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Intervention

Community Trials Intervention to Reduce High-Risk Drinking (RHRD) is a multicomponent, community-based program developed to alter alcohol-use patterns of people of all ages. It addresses underage drinking, acute (binge) drinking, and drinking and driving. The program uses a set of environmental interventions including community awareness, responsible beverage service (RBS), preventing underage alcohol access, enforcement, and community mobilization. Its aim is to help communities reduce various types of alcohol-related accidents, violence, and resulting injuries.

For the RHRD program to succeed, the implementing organization must first determine which program components will best produce the desired results for its community. RHRD uses five prevention components:

• Alcohol access. The program assists communities in using zoning and municipal regulations to restrict alcohol access through alcohol outlet (bars, liquor stores, etc.) density control.
• Responsible beverage service. Through training and testing, RBS assists alcohol beverage servers and retailers in developing policies and procedures to reduce intoxication and driving after drinking.
• Risk of drinking and driving. The program increases actual and perceived risk of arrest for driving after drinking through increased law enforcement and sobriety checkpoints.
• Underage alcohol access. RHRD reduces youth access to alcohol by training alcohol retailers to avoid selling to minors and those who provide alcohol to minors, and through increased enforcement of underage alcohol sales laws.
• Community mobilization. The program provides communities with the tools to form the coalitions needed to implement and support the interventions that will address the four aforementioned prevention components.

Understanding the community’s alcohol environment (norms, attitudes, usage locations, cultural and socioeconomic dynamics) and alcohol distribution systems (alcohol sales licensing, alcohol outlet zoning, and alcohol use restrictions) is key to RHRD startup. This requires gathering the data needed to determine which interventions to use and adapting them to the individual community. Project staff are essential to this information gathering and for working with a wide array of community components, including local community organizations, key opinion leaders, police, zoning and planning commissions, policymakers, and the general public. Though dependent on local conditions, staff generally include the following:

• The director is responsible for developing the initiative and its strategy, seeking funding, building coalitions with key community groups and leaders, and hiring project staff.
• An assistant director is responsible for day-to-day management of office operations and staff, recruiting and organizing volunteers, and implementing interventions/tactics.
• Data managers collect information to track program trends.
• Administrative staff assist with managing volunteers and processing information. They are the first line of information for public and other stakeholders.
• Volunteers provide general support for program interventions; elicit support from the broader community and participation by key community leaders (e.g., police); assist in the “synergistic” application of program components, such as media coverage of program efforts; attend community meetings and hearings to speak or gather information on targeted topics; and assist with public education projects and other interventions as needed.
• A program task force, composed of key community leaders (e.g., police captains, zoning officials, public safety and youth commissioners), can provide and further build coalitions to support program interventions.

Staff can be employees of the lead agency endeavoring to implement the program or may be hired and separate from existing entities.

Evaluation

The evaluation used a longitudinal, multiple-time series design across three intervention communities. The matched comparison communities served as no-treatment controls. Within this design, the effects of project interventions can be determined by comparing outcomes with those from the matched comparison communities.

Data collected as a part of the evaluation consisted of traffic crash records; emergency room surveys; local news coverage of alcohol-related topics; intoxicated patron and underage decoy surveys; roadside surveys conducted on weekend evenings; and a community telephone survey (including self-reported measures of drinking and of drinking and driving).

Outcome

The evaluation data shows decreases in substance use and behaviors related to risk factors. Specific findings include

• A 2 percent reduction in hospitalized assault injuries.
• A 6 percent reduction in crashes in which the driver had been drinking.
• A 6 percent decline in self-reported amounts of alcohol consumed per drinking occasion.
• A 10 percent reduction in nighttime injury crashes.
• A 43 percent reduction in assault injuries observed in emergency rooms.
• A 49 percent decrease in self-reported “having had too much to drink.”
• A 51 percent decline in self-reported driving when “over the legal limit” in the intervention communities.
  

Endorsements

• SAMHSA: Model Programs

References

Grube, Joel W. 1997. “Preventing Sales of Alcohol to Minors: Results From a Community Trial.” Addiction 92(Supplement 2):S251–60.

Gruenewald, Paul J. 1997. “Analysis Approaches to Community Evaluation.” Evaluation Review 21:209–30.

Holder, Harold D., Robert F. Saltz, Joel W. Grube, Robert B. Voas, Paul J. Gruenewald, and Andrew J. Treno. 1997. “A Community Prevention Trial to Reduce Alcohol-Involved Accidental Injury and Death: Overview.” Addiction 92:S155–71.

Holder, Harold D., and Andrew J. Treno 1997. “Media Advocacy in Community Prevention: News as a Means to Advance Policy Change.” Addiction 92(Supplement 2):S189–99.

Sanchez, Linda, George Gaumont, and Peter Roeper. 2000. “Effect of Community-Based Interventions on High-Risk Drinking and Alcohol-Related Injuries.” Journal of the American Medical Association 284:2341–47.

Reynolds, Robert I., Harold D. Holder, and Paul J. Gruenewald. 1997. “Community Prevention and Alcohol Retail Access.” Addiction 92(Supplement 2):S261–72.

Saltz, Robert F., and Paula Stanghetta. 1997. “A Communitywide Responsible Beverage Service Program in Three Communities: Early Findings.” Addiction 92(Supplement 2):S237–49.

Treno, Andrew J., and Harold D. Holder. 1997. “Evaluating Efforts to Reduce Community-Level Problems Through Structural Rather Than Individual Change: A Multicomponent Community Trial to Prevent Alcohol-Involved Problems.” Evaluation Review 21:133–39.

Voas Robert B. 1997. “Drinking and Driving Prevention in the Community: Program Planning and Implementation.” Addiction 92(Supplement 2):S201–19.

Contact

Andrew J. Treno, Ph.D.
Prevention Resource Center
1995 University Avenue, Suite 450
Berkeley, CA 94704
Phone: (510) 486-1111
Fax: (510) 644-0594
E-mail: andrew@prev.org
Web site: http://www.prev.org

Technical Assistance Provider

Andrew J. Treno, Ph.D.
Prevention Resource Center
1995 University Avenue, Suite 450
Berkeley, CA 94704
Phone: (510) 486-1111
Fax: (510) 644-0594
E-mail: andrew@prev.org
Web site: http://www.prev.org