If it works there, will it work here?: The effect of a multi-component responsible beverage service (RBS) programme on violence in Oslo

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Drug and Alcohol Dependence

j o u r n a l h o m e p a g e :w w w . e l s e v i e r . c o m / l o c a t e / d r u g a l c d e p

Full length article

If it works there, will it work here? The effect of a multi-component responsible beverage service (RBS) programme on violence in Oslo

Torbjørn Skardhamar

, Silje Bringsrud Fekjær

, Willy Pedersen

aDepartmentofSociologyandHumanGeography,UniversityofOslo,POBox1096,Blindern,Norway

bOsloUniversityCollegeofAppliedSciences,Centreforthestudyofprofessions,StOlavsPlass,0130Oslo,Norway

cTheNorwegianPoliceUniversityCollege,Postboks5027Majorstuen,0301Oslo,Norway

a r t i c l e i n f o

Articlehistory:

Received18February2016

Receivedinrevisedform5October2016 Accepted6October2016

Keywords:

Alcohol Violence

Responsiblebeverageservice(RBS) programme

a b s t r a c t

Background:TheStockholmPreventsAlcoholandDrugProblems(STAD)programmehasbeenregarded asoneofthemostsuccessfulprogrammestodate,inreducingalcohol-relatedviolence.Thismulti- componentResponsibleBeverageService(RBS)programmewasimplementedinStockholm,Sweden, andhasbeendocumentedtobeextremelyeffectiveinreducingalcohol-relatednightlifeviolence.The SALUTTprogrammeinOslo,NorwaywascarefullymodelledontheSTADproject.

Aim:WeinvestigatewhethertheresultsfromSTADwerereplicatedintheSALUTTintervention.

Design:Usinggeocodeddata,thelevelofviolenceintheinterventionareawascomparedwithdifferent controlareasbeforeandaftertheintervention.

Statistics:Autoregressivemovingaveragemodels(ARIMA).

Findings:TheSALUTTprogrammehadnostatisticallysignificanteffectonviolence.However,thelevelof violenceinthedifferentpotentialcontrolareasofOslofluctuatedwithoutaclearcommontrend.Hence, itwasdifficulttoestablishpropercontrolareas.

Conclusions:TheresultsfromtheSwedishSTAD-interventionwerenotreplicatedinOslo.Successful interventionsarenotnecessarilyreplicatedinothercontexts,andthecurrentliteraturedoesnotshed sufficientlightontheconditionsunderwhichsuchinterventionsactuallywork.Moreover,moreattention shouldbedevotedtotheidentificationofadequatecontrolareasinfutureresearch.

©2016PublishedbyElsevierIrelandLtd.

1. Introduction

STAD(StockholmPreventsAlcoholandDrugProblems)wasa multi-componentresponsiblebeverageservice(RBS)programme thatwasimplementedinStockholm,thecapitalofSweden.The STADinterventionincludedRBS-trainingofthestaffandowners oflicensedpremisescombinedwithincreasedenforcementbythe policeandthemunicipality.Itwasdocumentedtohaveproduced impressiveresultswithregardtothereductionofalcohol-related violence,andthekeypublicationshaveahighcitationrate(Wallin etal.,2005,2004,2003).Theinterventionstandsoutinaliterature withratherfewsuccessstories(GrahamandHomel,2008).

Basedonthisevidence,asimilarprogrammewasimplemented inOslo,thecapitalof Norway.Overtheprecedingfewdecades, therehadbeenrapidgrowthinthecity’snight-timeeconomy,the numberoflicensedpremiseshadincreased,andmanykeyactors, includingtheheadofthepoliceforce,hadarguedthatalcohol-

∗Correspondingauthor.

E-mailaddress:[email protected](T.Skardhamar).

relatedviolencehadbecomeamajorconcern(Andresen,2010).

GrytdalandMeland(2009)foundthatmostofthenight-timevio- lenceoccurredinconnectionwithpremisesservingalcohol,and that both perpetrator and victim wereusually intoxicated. The promisingresultsfromSwedeninspiredkeyactorsinOslotorepli- catetheexperiencesinacitywithmanysimilaritiestoStockholm.

