Redesign on the fly: Safer Bars and the Toronto experience

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JOHN PURCELL & KATHRYN GRAHAM &
                                        LOUIS GLIKSMAN & COLLEEN TESSIER & JENNIFER JELLEY

                               Redesign on the fly:
      Safer Bars                   and the Toronto experience

In this paper we describe the experiences and les-                        cludes: (1) a formal risk-assessment to help bar
sons learned at the 18-month mark of the Safer                            owners identify and modify physical and social as-
Bars project, a three-year randomised control eval-                       pects of the bar environment that may contribute
uation of an intervention to reduce bar violence.                         to aggression (Graham 1999), and (2) a three-
As part of the planning for the project, findings                         hour training programme for bar staff and man-
and lessons from bar-room intervention and ob-                            agement in ways to prevent and manage aggression
servation research in Australia (Homel et al.                             (Braun et al. 2000).
1997), the US (Saltz & Stanghetta 1997), the UK                              The intervention targets bars with frequent inci-
(MCM Research 1993), Canada (Graham &                                     dents of aggression, but feedback during the devel-
Wells 2001; Wells & Graham & West 1998), and                              opment phase suggested that even owners of non-
elsewhere (see review by Graham 2000) were in-                            problematic bars found the training useful. More-
corporated into the study methods and design.                             over, it was also apparent during the development
The project team also included investigators and                          phase that bar owners were sensitive about being
consultants who were experienced with the work-                           approached, thus, selecting bars specifically be-
ings of bars. In addition, the intervention had been                      cause they had a lot of aggression could pose prob-
tested extensively throughout the province of On-                         lems for recruitment. On the other hand, we need-
tario (see Chandler-Coutts et al. 2000). Neverthe-                        ed to have bars that did have problems with ag-
less, as so happens in real-world research, the im-                       gression so that the potential for improvement as a
plementation of this large-scale project in Toronto,                      result of the Safer Bars programme existed. There-
Canada encountered a number of challenges and                             fore, for the present study, we targeted large-capac-
setbacks. This paper describes the major challenges                       ity bars (>300) which tend to be at high risk for ag-
and how they were addressed.                                              gression. We also chose a time that would maxim-
                                                                          ise the incidence of aggression by conducting ob-
                                                                          servations during high risk periods for violence,
Description of the       Safer Bars     evaluation                        namely midnight to 2 a.m. on Friday and Saturday
                                                                          nights.
The objective of the Safer Bars project is to evalu-                         The original design of the study included 432
ate a newly developed research-based intervention                         pre-test observations in 125 bars to monitor the
(‘Safer Bars’) for preventing and minimising ag-                          environment and document incidents of aggres-
gressive behaviour in bars. The intervention in-                          sion, an intervention phase, 290 post-test observa-
Acknowledgement: This research was supported by a grant (R01 AA11505) to K. Graham from the U.S. National
Institute on Alcohol Abuse and Alcoholism, and its contents are solely the responsibility of the authors and do not
necessarily represent the official views of the NIAAA or NIH.

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Table 1. Revised Study Design

                                                 Baseline                    Recruitment Safer Bars                  First post-test     Second post-test
                                                 observations                of exp. bars intervention
                                            Number          Number                                               Number      Number      Number    Number
                                            of bars         of obser-                                            of bars     of obser-   of bars   of obser-
                                                            vations                                                          vations               vations
Experimental bars                               18              209                 18             18                18        216                   ?
Refusal bars                                     6               71                  6              -                 6         72                   ?
Non-random intervention bars                     5               42                  -              5                 5         60                   ?
Control bars                                    12              146                  -              -                12        144                   ?

Bars dropped from study
Non-random refusers                               2               17
Refusal bar and refused to
allow further observations                        1               11
Refusal bar because special
events and most staff including
doorstaff not permanent                           1               11
Bar closed just before
the intervention                                  1               11
Cost of training prohibitive
and matching problematic
due to size of bar                                1                 5
Rate of aggression too low                      65              294
Bar closed or dropped for other
reasons early in the study (e.g.,
closed, frequent all ages events,
closing at 1am if not busy)                       6                 8

