stewart: lifesavers 2008 what communities can do to prevent alcohol service problems: new and...

Stewart: Lifesavers 2008

What Communities What Communities Can Do to Prevent Can Do to Prevent

Alcohol Service Alcohol Service Problems:Problems:

New and Ongoing New and Ongoing ResearchResearchKathryn StewartKathryn Stewart

Prevention Research Center of thePrevention Research Center of thePacific Institute for Research and EvaluationPacific Institute for Research and Evaluation

Safety and Policy Analysis InternationalSafety and Policy Analysis International


Strategies Coordinating Strategies Coordinating Community Policy and Community Policy and

EnforcementEnforcement Preventing alcohol related problems at Preventing alcohol related problems at

the US/Mexico Borderthe US/Mexico Border Controlling alcohol outlet density to Controlling alcohol outlet density to

prevent alcohol problemsprevent alcohol problems Using policy and enforcement to Using policy and enforcement to

prevent alcohol problems in college prevent alcohol problems in college communitiescommunities

Using community awareness and Using community awareness and enforcement to reduce sales to minorsenforcement to reduce sales to minors


The Border The Border ProjectProject

Preventing alcohol-related Preventing alcohol-related problems at the US/Mexico problems at the US/Mexico

BorderBorder


Current sitesCurrent sites

San Diego -TijuanaSan Diego -Tijuana El Paso – JuarezEl Paso – Juarez Laredo –Nuevo LaredoLaredo –Nuevo Laredo Brownsville - MatamorosBrownsville - Matamoros


The ProblemThe Problem

Mexico’s drinking age is 18Mexico’s drinking age is 18 Some border towns provided Some border towns provided

plentiful, cheap sources of alcoholplentiful, cheap sources of alcohol



Mexico’s drinking age is 18Mexico’s drinking age is 18 Some border towns provided Some border towns provided

plentiful, cheap sources of alcoholplentiful, cheap sources of alcohol Young people traveled to Mexico to Young people traveled to Mexico to

drinkdrink Beverage service not always Beverage service not always

“responsible”“responsible”



Mexico’s drinking age is 18Mexico’s drinking age is 18 Some border towns provided plentiful, Some border towns provided plentiful,

cheap sources of alcoholcheap sources of alcohol Young people traveled to Mexico to drinkYoung people traveled to Mexico to drink Beverage service not always Beverage service not always

“responsible”“responsible” Heavy drinking occurredHeavy drinking occurred Sometimes resulted in problems in Sometimes resulted in problems in

MexicoMexico


The ProblemThe Problem Mexico’s drinking age is 18Mexico’s drinking age is 18 Some border towns provided plentiful, Some border towns provided plentiful,

cheap sources of alcoholcheap sources of alcohol Young people traveled to Mexico to drinkYoung people traveled to Mexico to drink Beverage service not always Beverage service not always

“responsible”“responsible” Heavy drinking occurredHeavy drinking occurred Sometimes resulted in problems in Sometimes resulted in problems in

MexicoMexico Impaired young people drove homeImpaired young people drove home


The Research StrategyThe Research Strategy

PIRE studied drinking behavior of PIRE studied drinking behavior of young US residents crossing into young US residents crossing into MexicoMexico

Documented the extent of heavy Documented the extent of heavy drinkingdrinking

Shed light on motivations and Shed light on motivations and behavior of border crossersbehavior of border crossers


The Implementation The Implementation StrategyStrategy

The nature and scope of the problem The nature and scope of the problem were explained to groups and were explained to groups and agencies on both sides of the borderagencies on both sides of the border

Media advocacy brought the Media advocacy brought the problem to the attention of the problem to the attention of the public through compelling news public through compelling news coveragecoverage


The Change StrategiesThe Change Strategies

Earlier bar closingsEarlier bar closings Stepped up DUI enforcement efforts Stepped up DUI enforcement efforts

on the US side of the border on the US side of the border Highly publicized enforcement of Highly publicized enforcement of

laws against crossing by youth under laws against crossing by youth under 1818

New restrictions on Marines from New restrictions on Marines from Camp PendletonCamp Pendleton


The ResultsThe Results

Dramatic decline in number of Dramatic decline in number of nighttime crossings by young peoplenighttime crossings by young people

Reduction in nighttime crashes Reduction in nighttime crashes involving drivers under 18involving drivers under 18

90% reduction in number of Marines 90% reduction in number of Marines driving back from the borderdriving back from the border


Alcohol Outlet Alcohol Outlet Density and Density and

Alcohol Alcohol ProblemsProblems

Making Enforcement More Making Enforcement More Effective through Alcohol Effective through Alcohol

PolicyPolicy



Neighborhoods where bars, Neighborhoods where bars, restaurants and liquor and other restaurants and liquor and other stores that sell alcohol are close stores that sell alcohol are close together suffer more frequent together suffer more frequent incidences of violence and other incidences of violence and other alcohol-related problems.alcohol-related problems.