ThisimplementationwascalledSALUTT(aNorwegianabbreviation forTogetherweMaketheNightlifeSafer).Theinitialimplementa- tionstartedin2011inapredefinedgeographicalarea,butthearea wassubstantiallyexpandedtoanewareainJanuary2014.Forrea- sonstobeexplainedbelow,weestimatetheeffectofthisexpansion onnight-liferelatedviolence.

Whilelicensedpremisesplayakeyroleinalcohol-relatedvio- lence(Grahametal.,2001;Gruenewaldetal.,2006),itisnoteasyto developsuccessfulinterventionsinthisarea.Tworecentreviews concludedthat most ofthe evaluationsof interventionsimple- mentedtoreducealcohol-relatedharmandoverservingindrinking environmentsare limitedbecause ofmethodological shortcom- ings(Jonesetal.,2011; Kurtzeetal.,2014).Hence,thegeneral effectsofsuchinterventionsstillseemtobeuncertain.However, in thesereviews, three intervention studies stoodout as more http://dx.doi.org/10.1016/j.drugalcdep.2016.10.019

0376-8716/©2016PublishedbyElsevierIrelandLtd.

robust,suggestingthatmulti-componentprogrammescombining communitymobilisation,RBStraining,increasedpoliceworkand stricterenforcementoflicensinglawshavethegreatestpotential toreduceviolentassaults.Amongthese,theSwedishSTADproject isgenerallyregardedasthemostsuccessfulintervention(Holder etal.,2000;Trenoetal.,2007).

STAD was set up as a research project, with an interven- tionareaand a controlareain centralparts ofStockholm. Key componentsoftheSTADprogrammewerea)anadvisorygroup withregularmeetings,formalizingthecollaborationbetweenthe countryadministration,thepoliceandrepresentativesofthebar andrestaurantindustryb)RBStrainingforservers,doormenand restaurant-owners(2-daycourse),c)increasedenforcement,done byregularmeetingsbetweenthepoliceandtheLicensingboard, increaseddistributionofnotificationletterstolicensedpremises andmutualcontrolsoflicensedpremisesconductedbytheLicens- ingboardandthepolice(Wallinetal.,2003).

Theevaluationshowedadecreaseinpolice-recordedcrimesby astriking29%intheinterventionarea,comparedtothecontrol area(Wallinetal.,2003).Recentre-analysisoftheoriginaldata set,usingmorerobuststatisticalmethodsandadditionalcompar- isonareas,revealedsmallereffects,butessentiallyconfirmedthe results(NorströmandTrolldal,2013).AccordingtoWallinetal.

(2003),theeffectonviolencemaybetransmittedbyareduction inoverserving,whichtheyfoundtobedrasticallyreduced.Wallin etal.(2004)pointedtofivekeyfactorsthatensurethesuccessof theSTADprogramme:adoption,sustainability,keyleadersupport, structuralchanges,andcompliance.Inaddition,anactiveuseof mediatopromotetheprogramme’sintentionswaslistedasanother keyfactortosuccess.

TheoriginalSTADprojectwaslaunchedonlyinonecity,but it is important toassess whetherit will also beeffective else- where.Theprogrammehassubsequentlybeendisseminatedtoa largenumberofSwedishmunicipalities,andtheestimatedeffect wasfarsmallerandonlysignificantinthesmallermunicipalities.

Trolldaletal.(2013)measuredthedegreeofimplementationas towhatextentthreekeycomponentswerepresent;RBS-training, supervisionoflicensedpremises,andhavingacommunitycoali- tionsteeringgroup.Increasingtheprogrammebyonecomponent decreasedviolenceby3percent.However,whentheytriedtoesti- matetheeffectofeach componentoftheprogramme,onlythe presenceofcommunitycoalitionsteeringgrouphadasignificant effect.

