A Multidimensional Community-Based Strategy for Preventing Underage Drinking

描述（由申请人提供）：预防青少年饮酒是一项重要的公共卫生优先事项。据估计，美国未成年人饮酒每年造成的损失为619亿美元（Miller, Levy, Spicer, & Taylor, 2006）。在美国，酒精是最常使用和滥用的药物，41%的人报告在过去30天内使用过（Johnston， O'Malley, Bachman, & Schulenberg, 2012）。饮酒的未成年人可能会大量饮酒（Flewelling, Paschall, & Ringwalt, 2004）。年轻人饮酒导致多达5000人死于机动车事故、他杀、自杀和其他伤害（Hingson & Kenkel， 2004年；国家公路交通安全管理局，2008年；国家酗酒和酒精滥用研究所，2007年）。该项目将以刚刚完成的一项旨在减少青少年接触酒精的社区干预实验评估为基础（Flewelling et al., 2012）。在那项研究中，俄勒冈州的36个社区被随机分配接受或不接受加强执法的法律，这些法律涉及向未成年人出售酒精饮料，另外还有一个奖励不向未成年人出售酒精饮料的店员的计划。干预措施减少了青少年接触酒精的机会。此外，在执法和奖励水平较高的社区，青少年吸毒的比例较低。然而，这种干预对饮酒的社会影响几乎没有改变。我们认为，增加旨在调动同伴和父母影响的干预措施，将改变政策干预措施未能充分解决的酗酒风险因素。因此，该项目将评估一项加强的干预措施，即：(a)提高执法水平和对不销售的奖励，以及(b)增加已被证明可增强社会影响的青年活动和家庭交流。根据最近关于将不吸烟与社会接受度联系起来的价值的研究（Gordon, Biglan, & Smolkowski, 2008），我们认为，一种将不饮酒与社会接受度联系起来的新型同伴影响干预比使用更传统的伤害相关和拒绝技巧方法的干预具有更大的威慑作用。此外，我们的研究还发现了一种简短、积极的家长沟通活动，它不需要大量的课堂时间，最大限度地减少了亲子冲突，并有效地传达了家长的期望（Biglan等人，1996）。我们建议在一项涉及36个社区的随机试验中评估干预措施。我们将通过购买调查、对8年级和11年级学生的调查以及执法记录来评估干预的影响。

DESCRIPTION (provided by applicant): Preventing drinking among youth is a major public health priority. The estimated cost of underage drinking in the U.S. is $61.9 billion annually (Miller, Levy, Spicer, & Taylor, 2006). Alcohol is the most commonly used and abused drug in the U.S., with 41% reporting use in the past 30 days (Johnston, O'Malley, Bachman, & Schulenberg, 2012). Underage persons who drink are likely to drink large amounts (Flewelling, Paschall, & Ringwalt, 2004). Drinking by young people results in as many as 5,000 deaths from motor vehicle crashes, homicides, suicide, and other injuries (Hingson & Kenkel, 2004; National Highway Traffic Safety Administration, 2008; National Institute on Alcoholism and Alcohol Abuse, 2007). This project will build on a just-completed experimental evaluation of a community intervention to reduce adolescent access to alcohol (Flewelling et al., 2012). In that study, 36 Oregon communities were randomly assigned to receive or not receive stepped up enforcement of laws regarding sale of alcohol to minors plus a program for rewarding clerks for not selling to minors. The intervention reduced youth access to alcohol. Also, communities that achieved high levels of enforcement and rewards had lower rates of youth use. However, the intervention did little to alter social influences to drink. We believe that the addition of interventions designed to mobilize peer and parent influences would alter risk factors for alcohol use that are not adequately addressed by policy interventions. Therefore, the project would evaluate a strengthened intervention that (a) increases the level of enforcement and rewards for not selling and (b) adds youth activities and family communications that have been shown to enhance social influences. Based on recent research on the value of associating not smoking with social acceptance (Gordon, Biglan, & Smolkowski, 2008), we believe that a novel peer influence intervention that associates not drinking with social acceptance can have a greater deterrent effect than interventions using more traditional harm-related and refusal skills approaches. In addition, our research has identified a brief, positive parent communication activity that does not require significant classroom time, minimizes parent-child conflict, and effectively conveys parental expectations (Biglan et al., 1996). We propose to evaluate the intervention in a randomized trial involving 36 communities. We will assess the impact of the intervention through purchase surveys, surveys of 8th- and 11th-grade students, and law enforcement records.