***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background An increased prevalence of risky alcohol consumption and alcohol-related harm has been reported for members of sporting groups and at sporting venues compared with non-sporting population s. While sports clubs and venues represent opportune setting s to implement strategies to reduce such risks , no controlled trials have been reported . The purpose of the study was to examine the effectiveness of an alcohol management intervention in reducing risky alcohol consumption and the risk of alcohol-related harm among community football club members . Method A cluster r and omised controlled trial of an alcohol management intervention was undertaken with non-elite , community football clubs and their members in New South Wales , Australia .  Risky alcohol consumption ( 5 + drinks ) at the club and risk of alcohol-related harm using the Alcohol Use Disorders Identification Test ( AUDIT ) were measured at baseline and postintervention . Results Eighty-eight clubs participated in the trial ( n=43 , Intervention ; n=45 , Control ) and separate cross-sectional sample s of club members completed the baseline ( N=1411 ) and postintervention ( N=1143 ) surveys . Postintervention , a significantly lower proportion of intervention club members reported : risky alcohol consumption at the club ( Intervention : 19 % ; Control : 24 % ; OR : 0.63 ( 95 % CI 0.40 to 1.00 ) ; p=0.05 ) ; risk of alcohol-related harm ( Intervention : 38 % ; Control : 45 % ; OR : 0.58 ( 95 % CI 0.38 to 0.87 ) ; p<0.01 ) ; alcohol consumption risk ( Intervention : 47 % ; Control : 55 % ; OR : 0.60 ( 95 % CI 0.41 to 0.87 ) ; p<0.01 ) and possible alcohol dependence ( Intervention : 1 % ; Control : 4 % ; OR : 0.20 ( 95 % CI 0.06 to 0.65 ) ; p<0.01 ) . Conclusions With large numbers of people worldwide playing , watching and sports officiating , enhancing club-based alcohol management interventions could make a substantial contribution to reducing the burden of alcohol misuse in communities . Trial registration number ACTRN12609000224224 In a cluster r and omized controlled trial , Anthony Shakeshaft and colleagues measure the effectiveness of a multi-component community-based intervention  for reducing alcohol-related harm Background The objective of this study was to establish baseline data on alcohol consumption patterns , behaviours and harms among amateur sportsmen in the Republic of Irel and . Findings The study presents findings from the baseline survey for a cluster r and omised controlled trial to evaluate the effectiveness of a community intervention programme to reduce problem alcohol use among a representative sample of Gaelic Athletic Association ( GAA ) clubs in two counties in the Republic of Irel and .  Self reported alcohol use , prevalence of binge drinking , AUDIT scores and alcohol-related harms were assessed in amateur GAA sportsmen aged 16 years and over . Nine hundred and sixty ( 960 ) players completed question naires ( 72 % response rate ) . Mean age was 24.0 years ( S.D. 5.2 ) . Of those aged 18 years or over , 75 % had post- primary education ; most ( 864 , 90 % ) were current drinkers and 8.2 % were regular smokers . The self-reported average yearly alcohol consumption was 12.5 litres . Almost one third ( 31 % ) of current drinkers reported drinking over the recommended limit of 21 st and ard drinks per week and just over half ( 54.3 % ) reported drinking 6 or more st and ard drinks in a row at least once a week ( regular binge drinking ) . Of those who ( self ) completed the Alcohol Use Disorder Identification Test ( AUDIT ) question naire , three-quarters ( 74.7 % ) had a score of 8 or more ; 11.5 % had a score of 20 or above warranting referral for diagnostic evaluation and treatment . Almost all ( 87.6 % ) of the 864 drinkers reported experiencing at least one harm due to their drinking . These alcohol misuse outcomes were higher than those found in a nationally representative sample of males of a similar age . There were strong associations between regular binge drinking and reporting harms such as being in a fight ( adjusted odds ratio ( OR ) 2.02 , p < 0.001 ) , missing time from work or college ( adjusted OR 1.39 , p = 0.04 ) or being in an accident ( adjusted OR 1.78 , p = 0.04 ) . Conclusions These male amateur sportsmen reported high rates of alcohol consumption and alcohol-related harm Development , content , and evaluation of the Alcohol Skills Training Program ( ASTP ) is described . Patterned after strategies for relapse prevention , the ASTP is a cognitive behavioral approach to the secondary prevention of alcohol problems . Format and context of the six group sessions are detailed , and process considerations are discussed . Results are summarized for two controlled investigations of the ASTP with young adult drinkers . The psychoeducational approach of the ASTP is recommended as an effective means for changing drinking patterns among young adults who are at risk for alcohol-related problems Introduction Alcohol consumption is a primary cause of physical , psychological and social harm to both the user and others . At both the professional and non-professional level , sports players and fans report consuming alcohol at greater levels than people not involved in sports . Limited systematic review s have been conducted assessing interventions targeting alcohol consumption behaviour and related harms in the sporting context . Methods and analysis The review aims to determine if interventions implemented in the sport setting decrease alcohol consumption and related harms .  