Theaimofthispaperistoexplorewhetheramulti-component ResponsibleBeverageService(RBS)programmediddecreasethe reportedlevelofalcohol-relatednightlifeviolence.Ourstudywill revealwhetheraprogrammemodelledbyasuccessfulprogramme inonecountry(Sweden)actuallyistransferabletoanothercountry (Norway).

1.1. TheSaluttinterventioninOslo

InOslo,theinterventionwasdesignedasareplicationofSTAD andtooktheformofacollaborationbetweentheCityofOslo,the policeandrepresentativesofthebarandrestaurantindustry.The interventionwascalledSALUTTandcontainedallthreecompo- nentsdiscussedbyTrolldaletal.(2013).Themainpurposewas topreventintoxicatedcustomersfrombeingservedalcohol,and topreventdisturbancesofthepeaceandalcohol-relatedviolence.

Theinterventionareawasdefinedastheareawiththemostvio- lenceinOslocitycentre.Inadditiontoreducingviolence,itwasa specificgoaltoincreasecooperationbetweenthekeyactors:The police,themunicipalityandrepresentativesofthebarandrestau- rantindustry.AsintheSTADintervention,thefocuswasonthree maincomponents:(i)increasingthecompetenceofallinstitutional actorsinvolved(i.e.,pubandbarstaff,thepoliceandthosefrom

the municipality responsibility for supervising pubs) regarding lawsandregulationsthroughtraining;(ii)betterdialoguebetween themunicipality/thepoliceandstaffandproprietorsofpubsand bars;(iii)anincreasedlevelofcontrolandsanctions.Thisincluded coursesforbartenders,meetingswithmanagers,intensifiedcon- trolbythelocalauthoritiesandpolicepatrolunitsintheproject area(BaklienandBuvik,2014).

While SALUTT includedall the key componentsfrom STAD, BuvikandBaklien(2014:58)claimthatSALUTTdiffersfromSTAD ontwopoints:abitmoreemphasisondialoguerelativetosanc- tions,andalesscentralpartplayedbythepoliceinSALUTT,since thepoliceinNorwayarenotinchargeoflicensingandcontrol.We mightalsoaddthattheSALUTTareawassmallerthanthatofStock- holm,restrictedtoanareawheretheseproblemswereparticularly prevalent.

SALUTTwasinitiallyimplementedinasmallareain2011,and thenexpandedinJanuary2014.Furtherexpansionswereplanned tocover a largepartofthe citycentre. Using avariety ofdata sources,arecentextensiveevaluationofSALUTTconcludedthat thetrainingprogrammehadfunctionedwell,thatthepolicehad becomemoreinvolvedinpreventiveworkandthattheindustry hadbecomemoreengagedinproactiveprevention(foradetailed description,see:BaklienandBuvik,2014:35–52).Theevaluation therebyconcludedthattheinterventionhasbeenimplementedas planned,thattheactorsinvolvedcooperatedbetterandthatbar- tendersinOsloalsoseemtohavebecomemorerestrictive,although notmoreintheinterventionareathaninotherareas.Theoverall levelofviolencealsoseemstohavedecreasedinthecity,(26per- centagepointsreductionincentralareas),buttheauthorsconclude thatthereductionmayhavebeencausedbyotherfactorsthanthe SALUTT-intervention.

BaklienandBuvik(2014)indicatedthatittooksometimeto establishgoodwaysof cooperationbetweenthekeyactors.For example, representatives fromthe industry were after a while includedinthesteeringgroup,andthepolicewerenottrulycom- mitteduntillate2013.TheRBScourseshadshiftedattentionfrom trainingofbarstafftotheownerssincethebarstaffprimarilyfollow theinstructionsfromtheiremployer.Hence,theinitialimplemen- tationperiodwasgradualbutfounditsfinalformbytheendof 2013,withfullcooperationbythepolice,keyleaders,aswellas strongpoliticalsupport.Whenlaunchingthesecondphaseofthe programmeinanewareain2014,whichwewillrefertoasSALUTT 2,itcouldbeexpectedtotakeimmediatelyfulleffect.Inthisphase, experiencewasdrawnfromthefirstimplementationandseveral actionsweretakensimultaneously:generalcollaborationbetween thepoliceandmunicipalitywasalreadyestablishedandwasinten- sified,theeducationprogrammehadfoundaneffectiveformand waseasytointroduceinanewarea,andthelargerSALUTTorgan- isationalsofunctionedwell(BaklienandBuvik,2014).Hence,the SALUTT2canbeexpectedtobemoreefficientandtohavehada moreclear-cutlaunchthanisthecaseformostotherprogrammes.