Total number of bars and
observations                                  118               825                                                  41        492

tions and 290 follow-up observations to monitor                                            in conducting research and implementing a pro-
the extent that changes were sustained. The study                                          gramme with bar owners and their staff that led to
used a randomised control design with 50 experi-                                           major changes in the study design, resulting in the
mental bars and 50 controls (matched on type of                                            revised design shown in Table 1.
bar, clientele, location, etc. prior to random as-
signment). A 50% participation rate was expected
based on previous research on responsible beverage                                         Changes to the design during the pre-
service (Saltz & Stanghetta 1997), thus resulting                                          test observation phase
in four groups of about 25 each: (1) bars that
would receive the Safer Bars intervention (experi-                                         The Alcohol and Gaming Commission of Ontario
mental group); (2) bars that were randomly select-                                         provided a list of about 700 licensed premises with
ed to be offered the intervention but were expected                                        capacity greater than 300. Exclusion of non-eligi-
to refuse (refusal group); (3) matched control bars                                        ble bars was done through personal knowledge or
for the experimental bars; (4) matched control                                             knowledge of colleagues, telephone calls to the
bars for the refusal bars. Using the frequency of                                          bars and/or site visits by the project field coordina-
aggression found in research on bars outside of                                            tors. All eligible bars were visited prior to observa-
Toronto during the development phase, sample                                               tions to document characteristics of bar patrons
size calculations suggested that we needed a mini-                                         relevant to sending observers, for example, ethnic-
mum 2.2 visits per bar.                                                                    ity, sexual orientation, demographics and dress
   In the following, we describe the various factors                                       codes. Despite these initial checks, a large number

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of visits were aborted and a number of bars were                         Changes to the design during the
found to be ineligible once observations began.                          intervention and post-test
Visits were aborted because (a) observers did not
meet the dress code or were not considered ‘good
looking’ enough by door staff; (b) the bar closed                        Previous experience recruiting bars outside
unexpectedly or was temporarily closed to the                            Toronto
public due to a special event; (c) observers stood in
line until after 1 a.m. only to be told that they                        During the development of Safer Bars, training
would not get in – this in a particularly cold Cana-                     events were completed with over 20 bars in towns
dian winter.                                                             and cities across Ontario. The most successful pi-
   As the observations progressed, it became appar-                      lot communities shared two things in common -
ent that large-capacity licensed premises in Toron-                      numerous violent incidents occurred in and
to were not as aggressive as anticipated. This                           around licensed establishments late at night, and
turned out to be the biggest problem of the study.                       local committees and associations gave strong sup-
Although many of the bars in the downtown en-                            port for the project and its goal of reducing aggres-
tertainment district were busy during observation                        sion.
periods, they had very low rates of aggression be-
cause: (a) the bars employed lots of well-trained                        Community support for the Toronto project
competent security staff; (b) most patrons used ec-
stasy or marijuana and drank very little; or (c) pa-                     The same community support and backing for the
trons were well-dressed and would be unlikely to                         project was expected in Toronto; however, this was
become involved in incidents that might ruin their                       not the case. The Alcohol and Gaming Commis-
expensive attire. Additionally, the evolution of the                     sion, which was very supportive at the time the
club/rave scene in Toronto during the past 10                            proposal was submitted, had cooled considerably
years, reputedly the largest in North America, ap-                       to research due to changes in the political orienta-
pears to have had a profound impact on the ex-                           tion of the Board as well as due to an increased fo-
pression of aggression. This can be attributed to a                      cus on gaming. Instead, they chose to adopt the
number of interacting factors: techno-trance mu-                         more cautious approach of waiting to see the re-
sic, synthetic ‘designer’ drugs (accompanied by re-                      sults of the outcome study.
duced alcohol consumption), and a diverse and                               We had also expected support from the police,
tolerant multicultural population. The effect is                         which had been very strong in other communities.
that physical aggression appears to have been                            The project manager contacted a community rela-
greatly reduced in this environment.                                     tions police officer who was initially very support-
    To illustrate the extent that bars were low on                       ive and enthusiastic about the project. However, at
aggression, our observers were trained to identify                       a subsequent meeting with police officers who
even the slightest nuance of aggression - a dirty                        worked in the entertainment district (where over
look, mild argument, horseplay, etc., yet, we had                        50% of the bars in the study were located), the in-
bars in the baseline sample that were visited five                       itial goodwill was not evident. Rather than enter-
nights between midnight and 2 a.m. and not a sin-                        ing into a partnership forged on harm reduction,
gle dirty look or mild argument was observed,                            the project manager found herself confronted by
much less physical aggression. Thus bars with no                         resistant police officers interested in whatever in-
or only minor non-physical aggression were ex-                           formation the project could provide them regard-
cluded and the sample of bars for the intervention                       ing violence in bars - specifically the names of bars
phase was reduced to less than 50. The sample for                        and descriptions of incidents.
the randomised experiment was eventually re-
duced to 36 with an additional five bars that re-                        Recruitment of bars
ceived training as part of stimulating interest in the
training among Toronto bar owners. In addition,                          Our experience was that researchers and commu-
the number of visits per bar was increased from                          nity staff from the Centre for Addiction and Men-
three to about 12 in order to increase statistical                       tal Health (CAMH) would have a difficult time
power, due to the reduced number of bars and                             recruiting bars without the support from the po-
generally low rate of aggression.                                        lice and the liquor licensing body. Although the

