Using free breath testing devices to change patron's transportation behaviour in the Kimberley.

Louise Spehr, Project Officer, Kimberley Public Health Unit July 2000 - 15^th June 2001;
Dr Donna Mak, Medical Officer, Kimberley Public Health Unit;
Dr Rina Cercarelli, Research Fellow and Deputy Director, Road Accident Prevention Research Unit, University of Western Australia; and
Sergeant Brian Jefferies, Staff Officer, Kimberley District Police Office

Mailing address:
Louise Spehr
RoadWise Regional Road Safety Officer
C/- Shire of Broome
PO Box 44
BROOME WA 6725

Ph: (08) 9191 3456, Mob: 0419 192 759
Fax: (08) 91913455
E-mail: roadwise@broome.wa.gov.au

ABSTRACT

Issue addressed: This paper reports on baseline surveys from a health promotion pilot project designed to examine the role that breath testing devices May have in road safety in the Kimberley region of Western Australia.

Methods: Baseline patron surveys were conducted in participating licensed premises to determine patrons' attitudes to alcohol consumption and drink driving/walking prior to the introduction of the breath testing devices.

Results: Four hundred and eighty eight patrons (71% non-Indigenous and 29% Indigenous) from eight licensed premises in six Kimberley towns were surveyed. Findings indicate that Indigenous people tend to binge drink while non-Indigenous persons drink on more days of the week. Nineteen percent of all patrons consumed alcohol in a licensed premises, on average, every day. Transportation behaviour after consuming alcohol was noteworthy with 19% of patrons planning to drive home after consuming alcohol and 36.5% planning to walk. Of those who planned to drive, 20% had consumed more than four drinks and 57.5% of those planning to walk had consumed more than four drinks. Patrons placed a high level of importance on staying under the legal limit when driving; and as expected, a relatively low level of importance was put on staying under the legal limit when walking.

Conclusions: Drink driving and drink walking behaviour is prevalent in the Kimberley. This study examines if self breath testing devices will change this behaviour. These findings will be compared with post intervention data (being collected presently) to assess the impact of breath testing machines on alcohol consumption patterns and transportation behaviour following alcohol consumption.

Key words: Alcohol, drink driving, drink walking, self breath testing devices.

1. INTRODUCTION

1.1 Alcohol consumption patterns and road safety in the Kimberley

Alcohol consumption is high in the northern part of Western Australia. The per capita consumption of alcohol in the Kimberley region for the financial year 1997/98 was 66 % higher (17.2 litres of absolute alcohol) than the state per capita consumption (10.3 litres of absolute alcohol), this has an impact on road safety in the region¹. In 1998, 46 % of road fatalities in the Kimberley had a blood alcohol concentration exceeding 0.05% compared to 34% for Western Australia as a whole².

Many education campaigns and other interventions are directed to those who live in the metropolitan area to reduce the impact of alcohol on road safety. However, not all of these programs are tested in the rural and remote regions of Western Australia. Breath testing devices (both wall mounted in licensed premises and hand held devices) are commonly found in the metropolitan area and have been found to have a positive effect on drinking and driving behaviour as they allow drivers to determine their blood alcohol concentration³. However, little is known of their role in rural and remote areas.

1.2 Educational Value of Breath Testing Devices

Self breath testing machines are a valuable tool for a person to learn about their own blood alcohol level. This knowledge is invaluable, as it has been found that the knowledge gained from self-testing can be, and has been, applied in future situations. Mackiewicz found after conducting over 300 interviews and observations in Melbourne, that those respondents who had used breath testing machines previously were more accurately able to estimate their blood alcohol content when compared to those who had never used one⁴.

1.3 Gaps in Breath Alcohol Testing

Literature demonstrating the effects of breath testing machines in rural and remote areas of Australia is sparse. Crundall carried out a trial of coin-operated breath testers in one capital city and three rural towns in the Northern Territory in 1996 and this is the only data that is available⁵. Data showing the effects of these devices in areas with large Aboriginal populations cannot be found. Garrow found that Aboriginal people were over represented in road traffic crashes in the Kimberley, yet self breath testing equipment is not currently available in any licensed premises the Kimberley⁶.

