what communities can do to prevent alcohol service ......brownsville - matamoros. stewart:...

Stewart: Lifesavers 2008

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


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


The Border Project

Preventing alcohol-related problems at

the US/Mexico Border


Current sites

◼ San Diego -Tijuana

◼ El Paso – Juarez

◼ Laredo –Nuevo Laredo

◼ Brownsville - Matamoros


The Problem

◼ Mexico’s drinking age is 18

◼ Some border towns provided plentiful, cheap

sources of alcohol


The Problem



sources of alcohol

◼ Young people traveled to Mexico to drink

◼ Beverage service not always “responsible”


The Problem



sources of alcohol



◼ Heavy drinking occurred

◼ Sometimes resulted in problems in Mexico


The Problem


◼ Some border towns provided plentiful, cheap sources of alcohol



◼ Heavy drinking occurred

◼ Sometimes resulted in problems in Mexico

◼ Impaired young people drove home


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


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


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


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


Alcohol Outlet

Density and Alcohol

ProblemsMaking Enforcement More Effective through

Alcohol Policy


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.


Problems include

◼ Impaired driving

◼ Property crime

◼ Violent crime

◼ Child abuse and neglect

◼ Underage drinking


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


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


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


Safer California Universities

Project Goal

To evaluate the efficacy of a“Risk Management” approach to

alcohol problem prevention

NIAAA grant #R01 AA12516with support from CSAP/SAMHSA.


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


What are we trying to prevent?

◼ Intoxication

◼ Harm related to intoxication


Random Assignment

Intervention Sites

▪ CSU Chico

▪ Sacramento State

▪ CSU Long Beach

▪ UC Berkeley

▪ UC Davis

▪ UC Riverside

▪ UC Santa Cruz

Comparison Sites

▪ Cal Poly SLO

▪ San Jose State

▪ CSU Fullerton

▪ UC Irvine

▪ UC Los Angeles

▪ UC San Diego

▪ UC Santa Barbara


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


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


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


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.


In addition…

No Displacement


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


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


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

◼ Now in second intervention year with 1st and 2nd intervention community cohorts


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


Community Interventions

◼ Mobilization

◼ Reward & Reminder

◼ Media


Reward & Reminder


Reward & Reminder

◼ Total number of communities: 13

◼ Total number of stores visited: 104

◼ Total number of visits: 184

◼ Total number of rewards given: 104


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


Alcohol Sources Among Oregon 8th and 11th Graders, 2006

0

10

20

30

40

50

60

70

80

90

100

Gro

cery sto

re

Con

venien

ce store

Gas

statio

n

Liqu

or sto

re

Bar/club/restau

rant

Intern

et

Any

com

mercial

Hom

e w/out permission Pa

rent

Sibling

Other fa

mily

mem

ber

Friend

< 21

Friend

> 21

Strang

er pur

chas

e Party

Any

soc

ial

Pe

rc

en

t

8th Grade

11th Grade


Reducing Youth Access to

Alcohol: A Randomized Trial

Summary

◼ Preliminary evidence of intervention

effects in 1st community cohort

◼ Stronger evidence if similar effects are

observed in subsequent cohorts with support

for intervening processes


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


www.resources.prev.org

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