Evidence-Based Prevention of Underage Drinking: An Overview - PowerPoint PPT Presentation

Scott Caldwell

Presentation to the Dane Co. Coalition to

Reduce Alcohol Abuse

March 31, 2009

• Definitions
• Levels of focus
• Strategies
• Measures

General values and values related to alcohol

Knowledge and perceptions about alcohol benefits and consequences

Expectations for alcohol effects

Evaluation of importance of benefits and consequences

Decision and intention to drink or to avoid alcohol

Drinking behavior

Source: Komo et al. (2006)

• Messages, behavior from adults
• Family, peer values
• Availability
• Social normative beliefs
• Media exposure
• Public policies

Source: Komo et al. (2006)

Source: Schinke et al. (2002)

• Based on a specific set of activities, the results of which can be detected and measured
• Driven by independent, replicated research
• Resource intensive to develop and typically requires a great deal of resources and coordination to implement
• Must be implemented with fidelity

• Policy
• Community
• Individual/families

Three levels:

• Strong evidence
• Moderate evidence
• Minimal evidence

Caveat: minimal evidence does not necessary mean the strategy would not be effective

• Raising the minimum drinking age
• Alcohol taxes/prices
• Over 100 studies
• 85% showed inverse correlation for tax/price and consumption (general population)
• Measures: car accidents, crime, sexual assault, medical mortality
• 10 of 13 studies with youth showed a similar correlation

Source: Wagenaar et al. (2006)

Strategies with moderate evidence:

• Server/manager training
• Advertising restrictions
• Individual level: alcohol SBIRT: Screening, Brief Intervention, and Referral for Treatment in “opportunistic” settings (e.g., primary care, schools, detention)

Source: Saltz (2006); Wagenaar et al. (2006)

Strategies with minimal evidence:

• Compliance checks
• Seller/server liability
• Community/public event restrictions
• Happy hour restrictions
• Social host liability
• Marketing campaigns to correct misperceptions (“social norms marketing”)
• Increasing law enforcement
• Increasing publicity about law enforcement
• Student orientation (w/ parents) about alcohol policies

Source: Saltz (2006); Wagenaar et al. (2006)

• Supply reduction – reducing availability and supply, monitoring access
• Demand reduction – increasing perception of risk for drinking; decreasing social desirability

• Scare tactics
• Confrontational interventions
• Knowledge-based education about alcohol effects
• Messages to “drink responsibly”
• Self BAL administration (college students)

• Alcohol consumption: past year, past month, at least one drink, and binge
• Age of initiation
• Perception of risk for alcohol
• Prevalence of related risk behavior
• Parent messages about drinking

• Several evidence-based policy, community, and person level strategies exist that can impact the cultural environment of drinking
• Some strategies have more evidence than others
• The goal is to most powerfully impact supply and demand

• Komro, K. A., Stigler, M. H., & Perry, C. L. (2006). Comprehensive approaches to prevent adolescent drinking and related problems. In M. Galanter (Ed.), Alcohol problems in adolescents and young adults (pp. 207-224). New York: Spinger.
• Schinke, S., Brounstein, P., & Gardner, S. (2002). Science-based prevention programs and principles, 2002. DHHS Publication No. (SMA) 03-3764. Rockville, MD: Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration.
• Staltz, R. F. (2006). Prevention of college student drinking problems: A brief summary of strategies and degree of empirical support for them. In M. Galanter (Ed.), Alcohol problems in adolescents and young adults (pp. 255-274). New York: Spinger.
• Wagenaar, A. C., Lenk, K. M., & Toomey, T. L. (2006). Policies to reduce underage drinking: A review of recent literature. In M. Galanter (Ed.), Alcohol problems in adolescents and young adults (pp. 275-297). New York: Spinger.