It is evident that many Aboriginal people prefer to drink in the open and at major social gatherings in the Kimberley rather than in a licensed premise. The availability of hand held breath testers to those who do not drink in licensed premises will ensure equity of access so that people to May learn more about their drinking and therefore make informed decisions about their behaviour relating to drink driving and drink walking.

1.4 The Kimberley Breath Testing Project

This project is being funded by Healthway and began on July 2nd 2000, it will run for two years until July 2002. The project will examine the role that free breath testing devices May have on road safety in a rural and remote region of Western Australia. It aims to promote safe transportation following alcohol consumption for both 'drivers' and 'pedestrians'. A range of strategies are being implemented including the provision of eight hand-held breath-testing devices free of charge for events and social gatherings, the installation of eight free breath testing machines in licensed premises, safe server training for hotel staff, posters and a radio advertising campaign. This paper will report on the results of baseline surveys conducted prior to the installation of the wall mounted machines and the use of the hand held machines at events.

2. METHODS

This project is being carried out in the Kimberley, which is a region in the Northwest of Western Australia. The regions population is estimated in the 1996 census as being 32, 781 making up less than 2% of the states overall population⁷. Aboriginal people in the region comprise 12,742 people, which is 25% of the states total Aboriginal population. Fifty seven percent of Aboriginal people live in remote areas compared with only 37% of the non Aboriginal population⁷.

2.1 Participants

Seven hotels and one club in six towns in the Kimberley are participating in the project. Each licensed premises agreed to have a wall mounted breath testing machine installed inside their premises.

Patrons on each of these premises at the time the Project Officer and Research Assistant visited the premises were asked if they would be willing to participate in the survey. A total of 488 baseline interviews with patrons (>18 yrs) were collected. Of those, 367 (75%) were male and 121 (25%) were female. One hundred and thirty nine (38.5%) patrons were Aboriginal and 349 (71.5%) were non-Aboriginal. Interviews were conducted in participating licensed premises in all six Kimberley Towns.

2.2 Survey Instrument

The survey instrument utilized was developed by the Project Officer in conjunction with The Health Promotion Evaluation Unit at the University of Western Australia. It was a challenge to come up with an instrument that could be understood by patrons with varying educational and comprehension levels. The survey instrument consisted of 17 questions. As well as basic demographic data (age, Aboriginality, gender, place of residence) questions addressed patrons' attitudes to alcohol and drink driving/walking, behaviour related to drink driving and other methods of transport after consuming alcohol, alcohol consumption patterns, attitudes to breath testing devices and past use of breath testing devices.

Data was collected during September, October and November 2000, by a Project Officer with the assistance of a male Aboriginal Research Assistant. The surveys were conducted on a one to one interview type basis, whereby each question including the available responses was read out to the respondent. The interviewer then checked the box on the questionnaire that matched the respondent's answer. The surveys were conducted in all eight participating licensed premises at various times of the day and on varying days of the week. Each prospective participant was given the opportunity to refuse to participate in the survey, refuse to answer any question or stop the survey at any time. The interview proceeded only if informed consent was given by the prospective participant.

3. RESULTS

3.1 Patrons knowledge and attitudes

The number of surveyed patrons, who knew what the legal blood alcohol limit for a standard driving licence is, was good. Three hundred and fifty four (72.5%) giving a correct answer, 102 (21%) didn't know and 25 (5%) gave an incorrect answer. Seventy three percent of all patrons surveyed thought it was very important to stay under the legal limit when driving home compared to 40% who thought it was very important when they were walking home (see figures 1 & 2).

Figure 1: Patrons perceived importance of staying under the legal limit when driving home.

Figure 2: Patrons perceived importance of staying under the legal limit when walking home.

Patrons were asked how often, on average, they drive or walk home after consuming alcohol. Tables 1 and 2 show the surveyed patrons responses to this question. If was found that 53.5% of patrons surveyed, on average, said that they never drive home after consuming alcohol while 24% said they never walk home. Two point five percent said they always drive home after consuming alcohol compared with 21% who always walk home.

Table 2: How often, on average, patrons said they consumed drinks containing alcohol and the drove home.

