completing Study Abroad Experiences: A Systematic Review.
in Substance use & misuse
Sivarajasingam V
(2016)
Trends in violence in England and Wales 2010-2014.
in Journal of epidemiology and community health
Aresi G
(2016)
Italian Credit Mobility Students Significantly Increase Their Alcohol Intake, Risky Drinking and Related Consequences During the Study Abroad Experience
in Alcohol and Alcoholism
Moore SC
(2016)
Human cognition tips the balance away from thresholds.
in Addiction (Abingdon, England)
Moore SC
(2016)
A rank based social norms model of how people judge their levels of drunkenness whilst intoxicated.
in BMC public health
Akbari A
(2017)
The ELAStiC (Electronic Longitudinal Alcohol Study in Communities) project IJPDS (2017) Issue 1, Vol 1:264 Proceedings of the IPDLN Conference (August 2016)
in International Journal of Population Data Science
Lloyd K
(2017)
Detecting violent and abnormal crowd activity using temporal analysis of grey level co-occurrence matrix (GLCM)-based texture measures
in Machine Vision and Applications
Mahedy L
(2017)
Parental alcohol use and risk of behavioral and emotional problems in offspring.
in PloS one
Edwards AC
(2017)
The Rate of Change in Alcohol Misuse Across Adolescence is Heritable.
in Alcoholism, clinical and experimental research
Webb BT
(2017)
Molecular Genetic Influences on Normative and Problematic Alcohol Use in a Population-Based Sample of College Students.
in Frontiers in genetics
Hammerton G
(2017)
Effects of Excessive Alcohol Use on Antisocial Behavior Across Adolescence and Early Adulthood.
in Journal of the American Academy of Child and Adolescent Psychiatry
Kendler Kenneth S.
(2018)
Childhood Risk Factors for Heavy Episodic Alcohol Use and Alcohol Problems in Late Adolescence: A Marginal Structural Model Analysis
in JOURNAL OF STUDIES ON ALCOHOL AND DRUGS
Piumatti G
(2018)
The relationship between alcohol use and long-term cognitive decline in middle and late life: a longitudinal analysis using UK Biobank.
in Journal of public health (Oxford, England)
Greene G
(2018)
Correspondence between self reported and GP coded alcohol consumption
in International Journal of Population Data Science
Piumatti G
(2018)
The relationship between alcohol use and long-term cognitive decline in middle and late life: a longitudinal analysis using UK Biobank.
in Journal of public health (Oxford, England)
Sear R
(2018)
The feasibility of characterising the effects of dental post-operative discomfort and sensitivity over time.
in Journal of dentistry
Paranjothy S
(2018)
Risk of emergency hospital admission in children associated with mental disorders and alcohol misuse in the household: an electronic birth cohort study.
in The Lancet. Public health
Kendler KS
(2018)
Childhood Risk Factors for Heavy Episodic Alcohol Use and Alcohol Problems in Late Adolescence: A Marginal Structural Model Analysis.
in Journal of studies on alcohol and drugs
Mahedy L
(2018)
The effect of parental drinking on alcohol use in young adults: the mediating role of parental monitoring and peer deviance.
in Addiction (Abingdon, England)
Aresi G
(2018)
Development and validation of a Multidimensional Motivations to Study Abroad Scale (MMSAS) among European Credit Mobility Students
in International Journal of Intercultural Relations
Aresi G
(2019)
A Longitudinal Study of European Students' Alcohol Use and Related Behaviors as They Travel Abroad to Study.
in Substance use & misuse
McQuire C
(2019)
Screening prevalence of fetal alcohol spectrum disorders in a region of the United Kingdom: A population-based birth-cohort study.
in Preventive medicine
Greene G
(2019)
Mental Health Moderates the Effect of Alcohol on Rate of Hospital Admission: A 15 Year Population-Based Longitudinal Study
in SSRN Electronic Journal
Gartner A
(2019)
Drinking beer, wine or spirits - does it matter for inequalities in alcohol-related hospital admission? A record-linked longitudinal study in Wales.
in BMC public health
Trefan L
(2019)
Electronic Longitudinal Alcohol Study in Communities (ELAStiC) Wales - protocol for platform development.
in International journal of population data science
Redfern J
(2020)
Association of violence with urban points of interest.
in PloS one
Lowthian E
(2020)
A Latent Class Analysis of Parental Alcohol and Drug Use: Findings from the Avon Longitudinal Study of Parents and Children.
