Transcript What Communities Can Do to Prevent Alcohol Service
What Communities Can Do to Prevent Alcohol Service Problems:
New and Ongoing Research
Kathryn Stewart
Prevention Research Center of the Pacific Institute for Research and Evaluation Safety and Policy Analysis International
Stewart: Lifesavers 2008
Strategies Coordinating Community Policy and Enforcement
Preventing alcohol related problems at the US/Mexico Border Controlling alcohol outlet density to prevent alcohol problems Using policy and enforcement to prevent alcohol problems in college communities Using community awareness and enforcement to reduce sales to minors Stewart: Lifesavers 2008
The Border Project
Preventing alcohol-related problems at the US/Mexico Border Stewart: Lifesavers 2008
Current sites
San Diego -Tijuana El Paso – Juarez Laredo –Nuevo Laredo Brownsville - Matamoros Stewart: Lifesavers 2008
The Problem
Mexico’s drinking age is 18 Some border towns provided plentiful, cheap sources of alcohol Stewart: Lifesavers 2008
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The Problem
Mexico’s drinking age is 18 Some border towns provided plentiful, cheap sources of alcohol Young people traveled to Mexico to drink Beverage service not always “responsible” Stewart: Lifesavers 2008
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The Problem
Mexico’s drinking age is 18 Some border towns provided plentiful, cheap sources of alcohol Young people traveled to Mexico to drink Beverage service not always “responsible” Heavy drinking occurred Sometimes resulted in problems in Mexico Stewart: Lifesavers 2008
Stewart: Lifesavers 2008
The Problem
Mexico’s drinking age is 18 Some border towns provided plentiful, cheap sources of alcohol Young people traveled to Mexico to drink Beverage service not always “responsible” Heavy drinking occurred Sometimes resulted in problems in Mexico Impaired young people drove home Stewart: Lifesavers 2008
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The Research Strategy
PIRE studied drinking behavior of young US residents crossing into Mexico Documented the extent of heavy drinking Shed light on motivations and behavior of border crossers Stewart: Lifesavers 2008
The Implementation Strategy
The nature and scope of the problem were explained to groups and agencies on both sides of the border Media advocacy brought the problem to the attention of the public through compelling news coverage Stewart: Lifesavers 2008
The Change Strategies
Earlier bar closings Stepped up DUI enforcement efforts on the US side of the border Highly publicized enforcement of laws against crossing by youth under 18 New restrictions on Marines from Camp Pendleton Stewart: Lifesavers 2008
The Results
Dramatic decline in number of nighttime crossings by young people Reduction in nighttime crashes involving drivers under 18 90% reduction in number of Marines driving back from the border Stewart: Lifesavers 2008
Alcohol Outlet Density and Alcohol Problems
Making Enforcement More Effective through Alcohol Policy
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The Problem
Neighborhoods where bars, restaurants and liquor and other stores that sell alcohol are close together suffer more frequent incidences of violence and other alcohol-related problems.
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Problems include
Impaired driving Property crime Violent crime Child abuse and neglect Underage drinking Stewart: Lifesavers 2008
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The Implementation Strategy
Make communities aware of the problems created by alcohol outlets Make communities aware of the policy strategies that can control outlet location and density Licensing policies Land use policies Stewart: Lifesavers 2008
The Results Communities can:
Set minimum distances between alcohol outlets Limit new licenses for areas that already have outlets too close together; Not issue a new license when an outlet goes out of business Permanently close outlets that repeatedly violate liquor laws Stewart: Lifesavers 2008
The Follow-up
Policy changes can permanently change the environment Reductions in alcohol problems can be sustained Communities are empowered to take control of the alcohol environment Stewart: Lifesavers 2008
Safer California Universities Project Goal
To evaluate the efficacy of a “Risk Management” approach to alcohol problem prevention
NIAAA grant #R01 AA12516 with support from CSAP/SAMHSA. Stewart: Lifesavers 2008
Why Care About College Student Drinking?