Participants may include all persons regardless of age or other characteristics . Studies will be included which have implemented interventions within the sport setting and have either measured : alcohol consumption , excessive alcohol consumption or intoxication or alcohol-related injury or violence . R and omised controlled trials , staggered enrolment trials , stepped-wedged trials , quasi-r and omised trials , quasi-experimental trials and natural experiments will be included . Studies without a parallel comparison group will be excluded . Data will be source d from a range of electronic data bases and sources of grey literature . Two authors will independently screen all titles and abstract s of papers identified through the search strategy . Two authors will independently examine the full text of all remaining papers to determine eligibility . Two authors will independently extract data from eligible studies and independently assess risk of bias by assessing the adequacy of study characteristics . Where studies are sufficiently homogeneous , trial results will be synthesis ed using a fixed-effects meta- analysis . St and ardised mean differences will be used for continuous outcomes and RRs will be used for binary outcomes . Dissemination The findings of this study will be disseminated widely through mechanisms including peer- review ed publications and conference presentations OBJECTIVE The purpose of this research was to examine whether the clustering of underage risky drinking and its consequences within communities might arise from shared perceptions regarding underage drinking as well as the social context of drinking . METHOD The Enforcing  Underage Drinking Laws R and omized Community Trial provided data from repeated cross-sectional sample s of 5,017 current drinkers ( 2,619 male ) ages 14 - 20 years from 68 communities surveyed in 2004 , 2006 , and 2007 .  Alternating logistic regressions were used to estimate the influence of social factors on the clustering of getting drunk , heavy episodic drinking , nonviolent consequences , and driving after drinking or riding with a drinking driver . RESULTS The clustering of getting drunk , heavy episodic drinking , and nonviolent consequences was no longer statistically significant after adjustment for drinking with friends and drinking with parents . Parents providing alcohol explained the clustering of heavy episodic drinking and nonviolent consequences , whereas drinking with other underage drinkers and friends providing alcohol explained the clustering of nonviolent consequences . Drinking with friends or other underage drinkers and friends providing alcohol increased the risk of these behaviors , whereas drinking with parents and parents providing alcohol were protective . Perceptions regarding peer drinking , community norms , consequences for drinking , and drinking at a party did not influence clustering . CONCLUSIONS These findings suggest that interventions to reduce underage  risky drinking in communities should focus on the differential effects of the social context in which drinking occurs PURPOSE This study examines heavy episodic alcohol consumption and associated harms in collegiate athletes in the United States . The factors which may promote or deter such use are explored . METHODS R and omly selected students in a nationally representative sample of 4-yr colleges in the United States completed self-report question naires in the spring of 1997 . Athletes were defined as students who participated in one or more hours of intercollegiate athletics per day . Heavy episodic or " binge " drinking for men was defined as consuming five or more alcoholic drinks on at least one occasion in the past 2 wk and four or more for women . Athletes were compared with other students at their colleges . RESULTS Athletes reported more binge drinking , heavier alcohol use , and a greater number of drinking-related harms . Athletes are more likely to exhibit the strong social ties found to be associated with binge drinking . Athletes , despite drinking more heavily than other students , report greater exposure to alcohol prevention efforts and possess unique motivations to limit their alcohol use . CONCLUSIONS Athletes are a high-risk group for binge drinking and alcohol-related harms . Although special educational programs have targeted this group they have not sufficiently impacted the problem . Future prevention efforts targeted for athletes should address the unique social and environmental influences on athletes . Programs should also take advantage of motives of