Problems includeProblems include

Impaired drivingImpaired driving Property crimeProperty crime Violent crimeViolent crime Child abuse and neglectChild abuse and neglect Underage drinkingUnderage drinking


The Implementation The Implementation StrategyStrategy

Make communities aware of the Make communities aware of the problems created by alcohol outletsproblems created by alcohol outlets

Make communities aware of the Make communities aware of the policy strategies that can control policy strategies that can control outlet location and densityoutlet location and density Licensing policiesLicensing policies Land use policiesLand use policies


The ResultsThe ResultsCommunities can:Communities can:

Set minimum distances between Set minimum distances between alcohol outletsalcohol outlets

Limit new licenses for areas that Limit new licenses for areas that already have outlets too close already have outlets too close together;together;

Not issue a new license when an Not issue a new license when an outlet goes out of businessoutlet goes out of business

Permanently close outlets that Permanently close outlets that repeatedly violate liquor lawsrepeatedly violate liquor laws


The Follow-upThe Follow-up

Policy changes can permanently Policy changes can permanently change the environmentchange the environment

Reductions in alcohol problems can Reductions in alcohol problems can be sustainedbe sustained

Communities are empowered to take Communities are empowered to take control of the alcohol environmentcontrol of the alcohol environment


Safer California Safer California UniversitiesUniversitiesProject GoalProject Goal

To evaluate the efficacy of To evaluate the efficacy of aa

“Risk Management” “Risk Management” approach to alcohol approach to alcohol problem preventionproblem prevention

NIAAA grant #R01 AA12516NIAAA grant #R01 AA12516with support from CSAP/SAMHSAwith support from CSAP/SAMHSA..


Why Care About College Student Why Care About College Student Drinking?Drinking?

Over 1,700 deaths among 18-24 year old college Over 1,700 deaths among 18-24 year old college studentsstudents

590,000 unintentionally injured under the influence of 590,000 unintentionally injured under the influence of alcoholalcohol

More than 690,000 assaulted by another student who More than 690,000 assaulted by another student who has been drinkinghas been drinking

More than 97,000 are victims of alcohol-related sexual More than 97,000 are victims of alcohol-related sexual assault or date rapeassault or date rape

About 25 percent of college students report academic About 25 percent of college students report academic consequences of their drinking including missing class, consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and falling behind, doing poorly on exams or papers, and receiving lower grades overall receiving lower grades overall


What are we trying to What are we trying to prevent?prevent?

IntoxicationIntoxication

Harm related to intoxicationHarm related to intoxication


Random AssignmentRandom Assignment

Intervention SitesIntervention Sites

CSU ChicoCSU Chico Sacramento StateSacramento State CSU Long BeachCSU Long Beach UC BerkeleyUC Berkeley UC DavisUC Davis UC RiversideUC Riverside UC Santa CruzUC Santa Cruz

Comparison SitesComparison Sites

Cal Poly SLOCal Poly SLO San Jose StateSan Jose State CSU FullertonCSU Fullerton UC IrvineUC Irvine UC Los AngelesUC Los Angeles UC San DiegoUC San Diego UC Santa BarbaraUC Santa Barbara


How is risk management How is risk management a unique approach?a unique approach?