Over 1,700 deaths among 18-24 year old college students 590,000 unintentionally injured under the influence of alcohol More than 690,000 assaulted by another student who has been drinking More than 97,000 are victims of alcohol-related sexual assault or date rape About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall Stewart: Lifesavers 2008
What are we trying to prevent?
Intoxication
Harm related to intoxication
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Random Assignment
Intervention Sites Comparison Sites
CSU Chico Sacramento State CSU Long Beach UC Berkeley UC Davis UC Riverside UC Santa Cruz
Cal Poly SLO San Jose State CSU Fullerton UC Irvine UC Los Angeles UC San Diego UC Santa Barbara
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How is risk management a unique approach?
Targets times and places instead of individuals
Focus on intoxication
Data driven and directive
Tied to continuous monitoring and improvement - emphasis on “control” rather than “one shot” interventions
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Strategies for Implementation
Focused on one (at most two) settings Focused on beginning of academic year Highly-specified planning and implementation process Minimal attention to motivation Maximum attention to tasks and implementation per se Stewart: Lifesavers 2008
Integrated Intervention Strategies for Off-Campus Parties
A Social Host Safe Party Campaign
Compliance Checks
DUI Check Points
Party Patrols
Pass Social Host “Response Cost” Ordinance
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Outcomes
Likelihood of getting drunk at bars or restaurants much less.
Likelihood of getting drunk at off campus parties much less.
Overall likelihood of getting drunk at any location much less.
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In addition… No Displacement
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In Sum…
We have the ability to create environments that help teens and young adults make healthy decisions about alcohol consumption We have ample evidence that these strategies are effective Our greatest impact will come from adopting mutually-reinforcing policies and practices Stewart: Lifesavers 2008
Reducing Youth Access to Alcohol: A Randomized Trial
Purpose of Study: Evaluate five combined environmental strategies to reduce youth access to alcohol and underage drinking Stewart: Lifesavers 2008
Reducing Youth Access to Alcohol: A Randomized Trial
Study Design
36 Oregon communities 18 randomly assigned to intervention Interventions staggered, ~6 communities every two years 2 nd Now in second intervention year with 1 st intervention community cohorts and Stewart: Lifesavers 2008
Reducing Youth Access to Alcohol: A Randomized Trial
Environmental Strategies
Reward and Reminder Program Minor Decoy Operations Shoulder Tap Operations Party Patrols Traffic Surveillance Media Advocacy Stewart: Lifesavers 2008
Community Interventions
Mobilization Reward & Reminder Media Stewart: Lifesavers 2008
Reward & Reminder
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Reward & Reminder
Total number of communities: 13 Total number of stores visited: 104 Total number of visits: 184 Total number of rewards given: 104 Stewart: Lifesavers 2008
Media
Topics: The problem of underage drinking The details of the project Endorsed proclamation Reward & Reminder results Alcohol and the teenage brain Prom and Graduation Parents who host parties Law enforcement activities in the community Stewart: Lifesavers 2008
Alcohol Sources Among Oregon 8 th and 11 th Graders, 2006 100 90 40 30 20 80 70 60 50
8th Grade 11th Grade
10 0
G ro ce C ry o s nv to en re ie n ce s to re G as s ta tio n L iq u B or ar s /c to lu re b/ re st au ra n t In te A rn n et y co m m er ci al H o m e w /o u t p er m is si on P ar en t O th S er ib f lin am g ily m em b er F ri en d < 2 1 F ri en S tr d > an 2 ge 1 r pu rc ha se
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P ar ty A n y so ci al
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Reducing Youth Access to Alcohol: A Randomized Trial
Summary
Preliminary evidence of intervention effects in 1 st community cohort Stronger evidence if similar effects are observed in subsequent cohorts with support for intervening processes Stewart: Lifesavers 2008
Conclusions
Communities can create environments that reduce alcohol related problems through Development of appropriate policies Strategic use of law enforcement resources Strategic use of community awareness Stewart: Lifesavers 2008
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Stewart: Lifesavers 2008