in Addictive behaviors
Moore S
(2020)
Preventing Alcohol-Related Problems: Evidence and Community-based Initiatives edited by Norman Giesbrecht and Linda M. Bosma, Washington, APHA Press, 2017, 623 pp., ISBN: 978-0-87-553-291-2
in Drugs: Education, Prevention and Policy
Aresi G
(2021)
Analysing change among study abroad students. A novel application of the person-centred approach to alcohol use patterns
in International Journal of Intercultural Relations
Trefan L
(2021)
Visualisation and optimisation of alcohol-related hospital admissions ICD-10 codes in Welsh e-cohort data.
in International journal of population data science
Moore SC
(2022)
Alcohol affordability: implications for alcohol price policies. A cross-sectional analysis in middle and older adults from UK Biobank.
in Journal of public health (Oxford, England)
Moore SC
(2022)
An Exploration of the Multiplicative Effect of "Other People" and Other Environmental Effects on Violence in the Night-Time Environment.
in International journal of environmental research and public health
Description | The ELAStiC project aimed bring together various sources of information concerned with health and alcohol related harm. The NHS holds data on patients' interactions with services, whereas survey data (e.g. the Welsh Health Survey) has information on how much people drink, and other characteristics. By bringing these data together we can understand the relationship between alcohol use and the burden on the NHS for alcohol-related harm. ELAStiC has been partially successful in its scope. There are considerable barriers to linking data, administrative but also privacy issues. The ELAStiC database has been confirmed and the meta data published (Trefan, et al. 2019), and ELAStiC is now inspiring future work. However, some data, notably held by NHS England and the Ministry of Justice were not successfully linked. Never-the-less, the ELAStiC data now provides a unique insight into alcohol related health across the lifespan and is live and available to researchers going forward. Notable outputs have identified the effect of parental alcohol use on child outcomes, which has fed into the Adverse Childhood Experience agenda, as such, the ELAStiC data is a new research resource. Through ELAStiC several postgraduate researchers have been able to develop their skills. Notably in structural equation modelling and the application of computer science methods to large data. New research questions have been identified and are receiving attention. In particular, the observation that up to 20% of parents who drink hazardously also misuse illicit substances. This has important implications for treatment and is to be discussed in the upcoming Commission on alcohol related harm. In sum, ELAStiC continues, and the data and skills involved in it's management and analysis are feeding into other research areas. |
Exploitation Route | The ELAStiC platform is being actively developed for further research and as a policy evaluation tool. Current plans are to capitalise in this investment and use these data in natural experiments evaluating policy outcomes. |
Sectors | Healthcare |
Description | The ELAStiC data is continually used in research projects and these in turn lead to policy relevant outputs. Notably, the data specification that identifies alcohol-related health activities is being used in ongoing evaluation projects (e.g. an NIHR project evaluating violence prevention initiatives), and elsewhere. |
First Year Of Impact | 2021 |
Sector | Healthcare |
Impact Types | Policy & public services |
Description | Does local authority care make a difference to the lives of vulnerable children? Longitudinal analyses of a retrospective electronic cohort |
Amount | £155,449 (GBP) |
Funding ID | ES/R005478/1 |
Organisation | Economic and Social Research Council |
Sector | Public |
Country | United Kingdom |
Start | 10/2019 |
End | 09/2022 |
Title | ELAStiC |
Description | ALSPAC has been successfully linked to primary care data with Section 251 approval (following delays), and to Key Stage education data. The Millenium Cohort Study (Wales) has been successfully linked to health data (patient episode data base, GP data) and key stage data. Caerphilly Health and Social Needs Electronic Cohort Study has been linked to Patient Episode Database for Wales, GP Data, ONS Births Table, Emergency Department Dataset. |
Type Of Material | Database/Collection of data |
Year Produced | 2019 |
Provided To Others? | Yes |
Impact | This is the first time routine data (Welsh Electronic Cohort for Children, Patient Episode Database for Wales, GP Data, Office for National Statistics Mortality Data, ONS Births table, Emergency Department Data Set) has been linked to cohort data in the study of alcohol-related harms. There have been significant delays and challenges bringing these data together, but it is now availble to future projects and is informing research opportunities across a number of teams. |
URL | http://www.cardiff.ac.uk/violence-research-group/research-projects/alcohol-misuse |
Description | Andrea Gartner presented "Does the type of alcohol drunk, smoking and BMI explain socioeconomic inequalities in alcohol-related hospital admission: a record-linked cohort study?" at a meeting at the Public Health Wales on 28th November 2018. |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Policymakers/politicians |
Results and Impact | Andrea Gartner did the presentation at a meeting at the Public Health Wales and there were the alcohol and licencing leads from all health boards, Beverley Morgan from WG presenting on Minimum Unit Price and Andrew Misell from Alcohol Change (formerly Alcohol Concern). |