Gradualimplementationishardtoevaluateasitishardtoknow whentheeffectshouldtakeplace,buttheimmediateimplemen- tationinSALUTT2allowsforapreciselydefinedtimeofeffective intervention.

2. Materialandmethods 2.1. Policedataonrecordedcrimes

OurdataonviolencearedrawnfromtheNorwegianpolicereg- ister(STRASAK),whichincludesallreportedviolentcrimesinOslo.

Mostoftheincidentswerealreadygeocodedbythepolice,butthere werealsoanumberofcrimeswhereinformationoncoordinates wasmissing.Casesthatwerenotgeocoded,butwheretherewasa

Fig.1.StudyareasinOslocitycentre.Theexperimentalarea,SALUTT,ismarkedE,thefirstcontrolareaismarkedC1andtheotherareasarecombinedtoformthesecond controlareasmarkedC2.Note:Themapisprocuedusingwww.OpenStreetMaporgandosmar(EugsterandSchlesinger,2013).

validstreetaddressweregeocodedbytheresearchersusingGoogle maps(KahleandWickham,2013).Thisallowedustoplaceallregis- teredviolentcrimeswithinthedefinedareasandtoconstructtime seriesforeacharea(seeFig.1).

Ourdependentvariableisthenumberofviolentincidentsreg- isteredbythepoliceeachmonthintheperiod1January2008to 21August2015.Sincealcohol-relatednightlifeviolencewasour focus,werestrictedtheoffencestothosethathadbeencommitted atnight.Thelargestbulkofviolenteventsoccurafterbarscloseat 3am,butweincludethebroaderintervalbetween10p.m.and6 a.m.aswasalsodoneintheSTADstudies(Wallinetal.,2003).This intervalcorrespondswelltothemostactivetimesofNorwegian nightlife,andcapturesthetimingofmostviolenteventsbyagood margin.Weincludedoffencesinthecategoriesviolence,robbery andviolenceagainstapublicservant(practicallyallcasesinvolve assaultorinflictingbodilyharm,Sections228and229oftheNor-

wegianGeneralCivilPenalCode).SALUTT2wasimplementedin January2014,andtwonewareaswereplannedforinclusionin theprogrammein2015and2016.Theseplannedextensionareas wereusedascontrolarea,whichwerefertoasCONTROL1.They wereparticularlysuitablesincetheywereperceivedashavingsim- ilarchallengesasSALUTT2asregardsalcohol-related,night-time violence.However,asanadditionalcheckandtoincreasethereli- abilityofouranalyses,inseparatemodelswealsocombinedmost otherremainingareasincentralOslowithahighdensityoflicensed premises.TheywerelabelledCONTROL2.InFig.1,theexperimen- talarea,SALUTT2,ismarkedE.CONTROL1surroundstheSALUTT areaandismarkedC1.CONTROL2comprisestheremainingareas (shadedlines)andismarkedC2.TheSALUTT1areaistheunmarked arearightnexttoSALUTT2.DatafromSALUTT1werenotincluded inanyofouranalyses.

Fig.2.Observed(grey)andsmoothedtrends(black)intheSALUTT-2area.VerticallineshowstheofficialdateofimplementationofSALUTT-2.