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study included monetary incentives for managers                                            guarantees that the requisite number of bars
and bar staff who participated, this was felt to be                                        would be recruited in the time period for the inter-
insufficient for recruiting the requisite number of                                        vention. Therefore, the research team took over
bars in the short time available (about 6 months).                                         the responsibility for enlisting bars and setting
Therefore, we began to look for alternative strate-                                        training dates, while the sole role of the training
gies for recruiting bars for training.                                                     agency was to provide the training. First, an enter-
   During the developmental phase of the study we                                          tainment promoter, who had numerous contacts
found that it was difficult to recruit bars initially;                                     with the club and bar industry was enlisted. Sec-
however, once they received the training, they be-                                         ond, a former field coordinator for the pre-test ob-
came strong proponents for the programme.                                                  servations who had previous experience in the in-
Therefore, we decided to draw a small number of                                            dustry as a doorman was also asked to recruit bars.
bars out of the sample to receive training as a kind                                       And finally, the most successful recruiters of all,
of ‘foot in the door’ to the Toronto bar scene. The                                        the recruiting dynamo of Lisa (a sales person) and
Safer Bars training component of this project had                                          Mary (a teacher), were enlisted as recruiters. This
been outsourced to a private company that special-                                         duo just could not take ‘no’ for an answer, and had
izes in delivering training programmes to the On-                                          a certain knack for making bar owners feel like
tario hospitality industry. Four upscale nightclubs                                        they had just won the lottery.
in the current study were owned by a member of                                                 Recruiters were compensated at the rate of
the agency’s board. This provided a convenient                                             $1000 Canadian (about $750 Euros) for each bar
opportunity to present Safer Bars to the Toronto                                           successfully recruited, plus a $250 bonus for bars
bar community, and by using the personal con-                                              signed up before the end of October. A list of the
tacts of the training agency, we were able to recruit                                      experimental bars was circulated to the recruiters,
five out of seven bars approached. These bars were                                         and they were instructed to choose four apiece,
provided training so that when the experimental                                            with new bars assigned after the initial four had
bars were approached, we could use these bars as                                           been completed. The majority of the bars agreed to
references. This strategy of first training several in-                                    participate within the first month, although a
fluential bars proved to be very useful in the subse-                                      number of them dragged their feet in following
quent recruitment phase, even though it did mean                                           through with their agreement to participate and
that the sample for the randomised control trial                                           several backed out altogether.
was reduced.                                                                                  The cash incentives appeared to be an important
   Once these bars were excluded from the ran-                                             aspect in both obtaining participation from the
domisation, this left 39 bars. Because of the small-                                       bar owners and in keeping attendance rates up for
er number of bars in the study, instead of assigning                                       the training. Managers and owners were given
half of the bars to the control condition, we devel-                                       $150 (about 100 Euros) to compensate for their
oped 13 matched triads of which two from each                                              time involved in completing the risk assessment,
group would be assigned to the experimental con-                                           motivating and organising their staff to partici-
dition and one to the control condition. With an                                           pate, and taking part in the training itself. Securi-
expected 50% recruitment rate, this would give us                                          ty/doorstaff, bartenders, servers and other support
13 experimental bars, 13 refusers and 13 controls.                                         staff were paid $45 (about 30 Euros) to participate
However, just as we started the intervention one of                                        in the three-hour training.
the most aggressive bars in the sample was sold and                                           Initially, 21 of the 26 experimental bars agreed
was being renovated and had to be dropped from                                             to participate in the Safer Bars programme. How-
the study. The matching now involved 12 matched                                            ever, although the intervention phase was extend-
groups (two of which contained four bars from                                              ed by two months, ultimately only 18 actually fol-
which three were randomly selected for the experi-                                         lowed through with the training. This participa-
mental condition). Thus, the study now involved                                            tion rate was higher than anticipated and included
approaching 26 bars to receive the intervention                                            enthusiastic participation from at least some of the
(i.e., 26 assigned to the experimental group and 12                                        high aggression bars.
assigned to the control group).
   Negotiations were held with the training agency
to pay them to recruit the bars for the study. How-
ever, they demanded an exhorbitant fee with no

