Effect of Community-Based Interventions on High-Risk Drinking and Alcohol-Related Injuries

• Published in: JAMA : the journal of the American Medical Association 2000-11, Vol.284 (18), p.2341-2347
• Main Authors: Holder, Harold D, Gruenewald, Paul J, Ponicki, William R, Treno, Andrew J, Grube, Joel W, Saltz, Robert F, Voas, Robert B, Reynolds, Robert, Davis, Johnnetta, Sanchez, Linda, Gaumont, George, Roeper, Peter
• Format: Article
• Language: English
• Subjects: Accidents, Traffic - prevention & control; Accidents, Traffic - statistics & numerical data; Alcohol use; Alcoholic Intoxication - complications; Alcoholic Intoxication - epidemiology; Alcoholic Intoxication - prevention & control; Alcoholism and acute alcohol poisoning; binge drinking; Biological and medical sciences; Bodily injury; California - epidemiology; Community Participation; driving ability; Drug and Narcotic Control; Emergency Medical Services; Humans; Intervention; Longitudinal Studies; Medical sciences; Outcome and Process Assessment (Health Care); Preventive Health Services; Risk Factors; South Carolina - epidemiology; substance abuse; Toxicology; Traffic accidents & safety; traffic safety; Violence - prevention & control; Violence - statistics & numerical data; Wounds and Injuries - epidemiology; Wounds and Injuries - etiology; Wounds and Injuries - prevention & control
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.284.18.2341

CONTEXT High-risk alcohol consumption patterns, such as binge drinking and drinking before driving, and underage drinking may be linked 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.