Spatial spillover effects of a community action programme targeting on-licensed premises on violent assaults: evidence from a natural experiment

J Epidemiol Community Health. 2016 Mar;70(3):226-30. doi: 10.1136/jech-2015-206124. Epub 2015 Oct 5.


Background: Spatial dependencies may influence the success of community action strategies to prevent and reduce harmful alcohol use. This study examined the effectiveness of a multicomponent Responsible Beverage Service (RBS) programme targeting on-licensed premises on police-recorded assaults in Swedish municipalities. It was expected that the implementation of the programme within any given municipality had an indirect effect by reducing violent assaults in adjacent municipalities.

Methods: This study was a natural experiment exploiting the temporal and spatial variation in the implementation of the RBS programme to predict change in the rate of violent assaults in all Swedish municipalities during 1996-2009 (n=288; T=14; N=4 032). Yearly police-recorded violent assaults per 100,000 inhabitants aged 15 and above committed on weekend nights were used as a dependent variable. Programme fidelity was identified by means of survey data. A semilogarithmic fixed-effects spatial panel regression model was used to estimate the direct, indirect and total effects of the programme.

Results: The direct, indirect and total effects were -1.8% (95% CI -4.4% to 0.8%), -5.8% (95% CI -11.5% to -0.1%) and -7.6% (95% CI -13.2% to -2.2%), respectively. Averaged over time and across all municipalities, implementing one additional programme component in all municipalities will thus reduce violent assaults in one typical municipality by nearly 8%.

Conclusions: The indirect effect of the programme was three times larger than its direct effect. Failing to account for such local spillover effects can result in a considerable underestimation of the programme's total impact and may lead to erroneous policy recommendations.


Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aggression
  • Alcohol Drinking / psychology*
  • Alcoholism / prevention & control*
  • Cities
  • Community Participation*
  • Community-Based Participatory Research
  • Crime / prevention & control
  • Crime / statistics & numerical data
  • Female
  • Humans
  • Licensure*
  • Male
  • Police
  • Public Facilities / statistics & numerical data
  • Social Responsibility
  • Sweden
  • Violence / prevention & control*
  • Violence / statistics & numerical data
  • Young Adult