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Working with bar owners and staff                                           While all bar staff were encouraged to attend the
                                                                         training, it was crucial that the individuals specifi-
Training of the experimental bars began in the fall                      cally hired to deal with patron disturbances attend
of 2001 and continued through the winter. The 18                         (i.e. security/doorstaff ). However, in a few cases,
participating bars included the following: seven                         the trainings were poorly attended by the security/
entertainment district nightclubs, three gay bars,                       doorstaff. This problem was particularly acute
two live music venues, one suburban ethnic night-                        with one of the suburban sports bars where several
club, two suburban ’sports bars’, one student bar                        incidents involving aggressive doorstaff had been
and two taverns. Despite the fact that all of the                        documented during the pre-test. Despite an im-
bars in the study were large-capacity establish-                         mediate interest in the training, the general man-
ments (minimum 300-person liquor licence) the                            ager insisted that getting the doorstaff to attend
size of the staff employed varied widely. Four of the                    would be problematic because they were too busy
entertainment district nightclubs employed over                          with their various jobs, and it would be difficult to
50 individuals apiece and required two separate                          find a mutually convenient time. After much ne-
training sessions. At the other end of the scale was                     gotiation, training was set for a Sunday afternoon
a skid-row tavern where training was completed                           to maximize attendance. Yet despite accommodat-
with 3 out of their 4 staff. The interactive training                    ing their busy schedules, and 100% attendance by
format, which was specifically designed to accom-                        non-security staff, the doorstaff did not show up!
modate a wide variety of bars, was generally well                        In a last ditch effort, the project manager (Purcell)
received by participants (overall average ratings on                     visited the bar on a Friday night to recruit the
the value of different components of the training                        doorstaff personally, emphasising the $45 com-
ranged from 7.4 to 9.0 out of 10). Results of the                        pensation and certification that would be provid-
pre/post knowledge/attitude test also indicated                          ed. Grudgingly, five out of the seven doorstaff
significant improvement.                                                 agreed to participate in the training held the fol-
   Among the 18 bars that participated in the                            lowing weekend (but insisted that they had to be
training, a wide range of motivations for taking the                     paid $50 - not the going rate of $45!).
training was apparent. For some, the practical in-                          While the training consistently received positive
centives of preventing and minimising violence                           reviews from the bars and their staff, it became ap-
from occurring in their establishments was obvi-                         parent that several factors could mitigate against
ous. For others the practical benefits were not real-                    being able to demonstrate a positive impact of the
ized until after the training. During follow-up                          intervention. These include (a) staff who were al-
with a club in the entertainment district, the own-                      ready well-trained; (b) low staff turnout at some
er stated that although he was initially attracted by                    bars, especially for security staff who have the main
the monetary incentives for him and his staff, he                        role in controlling aggression; (c) low levels of ag-
was glad his staff had participated as they were sur-                    gression observed in pre-test observations; and (d)
prised by many of the liability issues covered in the                    ambivalent management who are not invested in
training.                                                                the goals of the project.
   Critical to the success of the training was having
the bar owner/manager onside with the intentions                         Refusals
and goals of the project. Without this the long-
term impact of the intervention is questionable.                         Of the seven bars that did not participate in the
One of our training success stories involved the                         training, three were clear refusals. However, of the
manager of a boisterous downtown student bar                             others, only one bar, a suburban pool hall/sports
that had recently changed ownership. In addition                         bar establishment, gave us an immediate rejection,
to making the training mandatory for his staff of                        stating that this type of training, ’while useful, is
30 (15 of whom were doorstaff ), he actively par-                        not particularly relevant, as we’re not one of those
ticipated and helped deliver the course content. It                      kind of bars,’ despite the documentation of several
was clear that management wanted to effect a ‘cul-                       aggressive incidents during the pre-test observa-
ture-shift’ here. Promoting non-aggressive prob-                         tions. The recruiters felt that the real reason that
lem-solving strategies and distancing itself from its                    this owner refused was that drugs, not alcohol, was
fist-fight riddled past was definitely on their agen-                    the main business of the bar.
da.                                                                         Ironically, many of the problem bars in the study

