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VINTAGE project. Best practices for prevention of  alcohol-related harm in the elderly in the EU

VINTAGE project. Best practices for prevention of  alcohol-related harm in the elderly in the EU Emanuele Scafato, Istituto Superiore di Sanità, Rome, ITALY Director Population Health Unit -CNESPS Osservatorio Nazionale Alcol – CNESPS

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VINTAGE project. Best practices for prevention of  alcohol-related harm in the elderly in the EU

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  1. VINTAGE project. Best practices for prevention of  alcohol-related harm in the elderly in the EU Emanuele Scafato, Istituto Superiore di Sanità, Rome, ITALY Director Population Health Unit -CNESPS Osservatorio Nazionale Alcol – CNESPS WHO CC for Health Promotion and Research on Alcohol National Centre on Epidemiology, Surveillance and Health Promotion President Italian Society of Alcohology - SIA EAHC Workshop on Best Practice Models for Addiction Prevention Projects funded under the Health Programme – Luxenbourg 25-26/01/2010

  2. Project name: Good health into older age Acronym: VINTAGE Starting date: 01.03.2009 Duration: 18 months Main beneficiary: ISS - Istituto Superiore di Sanità, Rome, Italy Associated partners: UNIMAAS - Maastricht University, Netherlands GENCAT - Government of Catalonia, Barcelona, Spain IAS - Institute of Alcohol Studies, Huntingdon, United Kingdom IVZ - Institute of Public Health, Ljubljana, Slovenia THL - National Institute for Health and Welfare, Helsinki, Finland SZU - National Institute of Public Health, Praha, Czech Republic

  3. Harmful alcohol use is common amongst older people: as many as 27% of European people aged 55+ years binge drinked (5+ drinks, 50g alcohol on one occasion) at least once a week during the previous 12 months (Eurobarometer 2007). Alcohol use disorders are common in older people, and with an ageing European population will increase in absolute numbers (O’Connell et al 2003). Despite the extent of harmful alcohol use among older people and this demographic shift, there are surprisingly few recent systematic reviews that document the full extent of such harm, or that provide the evidence base for cost effective policies and programmes to reduce it. VINTAGE aims at reducing this knowledge gap, by providing evidence base of harmful alcohol use among older people and collecting concrete and practical examples of best practice across all European countries, at country, regional and municipal levels. Background

  4. "THE COUNCIL OF THE EUROPEAN UNION: • NOTES: • that older adults (aged 60 and above) are more • sensitive to the effects of harmful use of alcohol • than other adults, and that alcohol-related deaths • among older adults have increased markedly • over the last ten years, and that in some cases • the death rate has more than doubled; INVITES MEMBER STATES TO • INVITES THE COMMISSION AND MEMBER STATES TO • include in existing information systems scientific data on alcohol consumption and harm • caused by harmful use of alcohol in the age group of 60 and above; • - develop and implement early identification and brief intervention procedures in primary and elderly health care and in school health settings

  5. ITALY. Hazardous (daily) drinkers exceeding the National Guidelines limits for alcohol consumption. 2008

  6. The definition of hazardous drinkers (ISS criteria) According to the Italian guidelines for a healthy diet hazardous drinkers are subjects who fulfil one of the following criteria: 1 standard unit = 12 grams

  7. ITALY. Alcohol consumption INTAKE by daily drinkers ONLY, by age Contribution (%) of the different beverages to harmful consumption D A I L Y I N T A K E > 64 19-64 11-18 Contribution (%) of the different beverages to harmful consumption

  8. ITALY. Alcohol consumption , FEMALES INTAKE by daily drinkers ONLY , by age Contribution (%) of the different beverages to harmful consumption D A I L Y I N T A K E > 64 19-64 11-18 Contribution (%) of the different beverages to harmful consumption

  9. At present, there is no indication that light to moderate alcohol drinking would be harmful to cognition and dementia, and it is not possible to define a specific beneficial level of alcohol intake.