2.2. Modellingstrategy

We use autoregressive integrated moving average (ARIMA) modelsinasimilarwayasinthepriorstudiesofSTAD(Norström and Trolldal,2013; Wallin etal., 2003).The modelsis denoted ARIMA(p,d,q)wherepistheorderofautoregressivemodel,dis thedegreeofdifferencing,andqistheorderofthemovingaverage model.ThedateofimplementationofSALUTT2istreatedasan exogenousvariablewhencomparingwithCONTROL1.Hence,the modelisspecifiedas:

log(VEt)=˛+ˇ₁log(VCt)+ˇ₂W+ˇ₃It+εt

whereVEisviolenceintheexperimentalarea,VCisviolenceinthe controlarea,Iisadummytakingthevalue1whenintervention occursintheexperimentalareaand0otherwise,andεisanerror term.WisthenumberofFridayandSaturdaynightsinmontht (varyingbetween8and10).Theparameterofinterestisˇ3,which isinterpretableastherelativechangeinviolence,sothattheper- centagechangeinviolenceis:exp

ˇ₃

×100.

Thecontrolarea,VC,representsthegeneraltrendinviolence duringtheobservationperiod.Weusethepre-interventionperiod toselecttheautoregressiveterms of themodel(Hyndmanand Khandakar,2008),usingVCandWaspredictors,andthenmodel theentireobservationperiodwhen estimatingtheintervention effects.Themodelrestsontheassumptionthattheexperimental areawouldfollowthetrendinthecontrolareaiftheintervention hadnotoccurred,i.e.,itassumesthatacommontrendispresentin bothareas.

3. Results

The trends for violence in the SALUTT 2 area and the two controlareas areshown in Fig.2,where thegrey linesarethe observednumberofnight-timeviolentcrimesandtheblackline isasimpleexponentialsmootherofthetrend.Wewouldexpect SALUTT2totakeeffectfairlyquicklyafterimplementation, but thestrikingvisualfeatureofthis timeseriesis arelativelysta- ble,flattrendthroughoutthelatterpartoftheobservationperiod, includingtheperiodafterimplementation.ThetrendinCONTROL 1decreaseduntil2011,followedbyanincreaseandasubsequent

Table1

EstimatedinterventioneffectsofSALUTT2onpolice-recordedviolence.

Controlarea Modelspecification Estimate SE p-value Q CONTROL1 ARIMA(0,1,1)(0,1,1) −0.22 0.36 0.50 0.33 CONTROL2 ARIMA(1,1,1)(0,1,1) −0.15 0.39 0.70 0.42 Q=Box-Ljungtestforresidualautocorrelation.

slightdecreaseinthelastpartoftheobservationperiod.Themost strikingfeatureoftheCONTROL2trend,ontheotherhand,isthe gradualincreaseinviolencefrom2008through2013,whichisthen followedbyareduction.

Theestimatedinterventioneffectscomparedwiththetwocon- trolareasareshowninTable1.Theestimateinthecomparison withCONTROL1suggestsanegativepointestimate(−0.22),witha veryhighp-valuethatisfarfrombeingstatisticallysignificant.The estimateforCONTROL2suggestsasimilarpointestimate(−0.15), butthisestimateisalsofarfromstatisticallysignificant(p=0.73).

Thus,wefindnoeffectoftheintervention.

Sincethestandarderrorsarelarge,itcanbearguedthatthenull resultsarearesultoflowstatisticalpower.Thisisatbestonlyapar- tialexplanation.AsshowninFig.2,thereisnopost-intervention changeinviolenceintheSALUTTarea.Forthisreason,anestimated causaleffectcouldonlyariseifthecounterfactualoutcomewerean increaseinviolence.Whilethisisofcoursepossible,weseenointu- itivereasonwhythatshouldhavehappened,andthefactthatthe lineisapproximatelyflatindicatesnoimpactoftheintervention.

ConsideringFig.2again,its’perhapsmoststrikingfeatureis thelackofcommontrendsinthethreedifferentareasinvestigated duringtheperiodupuntiltheintervention.Thisraisestheconcern ofwhetherthecontrolareasareinfactsuitableinthefirstplace.