3.2 Alcohol Consumption behaviour

Patrons were asked on how many days in the last week they had consumed 4 or more (men) and 2 or more (women) drinks containing alcohol. Twenty nine point five percent of surveyed patrons said they consumed this amount of alcohol on all seven days in the last week, 15.5% on one day and 13% on two days (see table 3).

Table 3. Number of days in the last week patrons consumed 4 or more (men) and 2 or more (women) alcoholic drinks.

Further analysis by race found that non-Aboriginal patrons had consumed alcohol on more days of the week than Aboriginal patrons. Results showed that whilst Aboriginal patrons consumed alcohol more often between 0-2 days of the week, the number of non-Aboriginal patrons consuming alcohol on seven days in the last week was almost double the number of Aboriginal patrons. (see figure 3).

Figure 3: Percentage of patrons who consumed 4 or more (men) and 2 or more (women) alcoholic drinks by race and number of days in last week.

Patrons were also asked how many alcoholic drinks they had consumed on the day of the survey. Results showed that 42% had consumed between one and three drinks, 22% had consumed between four and six and 19% had consumed more than 10 drinks (see table 4).

Table 4: Number of drinks containing alcohol patrons had consumed on the day/night of the survey.

Further analysis by race found that Aboriginal patrons had consumed more drinks than non-Aboriginal patrons. Twenty nine percent of Aboriginal patrons had consumed more than ten drinks compared with 15% of non-Aboriginal patrons (see figure 4).

Figure 4: Percentage of patrons by race and number of drinks consumed on day/night of the interview.

Patrons were asked how they usually determined when they have reached the legal limit (0.05). Forty four point five percent of patrons surveyed said that they judged their blood alcohol level on how they felt, 32% by counting the number of drinks they had consumed and 10% didn't know what level they were.

3.3 Transportation behaviour

The most common method of transport home for surveyed patrons was walking alone (26%), followed by getting a lift (22%), driving (19%) and walking with others (14.5%). Of the 94 patrons who said they were going to drive 20% had consumed more than four drinks. Of the 200 patrons who said they were going to walk home 115 (57.5%) had consumed more than four drinks. One hundred and nine patrons indicated that they were getting a lift home, of which 40 (36.5%) said that the person who was driving the car they were going home in had consumed alcohol.

3.4 Attitudes to and use of breath testing machine

Patrons were asked if they would consider using a breath testing machine if there was one available at their drinking venue. Sixty seven percent of those surveyed said that they would use it, 29% said they would not and 4% didn't know. When those that answered no were asked why they would not use the machine a range of answers was given with the most common being that they "don't drive" (n = 34), followed by "I don't drink and drive" (n = 26) and "they are not accurate" (n = 16). Figure 5 shows patrons other responses.

Figure 5. Patrons reasons for not using a breath testing machine.

4. DISCUSSION

This survey aimed to gain baseline data of patrons', attitudes to alcohol and drink driving/walking, their behaviour related to drink driving and other methods of transport after consuming alcohol, alcohol consumption patterns, attitudes to breath testing devices and past use of breath testing devices. These findings give an overall picture of what patrons attitudes and behaviours were prior to the implementation of the Kimberley Breath Testing Project. The results will be used to assess, upon the completion of the project in July 2002, any behaviour modification in relation to drinking and driving/walking as well as changes in general alcohol consumption amongst patrons at the participating licensed premises.

The results from this survey show that at present the incidence of drink driving and walking whilst under the influence of alcohol is high in the Kimberley. The self-reported attitudes and behaviours of patrons at participating licensed premises found, as expected, little importance is placed on staying under the legal limit when walking home, however a high level of importance was placed on staying under the limit when driving home. This being contradictory to what almost 20% of patrons surveyed said they intended to do - drive home after consuming alcohol.

It was found that there were differences in alcohol consumption patterns between the Aboriginal and non-Aboriginal people surveyed. Non-Aboriginal patrons reported drinking on more days of the week than Aboriginal people and Aboriginal people reported consuming more alcohol when they drank compared to non-Aboriginal people. Overall alcohol consumption patterns in the Kimberley are high and this has an impact on road safety in the region.

