Effect of community-based interventions on high-risk drinking and alcohol-related injuries
Effect of community-based interventions on high-risk drinking and alcohol-related injuries
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DOI：
10.1001/jama.284.18.2341
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发表时间：
2000-11-08
影响因子：
120.7
通讯作者：
Roeper, P
中科院分区：
文献类型：
--
作者：
Holder, HD;Gruenewald, PJ;Roeper, P
高风险酒精消费模式，如酗酒和开车前饮酒，和未成年人饮酒可能与交通事故和社区环境中的暴力袭击有关。目的为了确定基于社区的环境干预措施在降低高危饮酒率和酒精中毒率方面的效果，设计和设置3个匹配干预社区的纵向多时间序列（北方加州、南方加州和南卡罗来纳州），1992年4月至1996年12月进行。通过每月对干预和比较地点随机选择的个人进行120次一般人群电话调查、机动车碰撞的交通数据以及在1个干预-比较对和1个额外干预地点进行急诊室调查，对结果进行评估。加强地方对酒后驾车法律的执行力度;通过分区来限制酒精的获取。主要结果测量自我报告的酒精消费和酒后驾车;在急诊室和医院观察到的与酒精有关的撞车和殴打伤害的发生率。据报告，每次饮酒的饮酒量从1.37杯下降到1.29杯，下降了6%。自我报告的“喝得太多”的比率从每6个月的0.43次下降到0.22次，下降了49%。自我报告的驾驶时，“超过法律的限制”是51%低（0.77比0.38倍），每6个月的干预社区相对于比较社区。交通数据显示，在干预社区与比较社区中，夜间伤害事故下降了10%，驾驶员饮酒的事故下降了6%。结论通过社区综合干预，可有效减少高危饮酒和因车祸、袭击等原因造成的酒精相关伤害。
Context High-risk alcohol consumption patterns, such as binge drinking and drinking before driving, and underage drinking may be lin ked to traffic crashes and violent assaults in community settings.Objectives To determine the effect of community-based environmental interventions in reducing the rate of high-risk drinking and alcohol-related motor vehicle injuries and assaults.Design and Setting A longitudinal multiple time series of 3 matched intervention communities (northern California, southern California, and South Carolina) conducted from April 1992 to December 1996. Outcomes were assessed by 120 general population telephone surveys per month of randomly selected individuals in the intervention and comparison sites, traffic data on motor vehicle crashes, and emergency department surveys in 1 intervention-comparison pair and 1 additional intervention site.Interventions Mobilize the community; encourage responsible beverage service, reduce underage drinking by limiting access to alcohol; increase local enforcement of drinking and driving laws; and limit access to alcohol by using zoning.Main Outcome Measures Self-reported alcohol consumption and driving after drinking; rates of alcohol-related crashes and assault injuries observed in emergency departments and admitted to hospitals.Results Population surveys revealed that the self-reported amount of alcohol consumed per drinking occasion declined 6% from 1.37 to 1.29 drinks. Self-reported rate of "having had too much to drink" declined 49% from 0.43 to 0.22 times per 6-month period. Self-reported driving when "over the legal limit" was 51% lower (0.77 vs 0.38 times) per 6-month period in the intervention communities relative to the comparison communities. Traffic data revealed that, in the intervention vs comparison communities, nighttime injury crashes declined by 10% and crashes in which the driver had been drinking declined by 6%. Assault injuries observed in emergency departments declined by 43% in the intervention communities vs the comparison communities, and all hospitalized assault injuries declined by 2%.Conclusion A coordinated, comprehensive, community-based intervention can reduce high-risk alcohol consumption and alcohol-related injuries resulting from motor vehicle crashes and assaults.