Theassumptioninthiskindofevaluationapproachisthatthereis somecommonunderlyingtrendacrossdifferentareasofthecity.

Wethereforecarriedoutanewsetofanalyses(seeSupplementary material),wherewecomparedthepre-interventiontrendsinvio- lenceforallcitydistrictsinOslo.Thefindingsrevealedthateach area’strendhaddistinctfeatures,withvaryingpeaksandreduc- tions.Indeed,ourexplorationofthetrendsineachsub-areadoes notprovideconvincingevidenceofanycommontrendinnightlife violenceacrosstherelevantareasofOslo.

4. Discussion 4.1. Mainfindings

Inthisstudywehaveevaluatedamulti-component,responsi- blebeverageservice(RBS)programmeinOslo,SALUTT,whichwas carefullymodelledontheSwedishSTADintervention.However, whereastheSTADinterventionwasregardedashighlysuccessful inreducingviolenceinthenight-timeeconomy,SALUTTdidnot haveanysignificanteffect.Wewillreturntopossiblesubstantive explanationsforthenullresults,butletusfirstconsiderpotential methodologicalproblemsinthestudy.

4.2. Methodologicalconsiderations

Firstly,ourmeasurewasviolentcrimesanddoesnotencompass threatsandharassment,whichwereincludedinthemeasureused intheSTADevaluation(Wallinetal.,2003).Thereisapossibility thatSALUTTreducedsomekindsofincidentsdespitenotaffecting recordedviolentcrimes.Itishardtoknowwhetherthemeasures ofviolencearecomparabletopriorstudies,but,ifthedifferences inresultsfrompriorstudiesareduetodifferencesinmeasures,this wouldhaveimplicationsfortheinterpretationofthosestudiesas well.

Asecondpotentialreasonforourlackofclearresultsisrelatedto lowbaseratesofviolenceintherelevantareasofOslo,whichcould berelatedtothescalingoftheproject.TheSALUTTprojectareais muchsmaller(onlyabout20ha)thantheSTADproject(412ha).

Thus,theabsolutenumberofoffencesislowinSALUTTandthe trendsaremoreunstable.Hence,ouranalyseshavelowerstatistical power.

Third,onemightbeconcernedthattheremightbespill-over effectsfromtheinterventionareastothecontrolareaswhichmakes ithardtodetectactualeffects.Thiscouldhappenifbarstaffhad beentocourseswhileworkingintheSALUTTareaandthenchanged jobtosomewhereoutsidethisarea,butcontinuingtocomplywith whatwastaughtatthecourses.Anotherpossibilityisthat,e.g.,the policingpracticesinhowdealingwith“problem-bars”changedalso outsidetheSALUTTarea.Whilesuchspill-overeffectscanbehard todefinitivelyruleout,wearenotawareofanyindicationsofthis happening.

Afourthexplanationmightberelatedtothesuitabilityofthe controlareas.Whenusingoneormultipleotherareasinthesame cityascontrolareasthesuitabilityoftheareasascontrolsiscru- cial.Mostimportantly,theimplicit assumptionisthattheareas followa commontrendsothatthedevelopmentinthecontrol areasrepresentswhatwouldhavehappenedinthetreatmentarea.

ThecontrolareasforSALUTTwaschosenasassumedsimilarareas nearby,inasimilarrationaleasintheevaluationofSTAD(Norström andTrolldal,2013).

However,interviewswithpoliceofficersandemployeesinthe night-timeeconomysuggestthatthesituationishighlydynamic andshifts overtime withregardtowhich areasare infashion, wherenewpubsandbarsopenandothersclose,andtheclien- tele that is attracted toeach areachanges over time. Previous researchon‘geographiesof thenight-timeeconomy’hasdocu- mentedthepresentrapidrestructuringofthisindustry,wherethe volumeofsalesofalcoholseemstobeadrivingforce,asthisis thekeytohighprofit(Jayneetal.,2006).Suchdynamicsinclude competitionbetweenlargecorporationsandsmallerindependent operatorsorolder‘traditional’pubs,ordevelopmentofurbancen- treswithlate-nightbarsandcommercialisedyouthful‘playscapes’