  10. Road accident in the elderly: the next priority?

  11. The main objective of VINTAGE is to improve knowledge and to build capacity, at European, national and local level, in order to prevent the harmful use of alcohol among elderly subjects: • provide evidence-based information on the impact of alcohol on health and well-being  systematic reviews • collect examples of best practices, effective policies and programmes for the reduction of harmful alcohol use  structured questionnaire • active dissemination of reports and database of best practices, relevant laws and infrastructures  VINTAGE website + other online networks + list serve of stakeholders Objectives and Methods

  12. VINTAGE websitehttp://www.epicentro.iss.it/vintage/

  13. An external evaluation has been undertaken, following a case study evaluation methodology: • Process evaluation • analysis of written documentation (meeting notes and minutes, reports, etc.) • network survey to project staff and members, assessment of quality of information • Output evaluation • review of project outputs, in terms of scientific accuracy, readability, usability and ease of access, by a panel of selected scientists • Outcome evaluation • assessment of long-term increased health and well-beeing of elderly subjects through 3 intermediate measures (extent of dissemination, hits to websites and numbers of documents downloaded, stakeholders intention of modifying existing policies and practices) Evaluation Plan

  14. Indicators used and link with the specific objectives

  15. Collected examples include a wide range of activities, for example laws and policies to reduce BAC level in older people, restrictions to alcohol access, information messages and campaigns, or alcohol prevention and treatment services, sensitive to the elder's need, including the transition from work to retirement Project any action (research, prevention, etc.) endorsed with a clear start and end point Programme a group of integrative, continuously implemented actions bPractices intervention approaches that, through experience or research, have been proven to reliably lead to a desired result (in a specific target group of people) Definition adopted in the collection of PPbP

  16. Duration of the project 18 months: 01.03.09-31.08.10 Time table of work packages and deliverables

  17. Evidence base • Definition of aims, methods and procedures for the literature review on alcohol and older people • Start of the formal and grey literature searches (almost 200 relevant publications already identified). In progress Experience base • Definition of aims, methods and instrument for collecting examples of PPbP • Start of data collection (almost all countries already contacted). In progress Dissemination • Design, implementation and launch of the project website http://www.epicentro.iss.it/vintage/ • Elaboration of the dissemination strategy • Creation of a list serve of stakeholders for dissemination of electronic copies of results. In progress Results achieved in reference to the specific objectives

  18. http://www.eurocare.org/library/latest_news/call_for_best_practices_on_preventing_the_harmful_use_of_alcohol_in_older_people__1http://www.eurocare.org/library/latest_news/call_for_best_practices_on_preventing_the_harmful_use_of_alcohol_in_older_people__1

  19. http://www.epicentro.iss.it/vintage/assessment.asp

  20. According to the original VINTAGE plan, collected examples of projects, programmes, practices, laws and infrastructures will be evaluated according to the following set of criteria: • Needs assessment • Accessibility • Setting approach • Collaborative capacity building and partnership • Evaluation • Sustainability • Transferability • Availability of results • Transparency of funding and support VINTAGE criteria for evaluation of PPbP

  21. Ranking and rating collected examples is not a goal of VINTAGE project and the results of the evaluation will not be public but internal • All findings (reports on literature review and examples of best practices, relevant laws and infrastructures), independently from their efficacy and effectiveness, will be disseminated to those responsible for aging population policy or alcohol policy and programme development, in order to encourage evidence- and experience-based decisions for the improvement of older people health and welfare • Any further analysis and evaluation of findings, even on the basis of EDDRA criteria, could be the possible objective of a VINTAGE2 project Aims and methods for evaluating collected examples

  22. THANK YOU FOR YOUR ATTENTION Emanuele Scafato ISTITUTO SUPERIORE DI SANITA' NATIONAL HEALTH INSTITUTE Via Giano della Bella, 34 00161 Rome, Italy  Tel : (+39) 06 4990 4028 o 4029 (segr.)Fax:  (+39) 06 4990 4193Mob. (+39) 346 6959152E-mail: emanuele.scafato@iss.it

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