Effect of community-based interventions on high-risk drinking and alcohol-related injuries

Context High-risk alcohol consumption patterns, such as binge drinking and drinking before driving, and underage drinking may be lin ked to traffic cr ashes and violent assaults in community settings. Objectives To determine the effect of community-based environmental interve ntions 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 interve ntion communities (northern California, southern California, and South Caro lina) conducted from April 1992 to December 1996. Outcomes were assessed by 120 general population telephone surveys per month of randomly selected in dividuals in the intervention and comparison sites, traffic data on motor v ehicle crashes, and emergency department surveys in 1 intervention-comparis on pair and 1 additional intervention site. Interventions Mobilize the community; encourage responsible beverage servic e, reduce underage drinking by limiting access to alcohol; increase local e nforcement of drinking and driving laws; and limit access to alcohol by usi ng zoning. Main Outcome Measures Self-reported alcohol consumption and driving after d rinking; 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 alcoho l 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 l imit" was 51% lower (0.77 vs 0.38 times) per 6-month period in the interven tion communities relative to the comparison communities. Traffic data revea led that, in the intervention vs comparison communities, nighttime injury c rashes declined by 10% and crashes in which the driver had been drinking de clined by 6%. Assault injuries observed in emergency departments declined b y 43% in the intervention communities vs the comparison communities, and al l hospitalized assault injuries declined by 2%. Conclusion A coordinated, comprehensive, community-based intervention can r educe high-risk alcohol consumption and alcohol-related injuries resulting from motor vehicle crashes and assaults.