or‘nightscapes’(Roberts,2015).Gentrificationofinner-cityareas canalsoresultinfrictionsandcontestsoverpublicspace(Pennay etal.,2014),apatternthathasalsocharacterisedOslo(Hjortholand Bjornskau,2005).Thus,peoplemaydrink(andfight)inarapidly

changingnight-timeurbanlandscape.Thismakesitreasonableto questionthepresenceofacommontrendinalcohol-relatedvio- lenceacrosssub-areasinthesamecity,whichwouldbenecessary forpropercausalinference.

4.3. Interpretationoffindings

Despitethemethodologicalconcerns,wedo notbelievethat ournull resultsareonlyduetomethodologicallimitations.The timeseriesfortheSALUTTarea(Fig.2)ispracticallyflataroundthe timeoftheimplementation.Anyclaim thatithashadaneffect onthe level of violencemust therefore rest onan assumption thatviolencewouldhaveincreasedintheabsenceoftheimple- mentation.Althoughsuchacounterfactualincreaseistheoretically possible,weseenoparticularreasonwhythatshouldhavehap- pened.

AmoresubstantivereasonforwhySALUTTdidnotsucceedin reducingviolencemight,instead,bethattheprogrammedidnotin factreducetheover-servingthatisbelievedtobecausallylinked toviolence.IntheSTADproject,thelevelofover-servingdidin factdecrease drastically,which couldexplainthereduced level ofviolence(Wallinetal.,2005).Previousresearchusingpurchase attemptswithpseudo-intoxicatedpatronshasshownthatthelevel ofover-servinginOsloishigh,andalthoughaslightdecreasehas takenplace, this decrease doesnot seemto bestronger inthe SALUTTareathan inotherareasofthecity(Baklienand Buvik, 2014;BuvikandRossow,2015).Hence,thelackofchangeinthe levelofover-servingintheinterventionarea,ascomparedtoother areas,mayexplainwhywedonotfindasignificantarea-specific reductioninthelevelofviolenceeither.

Arelatedissueconcernswhetherthereissomethingaboutthe localsettingthatmadetheprogrammeineffectiveinOslo.Itshould benoted,however,thatRBSprogrammeshavenotproveneffective inthemajorityofthestudiesfromothercountrieseither(Kurtze etal.,2014).Itisalsonotablethattheestimatedeffectoftheinitial STADprojectwasa29%reduction,whilethesubsequentextensions elsewhereinSwedenweremuchmoremodest,onlyaround3%on average(Trolldaletal.,2013).It couldperhapsbehypothesised thattheinitialSTADinterventionwasassociatedwithaso-called

‘Hawthorneeffect’,i.e.,theeffectsmayhavebeentheresultofthe effectsoftheinvolvedactorsandinstitutionsofbeingsingledout andmade tofeelimportant,andnot oftheintervention perse (Adair,1984;McCambridgeetal.,2014).Inlaterinterventions,it mayhavebeendifficulttoreplicatethiseffect.

Thisalsohighlightsthequestionofhoweasyitistotransfersuch programmestoothersettings.Thecausalmechanismsinvolvedin successfulRBSprogrammesandtheconditionsunderwhichthey maybeeffectivehavenotbeenwellspelledout.Giventhatthe originalSTADinterventionwasrolledoutinaverylargearea,we mustalsoassumethattheareaincludedagreatervarietyoflicensed premises.ThemuchsmallerSALUTT2areainOslowasconsidered tobeaparticularlyproblematicandconcentratedareawithregard tobingedrinkingandviolence.Wecanhypothesisethatlicensed premisesin‘averageareas’aremoreresponsivetosuchpolicies thantheareastargetedinSALUTT2.Thus,anyeffectofsuchinter- ventionsmightdependonthekindofclientele,bars,orkindsof areastargeted.

