Informing alcohol policy: The impact of evidence-based alcohol warnings on consumption

项目摘要 近三分之一的美国成年人超过了推荐的饮酒量上限，这增加了他们患酒精性心脏病的风险 健康问题，包括高血压性心脏病、损伤和几种癌症。大多数成年人都是 没有意识到饮酒的危害。酒精容器上的基于证据的警告 显示在包装正面的显著位置，包括图标等图片元素，并旋转其 随着时间的推移，内容可能会告知消费者，并阻止不健康的酒精消费。最重要的是 该提案的目的是评估基于证据的酒精警告对酒精的影响 消费。在目标1中，我们将利用现有的研究和专家审查来优化警告语句 描述了饮酒对健康的危害。然后，我们将测试一系列基于证据的警告 这是一项具有全国代表性的随机试验，抽样对象为910名成年常年饮酒者。这个 目标1的主要产品将是选择4个参与者认可为有效的基于证据的警告 在目标2中，我们将评估这些基于证据的酒精警告对酒精的影响 纵向随机对照试验中的消耗量。我们将招募786名成年定期饮酒消费者。参与者将是 随机分配到警告臂或控制臂。在一项为期4周的研究中，警告臂的参与者将 收到4个独特的基于证据的警告贴在他们的酒精容器上，按随机顺序分配。在……里面 控制臂，则不会应用新标签。我们将评估基于证据的酒精警告是否 减少饮酒量(使用日常日记来衡量)，并检查这种影响是否随 基线酒精使用、性别、年龄和教育程度。我们还将评估警告如何影响潜在的 心理调解人(以每周调查衡量)。目标2的最终产品将是对 基于证据的酒精警告对酒精消费的影响。在目标3中，我们将验证一个模型 饮酒警告会影响饮酒。我们将深入采访参加 AIM 2的警告部门S RCT，以启发对审判警告所通过的机制的见解 影响了他们的行为。然后，我们将对纵向每日日记和调查数据进行中介分析 收集在AIM 2‘S随机对照试验中，以确定试验警告对饮酒影响的中介。这个 Aim 3的最终产品将是一个基于证据的酒精警告如何影响酒精消费的模型。 这项研究通过进行酒精减少的原因分析来回应NOT-AA-21-028 政策和推进方法，通过实施创新的随机对照研究，自然地暴露在警告之下。 我们的发现将创建一个证据基础，为制定有效的酒精警告以及其他 传播活动。最终，新的基于证据的酒精警告可能会减少不健康的酒精 并解决美国和全球因酒精引起的疾病和死亡率不断上升的问题。

PROJECT ABSTRACT Nearly 1 in 3 American adults exceed the recommended limit for alcohol consumption, increasing their risk of health problems including hypertensive heart disease, injuries, and several types of cancer. Most adults are not aware of the harms of alcohol consumption. Evidence-based warnings on alcohol containers that are displayed prominently on the front of the package, include pictorial elements such as icons, and rotate their content over time could inform consumers and discourage unhealthy alcohol consumption. The overarching objective of this proposal is to evaluate the impact of evidence-based alcohol warnings on alcohol consumption. In Aim 1, we will use existing research and expert review to optimize warning statements describing the health harms of alcohol consumption. We will then test an array of evidence-based warnings in a randomized experiment with a nationally representative sample of 910 adult regular alcohol consumers. The main product of Aim 1 will be the selection of 4 evidence-based warnings that participants endorse as effective for use in Aim 2. In Aim 2, we will evaluate the impact of these evidence-based alcohol warnings on alcohol consumption in a longitudinal RCT. We will recruit 786 adult regular alcohol consumers. Participants will be randomly assigned to a warnings arm or a control arm. In a 4-week study, participants in the warnings arm will receive the 4 unique evidence-based warnings affixed to their alcohol containers, allocated in random order. In the control arm, no new labels will be applied. We will assess whether the evidence-based alcohol warnings reduce number of drinks consumed (measured using daily diaries) and examine whether this effect varies by baseline alcohol use, gender, age, and education. We will also evaluate how warnings influence potential psychological mediators (measured in weekly surveys). The final product of Aim 2 will be an estimate of the impact of evidence-based alcohol warnings on alcohol consumption. In Aim 3, we will validate a model of how alcohol warnings influence alcohol consumption. We will conduct in-depth interviews with participants in the warnings arm of Aim 2’s RCT to elicit insights about the mechanisms through which the trial warnings influenced their behavior. Then, we will apply mediation analyses to the longitudinal daily diary and survey data collected in Aim 2’s RCT to identify mediators of the impact of the trial warnings on alcohol consumption. The final product of Aim 3 will be a model of how evidence-based alcohol warnings influence alcohol consumption. This research is responsive to NOT-AA-21-028 by conducting causal analyses of an alcohol-reduction policy and advancing methods by implementing an innovative RCT with naturalistic exposure to warnings. Our findings will create an evidence base to inform development of effective alcohol warnings as well as other communication campaigns. Ultimately, new evidence-based alcohol warnings could reduce unhealthy alcohol consumption and address rising rates of alcohol-attributable disease and death in the US and globally.