Young Adult Drinking Prevention

The Community Trials Project
by National Institute of Health

(Page 2 of 3)

The Community Trials Project tested a five-component community intervention to reduce alcohol-related harm among people of all ages, although epidemiological research has shown that young adult drinkers had higher-than-average risks of alcohol-related trauma. For this 5-year study conducted in California and South Carolina, three experimental and three matched comparison communities were selected, each with a population of approximately 100,000. Each community was racially diverse, 40 percent or more of its population being minority group members.

This project included five intervention components that were based on research about drinking patterns, risk, and sources of alcohol: (1) a Media and Mobilization component to develop community organization and support for the goals and strategies of the project, in part by using local news media; (2) a Responsible Beverage Service component to reduce service to intoxicated patrons at bars and restaurants; (3) a Sales to Youth component to reduce underage access; (4) a Drinking and Driving component to increase local enforcement of laws against driving while intoxicated; and (5) an Access component to reduce the availability of alcohol by affecting the number, location, and concentration of alcohol outlets.

Each community was to implement the basic minimum elements for each component. A local community coordinator worked with the research team, and each community was free to seek the best means and timing for implementing each component.

Compared with control communities, communities in the intervention group experienced a 10-percent reduction in nighttime injury crashes and a 6-percent reduction in crashes in which police recorded that the driver had been drinking. Assault injuries seen in emergency departments in the intervention communities declined 43 percent compared with the rate seen in the comparison communities, and assault injuries requiring hospitalization declined by 2 percent, a statistically significant drop. Reports of driving after having had too much to drink declined 49 percent, and self-reports of driving when over the legal limit fell 51 percent. Surprisingly, although the size of the drinking population increased slightly in the experimental sites over the course of the study, there was a significant reduction in problematic alcohol use: The average number of drinks per occasion declined by 6 percent, and the variance in the frequency and volume of alcohol consumption (an indirect measure of heavy drinking) declined 21 percent.

Of particular interest for this article, the Sales to Youth component produced a significant reduction in alcohol sales to minors. This component consisted of training clerks and managers to conduct age identification checks, implementing effective policies governing licensed alcohol stores, and especially, threatening legal sanctions against alcohol outlets that sell to minors. Overall, alcohol retailers in experimental communities were half as likely as retailers in control communities to sell alcohol to minors.

Communities Mobilizing For Change on Alcohol

Communities Mobilizing for Change on Alcohol was a community-organizing effort to reduce underage access to alcohol by changing local policies and practices. Fifteen communities in Minnesota and western Wisconsin were matched and randomly assigned to the intervention or control condition, resulting in seven intervention sites and eight comparison sites, ranging in population from 8,000 to 65,000. Specific prevention activities varied across communities.

Each experimental community, with the assistance of a local coordinator, was free to develop an approach to curtailing underage drinking by reducing alcohol availability to underage drinkers. In all cases, communities were encouraged to use alcohol policy strategies that emphasized changes in the local drinking and alcohol sales environment.

After the fifth year of the project, the intervention communities, compared with control communities, reported more awareness of the need to regulate alcohol sales to youth. Surveys revealed that merchants checked for age identification more often and made fewer sales to minors, results which were confirmed by compliance checks using young-looking alcohol purchasers. Alcohol sales to minors decreased by 10.2 percent for restaurants and bars and 4.57 percent for liquor stores. A telephone survey indicated that 18- to 20-year-olds in the intervention communities were less likely than those in the control communities to consume alcohol themselves and less likely to provide it to others who were underage. The interventions reduced both drinking and drinking-related behavior (i.e., driving after drinking, attempting to purchase alcohol, and providing alcohol to minors) among 18- to 20-year-olds; that is, 7 percent fewer young people reported drinking during a 30-day period, and the number of drinking occasions declined 4 percent. Compared with the control communities, the intervention communities saw fewer drinking-and-driving arrests and fewer disorderly conduct violations among 15- to 17-year-olds.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.