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
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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
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San Diego -Tijuana
El Paso – Juarez
Laredo –Nuevo Laredo
Brownsville - Matamoros
Stewart: Lifesavers 2008
The Problem
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Mexico’s drinking age is 18
Some border towns provided plentiful, cheap
sources of alcohol
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Stewart: Lifesavers 2008
Stewart: Lifesavers 2008
Stewart: Lifesavers 2008
The Problem
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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
Stewart: Lifesavers 2008
Stewart: Lifesavers 2008
The Problem
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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
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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
Stewart: Lifesavers 2008
The Research Strategy
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PIRE studied drinking behavior of young US
residents crossing into Mexico
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Documented the extent of heavy drinking
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Shed light on motivations and behavior of
border crossers
Stewart: Lifesavers 2008
The Implementation Strategy
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The nature and scope of the problem were
explained to groups and agencies on both sides
of the border
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Media advocacy brought the problem to the
attention of the public through compelling news
coverage
Stewart: Lifesavers 2008
The Change Strategies
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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
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Dramatic decline in number of nighttime
crossings by young people
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Reduction in nighttime crashes involving drivers
under 18
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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
Stewart: Lifesavers 2008
The Problem
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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.
Stewart: Lifesavers 2008
Problems include
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Impaired driving
Property crime
Violent crime
Child abuse and neglect
Underage drinking
Stewart: Lifesavers 2008
Stewart: Lifesavers 2008
The Implementation Strategy
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Make communities aware of the problems
created by alcohol outlets
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Make communities aware of the policy strategies
that can control outlet location and density
Licensing policies
 Land use policies
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Stewart: Lifesavers 2008
The Results
Communities can:
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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
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Policy changes can permanently change the
environment
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Reductions in alcohol problems can be sustained
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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.
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Why Care About College Student Drinking?
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Over 1,700 deaths among 18-24 year old college students
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590,000 unintentionally injured under the influence of alcohol
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More than 690,000 assaulted by another student who has been
drinking
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More than 97,000 are victims of alcohol-related sexual assault or
date rape
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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?
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Intoxication
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Harm related to intoxication
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Random Assignment
Intervention Sites
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CSU Chico
Sacramento State
CSU Long Beach
UC Berkeley
UC Davis
UC Riverside
UC Santa Cruz
Comparison Sites
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Cal Poly SLO
San Jose State
CSU Fullerton
UC Irvine
UC Los Angeles
UC San Diego
UC Santa Barbara
Stewart: Lifesavers 2008
How is risk management a
unique approach?
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Targets times and places instead of individuals
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Focus on intoxication
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Data driven and directive
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Tied to continuous monitoring and improvement
- emphasis on “control” rather than “one shot”
interventions
Stewart: Lifesavers 2008
Strategies for Implementation
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Focused on one (at most two) settings
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Focused on beginning of academic year
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Highly-specified planning and implementation
process
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Minimal attention to motivation
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Maximum attention to tasks and implementation per
se
Stewart: Lifesavers 2008
Integrated Intervention Strategies for
Off-Campus Parties
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A Social Host Safe Party Campaign
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Compliance Checks
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DUI Check Points
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Party Patrols
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Pass Social Host “Response Cost” Ordinance
Stewart: Lifesavers 2008
Outcomes
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Likelihood of getting drunk at bars or
restaurants much less.
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Likelihood of getting drunk at off campus
parties much less.
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Overall likelihood of getting drunk at any
location much less.
Stewart: Lifesavers 2008
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In addition…
No Displacement
Stewart: Lifesavers 2008
In Sum…
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We have the ability to create environments that
help teens and young adults make healthy
decisions about alcohol consumption
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We have ample evidence that these strategies are
effective
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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
 Now in second intervention year with 1st and
2nd intervention community cohorts
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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
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Stewart: Lifesavers 2008
Community Interventions
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Mobilization
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Reward & Reminder
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Media
Stewart: Lifesavers 2008
Reward & Reminder
Stewart: Lifesavers 2008
Stewart: Lifesavers 2008
Reward & Reminder
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Total number of communities: 13
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Total number of stores visited: 104
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Total number of visits: 184
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Total number of rewards given: 104
Stewart: Lifesavers 2008
Media
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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
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Stewart: Lifesavers 2008
Alcohol Sources Among Oregon 8th and 11th Graders, 2006
100
90
80
8th Grade
70
11th Grade
Percent
60
50
40
30
20
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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
Stewart: Lifesavers 2008
Conclusions
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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
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Stewart: Lifesavers 2008
www.resources.prev.org
Stewart: Lifesavers 2008