Florence 2011.
Methods | An interrupted time series measuring violence recorded by the police and hospital admissions related to violence in a city between 2000 and 2007. Collaborating partners Lead agency: Health Strategic involvement (policy making and service planning):secondary health care, local government, police Commissioning (implementing strategy taking account of resources available): secondary care, local government, police, ambulance, local licensees Operational (providing services directly): secondary care, local government, police, ambulance, local licensees. Set in UK |
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Participants | Rates of violence reported to the Cardiff police and hospital admissions in Cardiff due to violence were recorded for the population of Cardiff (324,800 in 2001), surrounding areas and visitors. Data collection was monthly between 2000 and 2007. There were 33 months of observations before the programme was implemented and 51 months after implementation. Changes in violence were also compared with 14 control cities classified as most similar by the Home Office (Birmingham, Bristol, Coventry, Derby, Leeds, Leicester, Lincoln, Newcastle upon Tyne, Northampton, Plymouth, Preston, Reading, Sheffield, Stoke on Trent). |
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Interventions | Cardiff Violence Prevention Programme was established to share data between agencies and use the information for violence prevention through targeted policing and other strategies. The multiagency violence prevention group was set up in 1997 and included city government (education, transport, licensing regulators) police, an emergency department consultant and an oral and maxillofacial surgeon, ambulance service and local licensees. The programme became operational in January 2003 with full data sharing between partners. Information from emergency department consultations and police intelligence data was combined to generate constantly updated violence hotspot maps and summaries of weapon use and violence type, classified to fit with national crime survey categorisation. Adjustments were made to police patrol routes, moving resources from the suburbs into the city centre at weekends, targeting problematic licensed premises and deployment of closed circuit television. Traffic flows and public transport were improved. Sections of the city centre where bars and nightclubs were concentrated were pedestrianised (2004). Plastic glassware was mandated in selected licensed premises (2005). The national crime recording standard was introduced police force by police force between 1999 and 2002 to increase and standardise reporting rates. It was introduced in the South Wales police force, incorporating the Cardiff area in April 2002. |
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Outcomes | Health service records of hospital admissions related to violence and police recordings of woundings and less serious assaults | |
Notes | Additional resource was a data analyst to combine health and police data. Changes were introduced sequentially through the life of the programme. Overall risk of bias was unclear. |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Intervention and control populations unlikely to have been aware of formal study |
Blinding (performance bias and detection bias) All outcomes | Low risk | Research team aware of status of intervention and control areas but routinely collected data (police reports and hospital activity) used to assess progress |
Incomplete outcome data (attrition bias) All outcomes | Low risk | No evidence of incomplete data due to outcomes measured by routine data collection |
Selective reporting (reporting bias) | Low risk | No evidence of selective reporting. |
Other bias | High risk | Control cities selected to be similar in a range of sociodemographic and geographic factors which together are linked to levels of crime. Study design not an RCT and has an inherent risk of bias. |
Randomisation adequately described/protected? | High risk | No randomisation but the intervention city was compared to a range of other cities. |
Protection against contamination? | Low risk | Contamination unlikely. Intervention required 33 months to develop for the intervention city. No such time or resource was possible in the control cities. |
Follow‐up rate adequate? | Low risk | Routinely collected population data used |
Reliable primary outcome measure? | Low risk | Yes, routinely collected data |
Groups measured at baseline? | Low risk | Good information pre‐intervention |
Appropriate choice of controls (CBA studies only)? | Unclear risk | N/A |
Contemporaneous data collection (CBA studies only)? | Unclear risk | N/A |
IS THE STUDY AT LOW RISK OF BIAS? | Unclear risk | Well conducted study. At low risk of bias for an ITS |