Weshouldalsorememberthattheremarkablyhighreduction inviolenceinthefirstSTADprojectwasachieved20yearsago.If competenceinthepreventionofnight-timeviolencehasimproved ingeneral,newprogrammeswillmakelessdifferenceandhave lesseffect.Thataprogramme hasprovensuccessfulsomewhere elseandinanothertimeisnotbyitselfsufficienttoinferthatit willworkequallywellinanewsetting(CartwrightandHardie, 2012).

4.4. Conclusion

Themulti-componentSALUTTinterventioninOslowasmod- elledonthemostsuccessfulRBSinterventiontodate,theSTAD interventioninStockholm,andapreviousevaluationconcluded thatSALUTTwasimplementedaccordingtotheplan.However,we foundnoreductioninthelevelofviolenceintheinterventionarea inOslo.Hence,inthisrespecttheSALUTTinterventionwasnota success,asopposedtotheinitialSTADintervention.

Theoretically,thelackofobservedresultsinOslomaybedue tomethodologicalproblemssuchaslackofstatisticalpower.How- ever,itisnotlikelythatthisisthecorrectexplanationofthenull findings.Itismorelikelythatsuchinterventionsdonotnecessar- ily‘travelwell’,particularlywhenthemechanismsinvolvedinthe interventionsarenotbetteridentifiedthanintheliteratureonRBS.

Moreover,thecharacteristicsoftheareaswheretheprogrammes areimplemented,intermsoftheclientelevisitingthebars,sociode- mographicandsocioculturaldistinguishingmarks,andpatternsof useofalcoholmayhaveanimpactonthepotentialsuccessofa programme.Inaddition,thestudyshedslightontheproblemof establishingadequatecontrolareasinthis kindofresearch.The variouscitydistrictsinOslodisplaystrikinglydifferenttime-series patternsofviolence,probablyreflecting largeand rapidgeneral changesinthenight-timeeconomy.

Weconcludethatthereisneedformoreknowledgeaboutthe contextswheresuchinterventionsseemtoworkwellandaboutthe mechanismsthatmayenhanceorreducethelikelihoodofsuccess insuchprogrammes.

Funding

Nothingdeclared.

Contributors

Allauthorshavecontributedtothewritingandreviewofthe manuscript.

Conflictofinterest Noconflictdeclared.

Contributors

TorbjørnSkardhamarhashadthemainresponsibilityforthesta- tisticalanalysisanddatamanagement,andtakenpartinallstages oftheresearchprocess,fromthedesignofthestudy,throughout theprocessofanalyzingthedata.Hehashadthemainresponsi- bilityforfinalizingthemanuscript.Hehasreadandapprovedthe finalversionofthearticle.

SiljeB.Fekjærhastakenpartinallstagesoftheresearchprocess, fromthedesignofthestudy,throughouttheprocessofanalyzing thedataanddiscussingthefindings.Shewasresponsibleforapply- ingforpermissionsforthedataandhandlingtheregistersfrom whichthedataiscollected.Shehasalsocontributedtothewriting ofallpartsofthemanuscript.Shehasreadandapprovedthefinal versionofthearticle.

Willy Pedersen has taken part in all stages of theresearch process,fromthedesignofthestudy,throughouttheprocessof analyzingthedata,discussingthefindings,hehasalsotakenpart inwritingthevariousdraftsofthepaperandfinallyindecidingthat thepaperwasreadyforsubmission.Hehasreadandapprovedthe finalversionofthearticle.

Acknowledgements

WearegratefulfromcommentsanddiscussionswithKristin Buvik,andpoliceofficersinOsloandJohnnyBrennaresponsible fortheSALUTTimplementation.Wearealsogratefulformethod- ologicalcommentsbyRichardBerk.Thisworkwasfundedbythe NorwegianResearchCouncilgrant219129and240129.

AppendixA. Supplementarydata

Supplementarydataassociatedwiththisarticlecanbefound,in theonlineversion,athttp://dx.doi.org/10.1016/j.drugalcdep.2016.

10.019.

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