It could be said from the results that there was a fairly high acceptance of breath testing machines amongst those that were surveyed with 67% of those surveyed indicating that they would use one. However, almost 30% of patrons indicated that they would not use a breath testing machine if there was one in their licensed premises. Inaccuracy, not drinking and driving and not drinking alcohol were the main reasons given by patrons for not using a breath testing machine.

It should be remembered that these findings are derived from self-report, and it could be argued that this also results in some over or under-estimation of the amounts of alcohol consumed. Anecdotally, it was also found that some patrons falsely reported their intentions on how they were getting home. This false reporting could possibly be because it is illegal to drink and drive and or because it is becoming more socially unacceptable to drink and drive.

It must also be remembered that the sample used for this project are those persons who generally are drinkers of alcohol and frequent licensed premises. It was decided to only survey those persons inside the licensed premises as it was those people who made up the target group and therefore more likely to use a breath testing machine.

5. CONCLUSIONS

The findings from this survey provide some understanding of the attitudes and behaviours of patrons at the licensed premises participating in the Kimberley Breath Testing Project. Such data provides an evidence base upon which the success of the project can be determined. Data post installation of the breath testing machines is presently being collected and it is hoped, if the results are positive, that they can be used to lobby government and Liquor Licensing authorities for more widespread availability of breath testing devices at licensed premises and venues.

6. REFERENCES

Unwin. E. 2000. Personal Communication. Health Department of Western Australia: Health Info Centre.

Cercarelli, LR, Krov,C & Legge,M. 1999. Reported Road Crashes in Western Australia, 1998. Road Accident Prevention Unit: Perth.

Mackiewicz, G. 1988. The efficacy and educative value of coin-operated breath testers. Road Traffic Authority, Victoria.

Mackiewicz, G. 1989. The efficacy and educative value of coin-operated breath testers. Proceedings of the 11^th International Conference on alcohol, Drugs and Traffic Safety. National Safety Council, Chicago.

Crundall, I. 1996. A trial of coin-operated breathalysers in the Northern Territory. Alcohol and Other Drugs Services, Territory Health Services.

Garrow, S. 1997. Vehicle crash mortality in the Kimberley region, 1990-94 - The role of open load space passengers in utility trucks. Australian and New Zealand Journal of Public Health, 21(3), 341 - 342.

Australian Bureau of Statistics. 1996. Population distribution, Indigenous Australians. Catalogue No. 4705.0. Canberra: Australian Government Publishing Service.

7. ACKNOWLEDGEMENTS

The authors would like to thank Jo Clarkson from the Health Promotion Evaluation Unit at the University of Western Australia for her valuable help with the development of the survey instrument.

BIOGRAPHY OF THE AUTHORS

Louise Spehr is presently the RoadWise Regional Road Safety Officer for the Kimberley. From July 2000 - June 2001 she worked with the Kimberley Public Health Unit as the Project Officer for the Kimberley Breath Testing Project. Prior to this she worked as a Health Promotion Officer with the Pilbara Public Health Unit responsible for all injury prevention programs including road safety programs. She has 3 years experience working in the area of road safety in the North West of Western Australia and holds a Bachelor of Health Science with a Major in Health Promotion.

Dr Donna Mak has been working as a public health physician at the Kimberley Public Health Unit for six years. Previously she was a general practitioner at Fitzroy Crossing. Donna initiated the Kimberley Breath Testing Project because of public demand for regional road safety programs to address alcohol-related road injury.

Dr Rina Cercarelli is a Research Fellow and Deputy Director of the Injury Research Centre of the University of Western Australia. She has a Bachelor of Arts degree with Honours in Psychology, and a PhD from the University of Western Australia, and has over 10 years of experience in road safety research. Her main research interests have been in the areas of human behaviour in road safety. She is the Chair of the Drink/Drug Driving Task Force, and is a member of the Aboriginal Road Users Task Force, Driver Training and Licensing Task Force, Fatigue Management Task Force, and the Motorcycle Reference Group, as well as President of the Injury Control Council of Western Australia.

Sergeant Brain Jefferies is presently the Staff Officer at the Kimberly District Police Office and part of his role is District Traffic Coordination. Brian has been involved in traffic management and road safety in excess of 20 years and holds a Diploma of Policing.

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