A Comprehensive Analysis of State Alcohol Policy Environment and Its Effects

描述（由申请人提供）：饮酒与一系列广泛的公共卫生问题有关。理论和研究表明，制定酒精政策可以减少酒精的使用和相关问题。以前的大多数研究都侧重于评估个人酒精政策的影响；然而，一些研究已经开始通过简单的指数来评估各州酒精政策的“计数”效果。这种方法促进了研究文献的发展，但它是有限的，因为简单地计算或汇总政策是否存在，并不能向各州提供有关酒精政策的最佳组合可以有效减少酒精使用和相关问题的信息。汇总政策也没有考虑到各州特定酒精政策的不同强度。此外，大多数先前的研究在包括控制变量和/或关键干预变量（如执行实践）方面受到限制。研究小组将在以往研究的基础上开展一项研究，该研究将解决四个具体目标：(1)制定各州特定酒精控制政策力度的衡量标准；(2)利用潜在变量分析测度国家整体酒精政策环境；(3)评估各州酒精政策的执行水平；(4)评估酒精政策环境与相关后果（包括酒精消费水平与交通事故和伤害死亡率）之间的关系，并评估执法水平如何影响这些关系。我们将在四年的时间里进行这个项目。在第一年，我们将收集执法数据，并制定酒精政策措施，其中包括各州政策力度的差异。在第二年，我们将开发酒精政策环境和执法水平的测量模型，并收集结果变量数据。在第三年，我们将进行分析，以评估国家酒精政策环境与我们的各种结果措施之间的关系，以及执法如何影响这些关系。在第4年，我们将进行子分析，以评估国家酒精政策环境对我们结果的影响是否因年龄或种族/民族而异。该项目将扩大实地对酒精政策组合或模式对酒精消费和有关问题的影响的了解。该提案涉及几个国家级机构的建议，为未来的研究提供了一个工具，并将为各州决定如何改变其酒精政策环境以解决各种公共卫生问题提供信息。公共卫生相关性：我们建议首先确定衡量州酒精政策环境的最佳方法。然后，我们将评估新制定的酒精政策环境措施与酒精使用和酒精相关问题的若干措施之间的联系。这项研究的结果可以帮助指导政策制定者的决策，因为他们试图减少一系列与酒精有关的问题。

DESCRIPTION (provided by applicant): Alcohol use is associated with a wide array of public health problems. Theory and research suggest that enactment of alcohol policies can reduce alcohol use and related problems. Most previous research has focused on evaluating effects of individual alcohol policies; however, a few studies have started assessing effects of "counts" of state alcohol policies measured through simple indices. This approach has advanced the research literature however it is limited because simply counting or summing whether policies are present does not provide information to states about what optimal combination of alcohol policies may effectively reduce alcohol use and related problems. Summing policies also does not take into account the varying strength of specific alcohol policies across states. Furthermore, most previous studies are limited in terms of inclusion of control variables and/or critical intervening variables such as enforcement practices. The research team will build upon previous studies by conducting a study which will address four specific aims: (1) Develop a measure of the strength of specific alcohol control policies across states; (2) Measure the overall state alcohol policy environment using latent variable analyses; (3) Assess levels of enforcement of alcohol policies within each state; and (4) Assess the relationships between the alcohol policy environment and related consequences (including alcohol consumption levels and rates of traffic crashes and injury mortality), and assess how enforcement levels influence these relationships. We will conduct the project across four years. In Year 1 we will collect enforcement data, and develop measures of alcohol policies that include differences in the strength of policies across states. In Year 2 we will develop measurement models for the alcohol policy environment and levels of enforcement, and collect outcome variable data. In Year 3 we will conduct analyses to assess the relationships between the state alcohol policy environment and our various outcome measures, and how enforcement affects these relationships. In Year 4 we will conduct sub-analyses to assess whether effects of state alcohol policy environment on our outcomes vary by age or race/ethnicity. The project will expand the field's understanding of the effects of combinations or patterns of alcohol policies on alcohol consumption and related problems. The proposal addresses recommendations from several national-level institutions, provides a tool for future research studies, and will inform states' decisions about how to change their alcohol policy environments to address a variety of public health issues. PUBLIC HEALTH RELEVANCE: We propose to first determine the optimal way to measure state alcohol policy environments. We will then assess associations between the newly developed measures of alcohol policy environments and several measures of alcohol use and alcohol-related problems. Results from this study can help guide decisions among policy makers as they attempt to reduce a wide array of alcohol-related problems.