Year(s) Of Engagement Activity | 2018 |
Description | Andrea Gartner presented a paper entitled "Do people in more deprived areas have a higher risk of alcohol-related hospital admission, after accounting for individually record-linked data on alcohol consumption and smoking?" at the Annual conference of the Society for Social Medicine and Population Health in Glasgow, U.K. on 5-7 September 2018 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Andrea Gartner proactively discussed the findings with researchers from Glasgow University after the presentation. She has been invited by PHW to present at a meeting on 28th November 2018 with the alcohol and licencing leads (in health boards) and will be using some of the results of this study in that. |
Year(s) Of Engagement Activity | 2018 |
URL | https://socsocmed.org.uk/annual-scientific-meeting/ |
Description | European Research Area Network on Illicit Drugs |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Rapporteur and committee member for the ERANID funding body, a component of the EU 7th Framework Programme |
Year(s) Of Engagement Activity | 2016 |
URL | http://www.eranid.eu/home/ |
Description | NICE Expert Witness |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Expert witness to the National Institute for Health and Care Excellence for the "Drug misuse prevention: targeted interventions" guidance development |
Year(s) Of Engagement Activity | 2016 |
URL | https://www.nice.org.uk/guidance/indevelopment/gid-phg90 |
Description | Presentation of "ELASTiC - progress, challenges, potential for future work and impact" at the Population Health Conference in Cardiff on 16th May 2017 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Simon Moore presented a talk that updates the progress of ELAStiC project and the challenges it faced at the Population Health Conference in Cardiff on 16th May 2017. |
Year(s) Of Engagement Activity | 2017 |
Description | Presentation of a conference poster entitled ELAStiC: Electronic Longitudinal Alcohol Study in Communities |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | Yes |
Type Of Presentation | poster presentation |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | This output raised awareness of this newly funded project in one relevant community. None |
Year(s) Of Engagement Activity | 2015 |
URL | http://www.farrinstitute.org/ |
Description | Presentation of a paper entitled "The effect of parental drinking on adolescent alcohol use: the mediating role of parental monitoring and peer deviance" at the KBS annual meeting in Sheffield on 5-9 June 2017 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | The paper sparked questions, discussion and many constructive suggestions which contributed to the revision of the paper. |
Year(s) Of Engagement Activity | 2017 |
Description | Presentation of a poster entitled "How does parental drinking, smoking and substance use affect children's well-being - a meta analysis" at Population Health Conference in Cardiff on 16th May 2017 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Professional Practitioners |
Results and Impact | Vanessa Gross presented the poster on parental drinking, smoking and substance use's effect on children's well-being at the Population Health Conference in Cardiff on 16th May 2017. |
Year(s) Of Engagement Activity | 2017 |
Description | Presentation of a poster entitled "The ELAStiC (Electronic Longitudinal Alcohol Study in Communities) project " at ADRN 2017 conference in Edinburgh, U.K. on 1-2 June 2017 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Ashley Akbari, Senior Research Analyst, presented the poster that introduced the objectives and designs of the ELAStiC project at the ADRN 2017 conference in Edinburgh on 1-2 June 2017. |
Year(s) Of Engagement Activity | 2017 |
URL | https://adrn.ac.uk/understand-data/courses/eventitem?eventid=4807 |
Description | Presentation of a poster entitled "The ELAStiC (Electronic Longitudinal Alcohol Study in Communities) project " at Informatics for Health 2017 in Manchester, U.K. on 24-26 April 2017 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Ashley Akbari, Senior Research Analyst, presented a poster that introduced the project's objectives and designs at the conference of Informatics for Health 2017 in Manchester, U.K. on 24-26 April 2017. |
Year(s) Of Engagement Activity | 2017 |
URL | http://www.farrinstitute.org/events-courses/event/informatics-for-health-2017 |
Description | Presentation of a poster entitled Electronic Longitudinal Alcohol Study in Communities at the International Population Data Linkage Conference 2016 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Ashley Akbari, Senior Research Analyst, presented a poster about the ELAStiC project at the International Population Data Linkage Conference 2016 on 24-26 August at Swansea University. The purpose of the presentation was to introduce the project to the research community interested in data linkage and to build up collaborative links for future research. |
Year(s) Of Engagement Activity | 2016 |
URL | http://www.ipdlnconference2016.org/ |
Description | Presentation of a poster on the overview of the ELAStiC project at the Alcohol and Criminal Justice System Conference in Darlington on 5th October 2017 |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | The poster generated interest and sparked questions about the ELAStiC project. |
Year(s) Of Engagement Activity | 2017 |