An Aboriginal community-led approach to reducing alcohol-related harm: A multiple baseline, stepped wedge evaluation.

Objectives: Three Aboriginal communities in regional Australia led the development and implementation of a community-based program aimed at: i) reducing alcohol-related criminal incidents; and ii) improving community perceptions of community safety and empowerment. Study design: A multiple baseline, stepped-wedge evaluation. Methods: The co-designed program comprised community-specific activities to operationalise three core components that were standardised across all communities: i) improving service engagement; ii) promoting community activities; and iii) increasing community members' empowerment for action. Outcome measures were de-identified crime data (persons of interest and victims from January 1, 2005 to December 31, 2017) and pre/post community surveys. Results: Statistically significant improvements in perceptions of alcohol harm were reported in all three communities: i) community 1 significantly increased community empowerment; ii) community 2 reported significantly less alcohol-related verbal abuse and injuries, and feeling significantly safer during the day and at night; and iii) community 3 reported feeling significantly safer at night. There were no statistically significant reductions in alcohol-related crime. Conclusion: This is the first Aboriginal-specific, community-based project in Australia to use a multiple baseline, stepped-wedge evaluation design and an innovative program logic model. Future research could seek to uncover the mechanisms associated with different program impacts on different outcomes and in different communities, and seek to sustain impacts over longer timeframes.