Targets times and places instead of Targets times and places instead of individualsindividuals

Focus on intoxicationFocus on intoxication

Data driven and directiveData driven and directive

Tied to continuous monitoring and Tied to continuous monitoring and improvement - emphasis on “control” rather improvement - emphasis on “control” rather than “one shot” interventionsthan “one shot” interventions


Strategies for Strategies for ImplementationImplementation

Focused on one (at most two) Focused on one (at most two) settingssettings

Focused on beginning of academic yearFocused on beginning of academic year

Highly-specified planning and Highly-specified planning and implementation processimplementation process

Minimal attention to motivationMinimal attention to motivation

Maximum attention to tasks and Maximum attention to tasks and implementation per seimplementation per se


Integrated Intervention Integrated Intervention Strategies for Off-Campus Strategies for Off-Campus

Parties Parties

A Social Host Safe Party CampaignA Social Host Safe Party Campaign

Compliance ChecksCompliance Checks

DUI Check PointsDUI Check Points

Party PatrolsParty Patrols

Pass Social Host “Response Cost” Pass Social Host “Response Cost” OrdinanceOrdinance


OutcomesOutcomes

Likelihood of getting drunk at bars Likelihood of getting drunk at bars or restaurants much less.or restaurants much less.

Likelihood of getting drunk at off Likelihood of getting drunk at off campus parties much less.campus parties much less.

Overall likelihood of getting drunk at Overall likelihood of getting drunk at any location much less.any location much less.


In addition…In addition…

No DisplacementNo Displacement


In Sum…In Sum…

We have the ability to create We have the ability to create environments that help teens and environments that help teens and young adults make healthy decisions young adults make healthy decisions about alcohol consumptionabout alcohol consumption

We have ample evidence that these We have ample evidence that these strategies are effectivestrategies are effective

Our greatest impact will come from Our greatest impact will come from adopting mutually-reinforcing policies adopting mutually-reinforcing policies and practicesand practices


Reducing Youth Access to Reducing Youth Access to Alcohol: Alcohol:

A Randomized TrialA Randomized Trial

Purpose of Study: Purpose of Study: Evaluate five Evaluate five combined environmental strategies to combined environmental strategies to reduce youth access to alcohol and reduce youth access to alcohol and underage drinkingunderage drinking


Reducing Youth Access to Reducing Youth Access to Alcohol: Alcohol:

A Randomized TrialA Randomized Trial

Study DesignStudy Design

36 Oregon communities36 Oregon communities 18 randomly assigned to intervention18 randomly assigned to intervention Interventions staggered, ~6 Interventions staggered, ~6 communities every two yearscommunities every two years Now in second intervention year with Now in second intervention year with 11stst and 2 and 2ndnd intervention community intervention community cohortscohorts


Reducing Youth Access Reducing Youth Access to Alcohol: A to Alcohol: A

Randomized TrialRandomized TrialEnvironmental StrategiesEnvironmental Strategies

Reward and Reminder ProgramReward and Reminder Program Minor Decoy Operations Minor Decoy Operations Shoulder Tap Operations Shoulder Tap Operations Party Patrols Party Patrols Traffic SurveillanceTraffic Surveillance Media AdvocacyMedia Advocacy


Community InterventionsCommunity Interventions

MobilizationMobilization

Reward & ReminderReward & Reminder

MediaMedia



Total number of communities: 13Total number of communities: 13

Total number of stores visited: 104Total number of stores visited: 104

Total number of visits: 184Total number of visits: 184

Total number of rewards given: 104Total number of rewards given: 104


MediaMedia

Topics:Topics: The problem of underage drinkingThe problem of underage drinking The details of the projectThe details of the project Endorsed proclamationEndorsed proclamation Reward & Reminder resultsReward & Reminder results Alcohol and the teenage brainAlcohol and the teenage brain Prom and GraduationProm and Graduation Parents who host partiesParents who host parties Law enforcement activities in the Law enforcement activities in the

communitycommunity


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

0

10

20

30

40

50

60

70

80

90

100

Perc

ent

8th Grade

11th Grade


Reducing Youth Access Reducing Youth Access to Alcohol: A to Alcohol: A

Randomized TrialRandomized TrialSummarySummary

Preliminary evidence of Preliminary evidence of intervention effects in 1intervention effects in 1stst community cohortcommunity cohort Stronger evidence if similar Stronger evidence if similar effects are observed in effects are observed in subsequent cohorts with support subsequent cohorts with support for intervening processesfor intervening processes


ConclusionsConclusions

Communities can create Communities can create environments that reduce alcohol environments that reduce alcohol related problems through related problems through Development of appropriate policiesDevelopment of appropriate policies Strategic use of law enforcement Strategic use of law enforcement

resourcesresources Strategic use of community awarenessStrategic use of community awareness


www.resources.prev.orgwww.resources.prev.org

stewart: lifesavers 2008 what communities can do to prevent alcohol service problems: new and...

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