athletes for self-limiting alcohol intake . Colleges , athletic departments , coaches , and sports medicine professionals are urged to act to help reduce athletes risk of alcohol-related harms BACKGROUND Practitioners and policymakers need credible evidence of effectiveness to justify allocating re sources to complex , expensive health programs . Investigators , however , face challenges in design ing sound effectiveness and translation research with relevance for " real-world " setting s. METHODS Research experts and federal and foundation funders ( n= approximately 120 ) prepared for and participated in a symposium , held May 4 - 5 , 2004 , to weigh the strengths , limitations , and trade-offs between alternate design s for study ing the effectiveness and translation of complex , multilevel health interventions . RESULTS Symposium attendees acknowledged that research phases ( hypothesis generating , efficacy , effectiveness , translation ) are iterative and cyclical , not linear , since research in advanced phases may reveal unanswered questions in earlier phases . Research questions thus always need to drive the choice of study design . When r and omization and experimental control are feasible , participants noted that the r and omized controlled trial with individual r and om assignment remains the gold st and ard for safeguarding internal validity . Attendees highlighted trade-offs of r and omized controlled trial variants , quasi-experimental design s , and natural experiments for use when r and omization or experimental control or both are impossible or inadequately address external validity . Participants discussed enhancements to all design s to increase confidence in causal inference while accommodating greater external validity . Since no single study can establish causality , participants encouraged replication of studies and triangulation using different study design s. Participants also recommended participatory research approaches for building population relevance , acceptability , and usefulness . CONCLUSIONS Consideration of the study design choices , trade-offs , and enhancements discussed here can guide the design , funding , completion , and publication of appropriate policy- and practice -oriented effectiveness and translational research for complex , multilevel health interventions High-risk drinking on game day represents a unique public health challenge . Objective : The authors examined the drinking behavior of college football fans and assessed the support for related interventions . Participants : The authors r and omly selected 762 football fans , including college students , alumni , and other college football fans , to complete an anonymous online game-day survey .  Methods : The authors collected data on participants ' drinking behaviors and support for specific game-day interventions . Results : Analysis revealed that , overall , fans drank significantly more on game day than they did the last time they partied or socialized . Nondrinkers were the most supportive of game-day interventions , followed by moderate drinkers , whereas heavy drinkers offered the least support . Conclusions : With the exception of limiting tailgating hours on game day , fans support game-day interventions , including alcohol-free alternatives , design ating tailgating areas where open containers are permitted , and increasing law enforcement efforts AIMS The efficacy of batterer intervention programs to reduce intimate partner violence ( IPV ) is question able , with individuals with alcohol problems particularly unlikely to benefit . We examined whether adding adjunctive alcohol intervention to batterer intervention reduced the likelihood of substance use and violence relative to batterer intervention alone . DESIGN R and omized clinical trial . SETTING Batterer intervention programs in Rhode Isl and , USA . PARTICIPANTS A total of 252 hazardous drinking men in batterer intervention programs . Participants were r and omized to receive 40 hours of st and ard batterer program ( SBP ) or the SBP plus a 90-minute alcohol intervention ( SBP + BAI ) . None withdrew due to adverse effects . Data were collected at baseline , 3- , 6- and 12-month follow-up , with follow-up rates of 95 , 89 and 82 % , respectively . MEASUREMENTS Substance use was measured with a well-vali date d calendar-assisted interview . Violence was measured with a vali date d question naire . Arrest records were obtained for all participants . The primary substance use outcome was drinks per drinking day ( DPDD ) and the primary violence outcome was frequency of any physical IPV . FINDINGS Relative to SBP alone , men receiving SBP + BAI reported consuming fewer DPDD at 3-month follow-up [ B = -1.36 , 95 % confidence 
    Output:
    
The Australian study found a significant intervention effect for both risky alcohol consumption at sports clubs and overall risk of alcohol-related harm .
Conclusions A limited number of studies have been conducted to assess the effect of interventions implemented in sports setting s on alcohol consumption and related harms .