                                     N O R D I S K A L K O H O L- & N A R K OT I K AT I D S K R I F T   VO L . 20, 2 0 0 3 ( ENGLISH SUPPLEMENT)   159
– the ones that scored high on the outcome meas-                                          ing a group of this size. The prospect of getting
ure of observed physical aggression during the pre-                                       paid to go to bars with a different partner each
test – were also the most reluctant to commit to                                          week with expenses paid is a dream job for many
the training. Despite our emphasis on liability                                           and attracted some questionable candidates. De-
concerns, and subtly trying to hint that they were                                        spite our intensive screening efforts, a few bad
at serious risk of lawsuits and criminal charges if                                       seeds slipped through and caused some minor
they failed to get these problems under control,                                          problems (e.g. sexual harassment of the female
the bars continued to resist. One tactic that proved                                      partner, or failing to show up for assignment).
effective was to emphasise that in the event of a                                           Finally, although the recruitment of bars turned
lawsuit or liquor licence violation, the onus was on                                      out to be very successful, the time frame for re-
them to prove that they had taken all the necessary                                       cruitment was unrealistic. That so many bars were
steps to prevent the situation from occurring. At                                         recruited depended partly on luck and partly on
this point, the Safer Bars training usually became a                                      the rabid determination of the project team!
little more enticing.

Lessons learned                                                                           REFERENCES

                                                                                             Braun, K. & Graham, K. & Bois, C. & Tessier, C.
Without community support from the police and
                                                                                          & Hughes, S. & Prentice, L. (2000): Safer Bars
the Alcohol and Gaming Commission, it was still
                                                                                          Trainer’s Guide. Toronto: Centre for Addiction and
possible to recruit 18 out of the 26 bars originally                                      Mental Health
assigned to the experimental condition. We hope                                              Chandler-Coutts, M. & Graham, K. & Braun, K.
to be able to discern a meaningful long-term im-                                          & Wells, S. (2000): Results of a pilot programme for
pact on the frequency and severity of aggression in                                       training bar staff in preventing aggression. Journal of
at least some of these bars. However, as described                                        Drug Education 30 (2): 171–191
in the preceding, this ambitious large-scale ran-                                            Graham, K. (1999): Safer Bars. Assessing and re-
domised control study has encountered many ob-                                            ducing risks of violence. Toronto: Centre for Addic-
stacles and roadblocks along the way. One prob-                                           tion and Mental Health
lem was a lack of detailed knowledge regarding                                               Graham, K. (2000): Preventive interventions for
Toronto bars. As a result of the extensive develop-                                       on-premise drinking. A promising but underre-
ment and successful piloting of the project in                                            searched area for prevention. Contemporary Drug
smaller communities throughout the province, the                                          Problems 27 (Fall): 593–668
Toronto phase proceeded full steam ahead without                                             Graham, K. & Wells, S. (2001): Aggression among
fully appreciating the urban dynamics and bar cul-                                        young adults in the social context of the bar. Addic-
                                                                                          tion Research 9 (3): 193–219
ture-shift that has taken place in Toronto. The im-
                                                                                             Homel, R. & Hauritz, M. & Wortley, R. & McIl-
mediate impact of this was a much lower rate of                                           wain, G. & Carvolth, R. (1997): Preventing alcohol-
aggression observed in many of the study bars dur-                                        related crime through community action: The Surf-
ing the pre-test. Consequently, many bars were                                            ers Paradise Safety Action Project. Crime Prevention
eliminated from the study and a redesign of the                                           Studies 7: 35–90
methodology was required to accommodate this                                                 MCM Research (1993): Keeping the peace: A
change.                                                                                   guide to the prevention of alcohol-related disorder.
   Lessons were also learned in terms of conducting                                       London: Portman Group
a large number of observations in a relatively short                                         Saltz, R.F. & Stanghetta, P. (1997): A community-
period of time. In particular, the amount of time                                         wide responsible beverage service programme in three
and energy involved in hiring and training observ-                                        communities: early findings. Addiction 92 (Supple-
ers and conducting the observations was underes-                                          ment 2): S237–S249
timated. In addition to the logistical challenges of                                         Wells, S. & Graham, K. & West, P. (1998): ‘The
interviewing several hundred candidates for the                                           good, the bad and the ugly’: Responses by security
observer positions and hiring over 100 field ob-                                          staff to aggressive incidents in public drinking set-
                                                                                          tings. Journal of Drug Issues 28 (4): 817–836.
servers to collect data over the period of the pre-
test, there were also frontline challenges in manag-

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